Pediatric forensic postmortem computed tomography: basics to advanced.

The approach to postmortem computed tomography (CT) differs significantly from that of diagnostic CT in living patients. Elimination of artifacts such as noise and beam hardening as well as optimization of tissue contrast requires alteration of exposure parameters from protocols designed to limit radiation dose in children. Multiple scans may be performed, and detailed post-processing can be used to enhance subtle findings such as small intracranial extra axial collections and non-displaced fractures.

Efficacy and safety of coronary computed tomography angiography in diagnosing coronary lesions in children.

Introduction: Identification of paediatric coronary artery abnormalities is challenging. We studied whether coronary artery CT angiography can be performed safely and reliably in children.

Materials: Retrospective analysis of consecutive coronary CT angiography scans was performed for image quality and estimated radiation dose.

Current utilization of pediatric postmortem imaging in North America: a questionnaire-based survey.

Background: Postmortem imaging is used more widely as the number of conventional autopsies has decreased over the last several decades. It is widely accepted in Europe, Asia and Oceania, but there has been a delay in acceptance in North America. Education, scanning protocols, resourcing and clinical incentives are needed to support this emerging field.

Magnetic resonance imaging of Müllerian anomalies in girls: concepts and controversies.

Female Müllerian anomalies are the result of failure of formation, fusion or resorption of the Müllerian ducts and are relatively common, with a prevalence of 5.5-7.0% in the general population.

Navigating the perils and pitfalls of pediatric forensic postmortem imaging in the United States.

Postmortem CT is widely used in the general adult and military populations. It is used extensively in pediatric death investigations in Europe and Asia, but distinctive challenges are encountered when launching a postmortem imaging program in the United States. We describe the issues we have encountered specific to establishing a pediatric postmortem imaging service in this country and propose potential solutions.

Tibial Intraosseous Insertion in Pediatric Emergency Care: A Review Based upon Postmortem Computed Tomography.

The proximal tibia is a recommended and commonly used site for pediatric emergency intraosseous vascular access (IO). During forensic whole body postmortem computed tomography (PMCT), we evaluated accuracy of emergency placement of tibial IO access. We conducted a retrospective review of 92 state medical examiner cases to assess presence and placement of tibial IO needles.

Pediatric postmortem computed tomography: initial experience at a children's hospital in the United States.

Postmortem CT might provide valuable information in determining the cause of death and understanding disease processes, particularly when combined with traditional autopsy. Pediatric applications of postmortem imaging represent a new and rapidly growing field. We describe our experience in establishing a pediatric postmortem CT program and present a discussion of the distinct challenges in developing this type of program in the United States of America, where forensic practice varies from other countries.

Pulmonary embolus as cause of death in an adolescent: demonstration on postmortem CT.

Computed tomography (CT) is widely accepted in adult forensic death investigations (determination of cause and manner of death) but is only beginning to play a larger role in the cause of death determination in infants and children. We present a case of an adolescent with nephrotic syndrome who sustained cardiac arrest and died in the emergency department. A postmortem CT was requested by the state Office of the Medical Examiner as part of the medicolegal death investigation.

Magnetic resonance imaging of acquired disorders of the pediatric female pelvis other than neoplasm.

Transabdominal US remains the primary screening imaging modality of the pediatric female pelvis. However, MRI has become an invaluable adjunct to US in recent years. MRI offers superb soft-tissue contrast resolution that allows for detailed evaluation, particularly of the ovaries and their associated pathology.

Magnetic Resonance Imaging of Developmental Anomalies of the Uterus and the Vagina in Pediatric Patients.

Developmental anomalies of the uterus and the vagina are associated with infertility and miscarriage and are most commonly detected in the postpubertal age-group. These conditions may also present in younger patients as a mass or pain owing to obstruction of the uterus or the vagina. Associated urinary tract anomalies are common, as well.

Useful signs for the assessment of vascular rings on cross-sectional imaging.

Vascular rings can be challenging to diagnose because they can contain atretic portions not detectable with current imaging modalities. In these cases, where the compressed airway and esophagus are not encircled by patent, opacified vessels, there are useful secondary signs that should be considered and should raise suspicion for the presence of a vascular ring. These signs include a double aortic arch, the four-vessel sign, the distorted subclavian artery sign, a diverticulum of Kommerell, a ductal diverticulum contralateral to the aortic arch, and a descending aorta contralateral to the arch or circumflex aorta.

Congenital urethral polyps in the pediatric population.

Congenital urethral polyps are a rare entity. Most commonly, they present as benign posterior urethral growths in the pediatric male patient. However, reports of urethral polyps in female patients or even those with an anterior urethral location can also be found in the literature.

Protocol for MRI of the hips after spica cast placement.

Background: In reduction of hip displacement in developmental dysplasia, concentric placement of the femoral head within the acetabulum is key. Magnetic resonance imaging (MRI) is an effective modality to assess the adequacy of the reduction, but sedation may be required due to the length of the examination. MRI is also more expensive than other imaging modalities.