Frequency of MRI Low Signal Intensity in the Buccal Fat of Fetuses and Speculation as to What It May Reflect.

Purpose: We aimed to characterize the fetal buccal fat pad (BFP) on magnetic resonance imaging (MRI) to determine the frequency and types of sequences on which the BFP demonstrates low signal intensity and determine any possible correlation with timing of the MRI during fetal development.

Materials And Methods: A retrospective review of all fetal MR studies was performed, and a pediatric radiologist blinded to the referring and final fetal diagnosis as well as outcome evaluated the included cases. A positive buccal fat pad sign (BFS) was recorded as present if a round, symmetric, and bilateral area was seen in the submalar region of the face with the following signal characteristics: T1 hyperintensity, low signal on echo planar imaging (EPI), low signal on true fast imaging with steady-state free precession (TRUFI), and with restriction on diffusion-weighted imaging (DWI).

Quality and Diagnosis on the Lateral View of Pediatric Upper Gastro-Intestinal Series.

Background: The standard imaging technique for the diagnosis of intestinal malrotation remains the upper gastro-intestinal series (UGIS). The lateral view is promoted as important for making a diagnosis. For this, the lateral view should be of adequate quality, and radiologists must know the normal appearance as well as the appearance of duodenal variants, as misdiagnosis may lead to unnecessary surgery.

Patient rotation chest X-rays and the consequences of misinterpretation in paediatric radiology.

Purpose: We aimed to demonstrate the consequences of rotation on neonatal chest radiographs and how it affects diagnosis. In addition, we demonstrate methods for determining the presence and direction of rotation.

Background: Patient rotation is common in chest X-rays of neonates.

Frequency of duodenal anatomical variants in neonatal and pediatric upper gastrointestinal tract series (UGI) and the influence of exam quality on diagnostic reporting of these.

Aim: To determine frequency of duodenal anatomical variants on clinically indicated pediatric UGI examinations and determine the influence of these variants and exam quality on the reliability of diagnosis.

Materials And Methods: Two-pediatric radiologists retrospectively reviewed 100-UGI exams performed on children ≤18-years. Exams were considered diagnostic if the duodenojejunal (DJ) flexure was identified.

Ultrasound shear wave elastography cannot discriminate between low- and high-pressure neurogenic bladders.

Background: Patients with neurogenic bladders are monitored with renal bladder ultrasounds and video urodynamics studies (VUDS) to assess upper urinary tract injury. Ultrasound shear wave elastography (US-SWE) can assess tissue stiffness. If bladder compliance is affected by bladder wall fibrosis and stiffening, then high-pressure bladders may be detectable by US-SWE therefore reducing the need for VUDS in some patients.

Potential benefits of functional magnetic resonance urography (fMRU) over MAG3 renal scan in children with obstructive uropathy.

Introduction: Functional renal imaging, most commonly with MAG3 nuclear medicine renal scan, is recommended in the evaluation of children with urinary tract dilation (UTD) suspected of obstructive uropathy. Alternatively, renal function can be evaluated with functional Magnetic Resonance Urography (fMRU), which has superior anatomic detail. However, there are not enough data comparing both methods' equivalency.

Utility of contrast-enhanced ultrasound for solid mass surveillance and characterization in children with tuberous sclerosis complex: an initial experience.

Background: Patients with tuberous sclerosis complex (TSC) can develop solid kidney masses from childhood. Imaging surveillance is done to detect renal cell carcinoma (RCC) and angiomyolipomas (AML), including AMLs at risk for hemorrhage. Intravenous contrast-enhanced ultrasound (CEUS) may be useful for screening as ultrasound is well tolerated by children and ultrasound contrast agents (UCA) are not nephrotoxic.

MRI for Response Assessment of Extensive Lymphatic Malformations in Children Treated With Sirolimus.

Extensive lymphatic malformations (LMs) may cause substantial morbidity. The mammalian target of rapamycin (mTOR) inhibitor sirolimus shows promise for treating vascular anomalies, although response assessment is not standardized. The purpose of this study was to retrospectively characterize changes seen on MRI of children with extensive LMs treated with sirolimus.

Normal Liver Stiffness Measured with MR Elastography in Children.

Background Stiffness thresholds for liver MR elastography in children vary between studies and may differ from thresholds in adults. Normative liver stiffness data are needed to optimize diagnostic thresholds for children. Purpose To determine normal liver stiffness, and associated normal ranges for children, as measured with MR elastography across vendors and field strengths.

Magnetic resonance elastography to quantify liver disease severity in autosomal recessive polycystic kidney disease.

Objectives: To evaluate whether liver and spleen magnetic resonance elastography (MRE) can measure the severity of congenital hepatic fibrosis (CHF) and portal hypertension (pHTN) in individuals with autosomal recessive polycystic kidney disease (ARPKD), and to examine correlations between liver MRE and ultrasound (US) elastography.

Methods: Cross-sectional study of nine individuals with ARPKD and 14 healthy controls. MRE was performed to measure mean liver and spleen stiffness (kPa); US elastography was performed to measure point shear wave speed (SWS) in both liver lobes.

Identification and characterization of calyceal diverticula with MR urography (MRU) in children.

Purpose: To determine the MRU imaging findings of calyceal diverticula in a large cohort of children and to compare the frequency of calyceal diverticula in our cohort with what has been previously reported.

Methods: This was a HIPAA-compliant, IRB-approved retrospective study of all patients with suspected CD based on their medical records. All patients in this study underwent MRU at our institution between 2010 and 2017.

State-of-the-Art Renal Imaging in Children.

