Pediatric contrast-enhanced chest CT on a photon-counting detector CT: radiation dose and image quality compared to energy-integrated detector CT.

Background: Photon counting detector (PCD) CT benefits from reduced noise compared with conventional energy-integrating detector (EID) CT, which should translate to improved image quality and reduced radiation exposure for pediatric patients undergoing chest CT with IV contrast.

Objective: To determine the differences in radiation exposure and image quality of PCD CT and EID CT in pediatric chest CT with intravenous (IV) contrast.

Materials And Methods: In this institutional review board-approved retrospective observational study, 20 scan pairs (20 PCD CT; 20 EID CT) for children who underwent chest CT with IV contrast on both a PCD CT (Siemens NAEOTOM Alpha) and an EID CT (Siemens SOMATOM Definition Edge or Force) within 12 months were reviewed independently by three pediatric radiologists for three subjective quality features on 5-point Likert scales: overall quality, small structure delineation, and motion artifact.

Growth plate injury at the base of the coracoid: MRI features.

Purpose: To assess the MRI features of growth plate injury at the base of the coracoid process.

Materials And Methods: Subjects were identified through retrospective search of our department imaging database and teaching files and the teaching files of two outside academic institutions. The coracoid base growth plate was examined with attention to widening, irregularity, abnormal signal intensity of the growth plate, and the presence of adjacent soft tissue edema.

Developing a framework for gathering and using service user experiences to improve integrated health and social care: the SUFFICE framework.

Background: More people than ever receive care and support from health and social care services. Initiatives to integrate the work of health and social care staff have increased rapidly across the UK but relatively little has been done to chart and improve their impact on service users. Our aim was to develop a framework for gathering and using service user feedback to improve integrated health and social care in one locality in the North of England.

The challenging ultrasound diagnosis of perforated appendicitis in children: constellations of sonographic findings improve specificity.

Background: Rapid and accurate diagnosis of appendicitis, particularly with respect to the presence or absence of perforation, is essential in guiding appropriate management. Although many studies have explored sonographic findings associated with acute appendicitis, few investigations discuss specific signs that can reliably differentiate perforated appendicitis from acute appendicitis prior to abscess formation.

Objective: The purpose of our study was to identify sonographic findings that improve the specificity of US in the diagnosis of perforated appendicitis.

Why do patients develop severe pressure ulcers? A retrospective case study.

Objectives: This study focuses on the ways in which the organisational context can influence the development of severe pressure ulcers. Severe pressure ulcers are important indicators of failures in the organisation and delivery of treatment and care. We have a good understanding of patients' risk factors, but a poor understanding of the role played by the organisational context in their development.

Relative distribution of pertinent findings on portable neonatal abdominal radiographs: can we shield the gonads?

Background: Shielding of the gonads is a dose-saving strategy in pediatric radiography and its use is the law in New York and the majority of other states. However, routine use of gonadal shields is controversial because of concerns that important diagnostic information can be obscured.

Objective: The purpose of this study was to assess the frequency and spatial distribution of key findings on portable neonatal abdominal radiographs.

The efficacy of digital fluoroscopic image capture in the evaluation of vesicoureteral reflux in children.

Background: In accordance with ALARA, minimizing radiation exposure associated with voiding cystourethrograms (VCUG) is of critical importance. Advances in fluoroscopic technology might help achieve this goal.

Objective: To determine the efficacy of fluoroscopic image capture compared to conventional digital radiographic spot (DRS) images in voiding cystourethrograms (VCUG) for the evaluation of vesicoureteral reflux (VUR) in children.

A large struma ovarii tumor removed via laparoscopy in a 16-year-old adolescent.

Struma ovarii is rare ovarian tumor that is characterized by the presence of at least 50% thyroid tissue on histologic examination. This usually benign neoplasm is predominantly found in women between the ages of 40 and 60 years and infrequently in the pediatric age group. In the foregoing report, we present an unusual case of a large struma ovarii in a 16-year-old adolescent girl with abdominal pain and increasing abdominal girth.

The relationship between alpha angle and resistive index of the femoral epiphysis in the normal and abnormal infant hip.

Background: The arterial vascularity of the hip has been investigated in normal infants using duplex Doppler sonography. This study addressed the differences in hip vascularity in infants with respect to gender and acetabular morphology.

Objective: To determine whether there is a relationship between the resistive index of the vessels of the femoral chondroepiphysis and the alpha angle in normal infant hips and in those with developmental dysplasia of the hip.

A comparison of offenders with intellectual disability across three levels of security.

Background: A number of authors have described, with disparate results, the prevalence of people with intellectual disability and their characteristics, in a range of offender cohorts defined by service use. These have included high security, a range of criminal justice services and community services. There is a need for research comparing cohorts of offenders with intellectual disabilities across different settings.

Appendicitis in children: low-dose CT with a phantom-based simulation technique--initial observations.

