Hemato-oncologic children form a heterogeneous group with a wide spectrum of ages, malignancy types, and immunosuppression grades during the different phases of their treatment. Immunosuppression is caused by multiple factors, including the malignancy itself, bone marrow suppression secondary to therapy, and wide use of steroids and antibiotics, among others. At the same time, the risk of infections in these patients remains high because of prolonged hospitalizations or the need for long-timing implanted devices between other features.
View Article and Find Full Text PDFWe present here a user-friendly calculator for the setting of a pediatric split-bolus polytrauma computed tomography (CT) protocol with a mixed arterial and venous phase, aiming to both reduce radiation dose and improve workflow while assuring optimal image quality. All the different parameters are calculated based on patient's weight with rapid computation of the injected contrast media and saline volumes, injection's flow rate, injection's timing, and optimal acquisition time. The designed calculator is built in a widely available Google Sheets file, accessible by a quick response (QR) code.
View Article and Find Full Text PDFBackground: ECG-gated cardiac CT is now widely used in infants with congenital heart disease (CHD). Deep Learning Image Reconstruction (DLIR) could improve image quality while minimizing the radiation dose.
Objectives: To define the potential dose reduction using DLIR with an anthropomorphic phantom.
Complex female genitourinary system anomalies include a wide spectrum of uncommon pathologies, caused from the abnormal separation of the urorectal septum and the urogenital sinus in early embryonic life. The resulting fusion of the distal urinary, genital and intestinal tracts increases the risk of death in utero and alters the normal organ functionality and the quality of life in survivors. An accurate prenatal identification of these pathologies depends mainly on prior suspicion at ultrasound screening, but also requires a solid knowledge of embryology and familiarity with the different patterns of malformation.
View Article and Find Full Text PDFBackground: The utilization of contrast-enhanced computed tomography (CT) of the chest for the diagnosis of necrotizing pneumonia (NP), a complication of community-acquired pneumonia, is controversial because of the inherent ionizing radiation involved. Over the past few years, the growing availability of bedside Lung Ultrasound (LUS) devices has led to increased use of this nonionizing imaging method for diagnosing thoracic pathology, including pneumonia.
Objective: The objectives of this study were as follows: first, to compare the performance of LUS vs.
Purposes: The classification of lung sequestrations distinguishes between extralobar and intralobar types, according to their venous drainage - systemic vs pulmonary - and the presence or absence of independent pleura. However, imaging, surgical and/or pathological findings often differ from this description. The objectives of this article are to quantify the percentage of lung sequestrations that do not fit the classic description of extra- and intralobar types and to evaluate the accuracy of the currently used classification.
View Article and Find Full Text PDFBackground: Anorectal malformation is a spectrum of congenital defects of the distal bowel, mostly diagnosed at birth.
Objective: To describe the prenatal imaging findings of anorectal malformations, explore the causes of the low rates of prenatal diagnosis, compare the accuracy of prenatal ultrasound (US) and magnetic resonnance imaging [MRI] and evaluate the relevance of information obtained at MRI.
Materials And Methods: Children treated for anorectal malformation at our hospital and with available prenatal studies were retrospectively identified and included in the study.
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View Article and Find Full Text PDFAlthough the World Health Organization suggests 10-15% as the adequate cesarean delivery rate to assure optimal prognosis for mother and children, cesarean rates have continuously increased worldwide over the last three decades, even in primiparous women. Moreover, uterine scars after myomectomies, complications of obstetrical interventions and more recently, after fetal surgery, are often observed. This review article describes the most commonly seen complications related to prior uterine scars and discusses their imaging findings, with emphasis on the increasing role of Magnetic Resonance Imaging for diagnosis.
View Article and Find Full Text PDFFast magnetic resonance imaging (MRI) led to the emergence of 'cine MRI' techniques, which enable the visualization of the beating heart and the assessment of cardiac morphology and dynamics. However, established cine MRI methods are not suitable for fetal heart imaging in utero, where anatomical structures are considerably smaller and recording an electrocardiogram signal for synchronizing MRI data acquisition is difficult. Here we present a framework to overcome these challenges.
View Article and Find Full Text PDFThe medical, psychological and social aspects of disorders of sex development (DSD) represent a challenge for the management of these patients. However, advances in our understanding of the etiology and genetics of this condition, novel surgical approaches and the growing influence of patient groups as well as wider recognition of ethical issues have helped improve the care of patients with a DSD. Importantly, a multidisciplinary approach involving specialists is crucial for understanding and treating such rare and complex cases.
View Article and Find Full Text PDFThe initial outcome in infants with congenital diaphragmatic hernia is mainly related to the associated lung hypoplasia. However, these patients frequently present with additional gastrointestinal pathology that also influences their quality of life and final prognosis. Congenital gastrointestinal anomalies are often observed and the displacement of the liver, the stomach and/or the intestines into the thorax may cause distortion of the vascular axis of these organs, increasing the risk of congestion and/or ischemia.