Imaging modalities for diagnosing kidney and urinary tract disorders in children have developed rapidly over the last decade largely because of advancement of modern technology. General pediatricians and neonatologists are often the front line in detecting renal anomalies. There is a lack of knowledge of the applicability, indications, and nephrotoxic risks of novel renal imaging modalities.

DTI of the kidney in children: comparison between normal kidneys and those with ureteropelvic junction (UPJ) obstruction.

Objective: To compare renal diffusion tensor imaging (DTI) parameters in patients with or without ureteropelvic junction (UPJ) obstruction.

Methods: Patients that underwent functional MR urography (MRU) with renal DTI were retrospectively selected. Kidneys deemed normal on T2-weighted images and functional parameters were used as controls and compared to those kidneys with morphologic and functional findings of UPJ obstruction.

Are we performing ultrasound measurements of the wall thickness in hypertrophic pyloric stenosis studies the same way?

Purpose: To retrospectively review imaging planes, number of visible pyloric layers and location of measurements, in infants with suspected (HPS).

Methods: 103 pyloric ultrasound studies for suspected HPS were included. For each study, we recorded whether longitudinal or transverse views were performed, the layers visualized (a schematic was developed for two pediatric radiologists to categorize the interfaces of the anatomic layers a-e) and position of the internal measurement cursor.

Supine versus prone positioning for ultrasound evaluation of postnatal urinary tract dilation in children.

Background: Ultrasound (US) is used in the initial evaluation and surveillance of urinary tract dilation in children. Urinary tract dilation is diagnosed in 1-2% of all pregnancies during routine prenatal sonography with technological advances in US imaging. Urinary tract dilation classification systems, including the 2014 multidisciplinary consensus, assess anterior-posterior renal pelvic diameter and calyceal dilation.

Liver, Spleen, and Kidney Size in Children as Measured by Ultrasound: A Systematic Review.

Ultrasound is commonly the first-line imaging modality for assessing the pediatric abdomen. An abnormal size of the liver, spleen, or kidneys may indicate disease, but the evaluation is challenging because the normal size changes with age. In addition, published normal value charts for children may vary by population and methods.

Intraoperative Contrast-Enhanced Ultrasound Imaging of Femoral Head Perfusion in Developmental Dysplasia of the Hip: A Feasibility Study.

Objectives: Developmental dysplasia of the hip (DDH) is one of the most common developmental deformities of the lower extremity. Although many children are successfully treated with a brace or harness, some require intraoperative closed or open reduction and spica casting. Surgical reduction is largely successful to relocate the hip; however, iatrogenic avascular necrosis is a major source of morbidity.

R2 relaxometry based MR imaging for estimation of liver iron content: A comparison between two methods.

Purpose: To compare the reproducibility and accuracy of R2-relaxometry MRI for estimation of liver iron concentration (LIC) between in-house analysis and FDA-approved commercially available third party results.

Methods: All MR studies were performed on a 1.5T scanner.

Morphologic and functional evaluation of duplicated renal collecting systems with MR urography: A descriptive analysis.

Purpose: To describe the morphology and function of duplicated collecting systems in pediatric patients undergoing functional MR urography (fMRU).

Methods: This is a HIPAA compliant IRB approved retrospective study of all patients with duplicated renal collecting systems undergoing fMRU at our institution between 2010 and 2017. Two pediatric radiologists evaluated the studies to determine the presence, morphology and function of duplicated collecting systems using both T2-weighted and dynamic post-contrast fat saturated T1-weighted images.

Three-dimensional printed models of the rib cage in children with non-accidental injury as an effective visual-aid tool.

Three-dimensional (3-D) printing is gaining terrain in medical education, presurgical evaluation and recently as forensic evidence in court. Physicians, including radiologists, often provide expert testimony in court cases involving children with rib fractures and other injuries concerning for child physical abuse. Effectively communicating the complexities of fractures and other skeletal findings to nonmedical personnel using standard radiology studies can be challenging, especially during medical courtroom testimony.

Incidental findings during ultrasound of thyroid, breast, testis, uterus and ovary in healthy term neonates.

Incidental sonographic findings in thyroid and estrogen-responsive organs have been described in children and adults, but no publications describe incidental findings of these organs in infancy. We describe ultrasound features in thyroid, breast buds, testes, uterus, and ovaries in infants up to 32 weeks old that vary from the expected tissue architecture. Infants described in this paper were enrolled as healthy term neonates in a longitudinal study of normal feeding practices.

Diffusion tensor imaging of the kidney in healthy controls and in children and young adults with autosomal recessive polycystic kidney disease.

Objective: To compare diffusion tensor imaging (DTI) of the kidneys and its derived parameters in children with autosomal recessive polycystic kidney disease (ARPKD) versus healthy controls.

Methods: In a prospective IRB-approved study, we evaluated the use of DTI to compare kidney parenchyma FA values in healthy controls (age-matched children with no history of renal disease) versus patients with ARPKD. A 20-direction DTI with b-values of b = 0 s/mm and b = 400 s/mm was used to acquire data in coronal direction using a fat-suppressed spin-echo echo-planar sequence.

Magnetic resonance elastography SE-EPI vs GRE sequences at 3T in a pediatric population with liver disease.

Purpose: The goal of our study is to compare hepatic stiffness measures using gradient-recalled echo (GRE) versus spin-echo echo planar imaging (SE-EPI)-based MR Elastography (MRE) at 3T used to measure hepatic stiffness in a patients with suspected liver diseases.

Materials And Methods: This retrospective study included 52 patients with liver disease who underwent a 3T MRE exam including both an investigational SE-EPI-based technique and a product GRE-based technique. Regions of interest (ROI) were placed on the elastograms to measure elastography-derived liver stiffness as well as the area included within the ROIs.