Purpose: To retrospectively determine the accuracy of low-dose (20-mAs) computed tomography (CT) in the diagnosis of acute appendicitis in children by using a technique that enables the simulation of human CT scans acquired at a lower tube current given the image acquired at a standard dose.

Materials And Methods: Institutional review board approval was obtained, informed consent was not required, and the study was HIPAA compliant. The authors reviewed 100 standard-dose pediatric abdominal-pelvic CT scans (50 positive and 50 negative scans) obtained in 100 patients and corresponding simulated low-dose (20-mAs) scans.

Metanephric adenoma in an 8-year-old child: case report and review of the literature.

Metanephric adenoma (MA) is a renal tumor that is rarely found in children. We present a case of MA that was incidentally discovered in an 8-year-old child on computed tomography. We also review the literature regarding this lesion in the pediatric population.

Spontaneous development of bilateral subdural hematomas in an infant with benign infantile hydrocephalus: color Doppler assessment of vessels traversing extra-axial spaces.

We present an infant with macrocrania, who initially demonstrated prominent extra-axial fluid collections on sonography of the brain, compatible with benign infantile hydrocephalus (BIH). Because of increasing macrocrania, a follow-up sonogram of the brain was performed; it revealed progressive enlargement of the extra-axial spaces, which now had echogenic debris. Color Doppler US showed bridging veins traversing these extra-axial spaces, so it was initially thought that these spaces were subarachnoid in nature (positive cortical vein sign).

Imaging evaluation of chest wall disorders in children.

This article discusses the imaging evaluation of chest wall disorders in children.

Treatment and management of challenging behaviours in congregate and noncongregate community-based supported accommodation.

Objectives: To compare the nature and prevalence of use of procedures employed to treat and manage challenging behaviours across two approaches to providing community-based supported accommodation for people with intellectual disabilities (ID) and severe challenging behaviour: noncongregate settings where the minority of residents have challenging behaviour, and congregate settings where the majority of residents have challenging behaviour.

Setting: Community-based supported accommodation for people with ID and challenging behaviour.

Design: Longitudinal matched groups design.

Quality and costs of community-based residential supports for people with mental retardation and challenging behavior.

A longitudinal matched-groups design was used to examine the quality and costs of community-based residential supports to people with mental retardation and challenging behavior. Two forms of provision were investigated: noncongregate settings, where the minority of residents had challenging behavior, and congregate settings, where the majority of residents had challenging behavior. Data were collected for 25 people in each setting.

Assessment of vasculature using combined MRI and MR angiography.

Objective: The purpose of this study was to compare combined cine gradient-recalled echo MRI and MR angiography with conventional angiography in the evaluation of the pulmonary vascular supply in patients with pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries.

Materials And Methods: Eleven patients who underwent both MRI and conventional angiography were retrospectively reviewed. Contiguous 2D cine gradient-recalled echo images (TR range/TE, 30-80/4.

Idiopathic intraparenchymal hematoma of the liver in a neonate.

Hepatic hematomas in newborn infants are not frequently detected clinically, but are often found at perinatal autopsies. These hematomas of the liver are usually subcapsular in location. A variety of etiologies for such hematomas has been implicated, such as trauma, sepsis, and coagulopathies.

Sclerosing stromal tumor of the ovary in a premenarchal female.

Sclerosing stromal tumor (SST) is a rare benign ovarian neoplasm of stromal origin with less than 100 cases reported in the literature. Unlike the other stromal tumors, thecomas and fibromas, which tend to occur in the fifth and sixth decades, sclerosing stromal tumors predominantly affect females in the second and third decades. Computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound findings have been described, but have not been reported previously in the pediatric literature.

Suspected appendicitis in children: focused CT technique for evaluation.

Purpose: To determine the accuracy of a focused computed tomographic (CT) technique with oral and intravenous contrast materials for the diagnosis of appendicitis.

Materials And Methods: Ninety-three abdominal-pelvic contrast material-enhanced CT scans obtained during 6 years in 54 girls and 39 boys (age range, 1-18 years) with right lower quadrant pain were retrospectively reviewed. The detected abnormal findings were recorded as being in the region above the upper pole of the right kidney, between the upper pole of the right kidney and the lower pole of the right kidney (RLP), or below the iliac crest.

Efficacy of CT in distinguishing small-bowel obstruction from other causes of small-bowel dilatation.

Objective: Dilatation of the small bowel is a common finding on plain abdominal radiographs. In such cases, it is often difficult to determine if the cause of the dilatation is small-bowel obstruction, paralytic ileus, or another intraabdominal disorder. Accordingly, we studied the efficacy of CT in making this distinction.

Predictive value of image-guided adrenal biopsy: analysis of results of 101 biopsies.

A retrospective study of 97 patients undergoing 101 image-guided adrenal biopsies (IGABs) was performed to analyze the effects of specific pathologic results on test characteristics. Three categories of pathologic results (benign adrenal tissue, malignant tissue, and nondiagnostic) were compared with outcomes. Diagnostic samples were obtained in 86% of cases.