View Article and Find Full Text PDFThe detection of fetal anomalies has improved in the last years as a result of the generalization of ultrasound pregnancy screening exams. The presence of a cystic imaging in the fetal pelvis is a relatively common finding, which can correspond to a real congenital cystic lesion or result from the anomalous liquid accumulation in a whole pelvic organ, mainly the urinary bladder, the uterus, or the vagina. In selected cases with poor prognosis and/or inconclusive echographic findings, magnetic resonance may bring additional information in terms of the characterization, anatomical location, and real extension of the pathology.
View Article and Find Full Text PDFThe generalization of screening pregnancy ultrasound (US) studies has increased the detection of congenital tumors, including hepatic masses. In these cases, prenatal MRI is often used as a complementary imaging study. We present three cases of congenital hepatic tumors-two hemangiomas and one hamartoma-detected in utero and followed up in our institution.
View Article and Find Full Text PDFIntroduction: Radiological techniques such as non-enhanced post-mortem computed tomography (PMCT) play an increasingly important role in death investigations, especially in cases of non-medicolegal context of death, where the consent of the next of kin is required to perform autopsy. Such consent is often difficult to obtain for deceased children, and radiological methods may be an acceptable alternative. The aim of our study was to evaluate the performance of PMCT explorations compared to medicolegal conventional autopsies in children and its potential usefulness in non-medicolegal situations.
View Article and Find Full Text PDFCongenital lung malformations are increasingly detected before birth. However, bronchial atresia is rarely identified in utero and not always recognized in neonates. There are two types of atresia: 1) proximal, located at the level of the mainstem or the proximal lobar bronchi, which is extremely rare and usually lethal during pregnancy, causing a tremendous volume increase of the distal involved lung with secondary hypoplasia of the normal lung, and 2) peripheral, located at the segmental/subsegmental bronchial level, which may present as an isolated lesion or as part of a complex congenital malformation.
View Article and Find Full Text PDFWe report a case of an extremely preterm infant with intestinal malrotation who contracted postnatal systemic cytomegalovirus (CMV) infection with a complicated intestinal evolution requiring repeated surgical interventions and antiviral treatment. This report is to emphasize that prolonged gastrointestinal symptoms in extremely preterm infants fed with non-pasteurized breast milk should lead to suspicion of CMV infection. The importance of preventive measures when feeding very preterm infants with breast milk needs to be considered.
View Article and Find Full Text PDFBackground: Diagnosing pediatric pneumonia is challenging in low-resource settings. The World Health Organization (WHO) has defined primary end-point radiological pneumonia for use in epidemiological and vaccine studies. However, radiography requires expertise and is often inaccessible.
View Article and Find Full Text PDFAm J Forensic Med Pathol
December 2015
Postmortem imaging techniques, especially postmortem computed tomography, have become integral tools in forensic investigations. Multiphase postmortem computed tomography angiography (MPMCTA) visualizes the vascular system in detail and makes it possible to evaluate the perfusion of even the smallest vessels. Although the technique has been well described for adults, no pediatric cases have been reported and no pediatric protocol has been established for this type of investigation.
View Article and Find Full Text PDFImaging plays a key role in the detection of a diaphragmatic pathology in utero. US is the screening method, but MRI is increasingly performed. Congenital diaphragmatic hernia is by far the most often diagnosed diaphragmatic pathology, but unilateral or bilateral eventration or paralysis can also be identified.
View Article and Find Full Text PDFBackground: The Contegra® is a conduit made from the bovine jugular vein and then interposed between the right ventricle and the pulmonary artery. It is used for cardiac malformations in the reconstruction of right ventricular outflow tract.
Objective: To describe both normal and pathological appearances of the Contegra® in radiological imaging, to describe imaging of complications and to define the role of CT and MRI in postoperative follow-up.
Objectives: To compare the accuracy of prenatal ultrasonography (US) to magnetic resonance imaging (MRI) in the characterisation of congenital lung anomalies, and to assess their agreement with final diagnosis. To evaluate the influence of additional MRI information on therapeutic management.
Methods: 26 prenatal congenital lung anomalies detected consecutively between 2006 and 2012 were retrospectively evaluated.
Anorectal malformations (ARMs) are a complex group of congenital anomalies involving the distal anus and rectum, as well as the urinary and genital tracts in a significant number of cases. Most ARMs result from abnormal development of the urorectal septum in early fetal life. In most cases, the anus is not perforated and the distal enteric component ends blindly (atresia) or as a fistula into the urinary tract, genital tract, or perineum.
View Article and Find Full Text PDFPurpose: To evaluate the diagnostic value of previously described MR features used for detecting suspected placental invasion according to observers' experience.
Materials And Methods: Our population included 25 pregnant women (mean age 35.16) investigated by prenatal MRI (1.