Comparison Between 1.5-T and 3-T MRI for Fetal Imaging: Is There an Advantage to Imaging With a Higher Field Strength?

Objective: Fetal MRI at 3 T is emerging as a promising modality for evaluating fetal anatomy. The objective of this study was to compare the quality of images obtained with commonly used fetal imaging sequences at 1.5 T and 3 T.

New Perspectives in Pediatric Neurology-Multiple Sclerosis.

With the creation of consensus definitions for pediatric multiple sclerosis (MS) and other acquired demyelinating syndromes, there has been an increased recognition, improved collaboration, and expanded access to care for children with central nervous system demyelination. As a result, clinicians and researchers have been able to learn more about clinical features specific to pediatric MS, the associated genetic and environmental risk factors, and its prognosis and comorbidities. Treatment options have also expanded significantly in the past few years and insight has been gained into the challenges with adherence and tolerability of these medications in the pediatric population.

Simultaneous Quantitation of Lamotrigine, Levetiracetam, 10-Hydroxycarbazepine, Topiramate, and Zonisamide in Serum Using HPLC-MS/MS.

Antiepileptic drugs (AEDs) are a diverse group of pharmacological agents used in the treatment of epileptic seizures. Over the past several decades some new AEDs, including lamotrigine (LTG), levetiracetam (LVA), oxcarbazepine (OXC), topiramate (TOP), and zonisamide (ZNS), have become widely used. This chapter describes a very simple and rapid liquid chromatography-tandem mass spectrometry method for simultaneous quantitation of LVA, ZNS, LTG, TOP, and MHD in human serum.

Diagnostic Performance of Whole-Body MRI as a Tool for Cancer Screening in Children With Genetic Cancer-Predisposing Conditions.

Objective: Children with cancer-predisposing conditions are at increased risk to develop and die of cancer. Limited data exist on the utility of whole-body MRI as a cancer screening tool in children. In this study, we examined the diagnostic performance of whole-body MRI as a mechanism of tumor surveillance for children at increased genetic risk for cancer.

Common Patterns of Congenital Lower Extremity Shortening: Diagnosis, Classification, and Follow-up.

Congenital lower limb shortening is a group of relatively rare, heterogeneous disorders. Proximal focal femoral deficiency (PFFD) and fibular hemimelia (FH) are the most common pathologic entities in this disease spectrum. PFFD is characterized by variable degrees of shortening or absence of the femoral head, with associated dysplasia of the acetabulum and femoral shaft.

Quantification of Bone Marrow Involvement in Treated Gaucher Disease With Proton MR Spectroscopy: Correlation With Bone Marrow MRI Scores and Clinical Status.

Objective: The objective of our study was to use proton MR spectroscopy (MRS) to quantitatively evaluate bone marrow infiltration by measuring the fat fraction (FF) and to compare the FF with semiquantitative bone marrow MRI scores and clinical status in children treated for type 1 Gaucher disease (GD).

Subjects And Methods: Over a 2-year period, we prospectively evaluated 10 treated GD patients (six males, four females; median age, 15.1 years) and 10 healthy age-matched control subjects (five males, five females; median age, 15.

Dynamic gadolinium-enhanced MRI of the proximal femur: preliminary experience in healthy children.

Objective: The purpose of this study is to use dynamic contrast-enhanced MRI to evaluate the perfusion characteristics of the proximal femur in the growing skeleton.

Materials And Methods: We evaluated 159 subjects (mean age, 5.67 years) who underwent a well-controlled protocol of contrast-enhanced MRI of the abdomen and hips.

Long-term treatment with oral N-acetylcysteine: affects lung function but not sputum inflammation in cystic fibrosis subjects. A phase II randomized placebo-controlled trial.

Purpose: To evaluate the effects of oral N-acetylcysteine (NAC), which replenishes systemic glutathione, on decreasing inflammation and improving lung function in CF airways.

Methods: A multicenter, randomized, double-blind proof of concept study in which 70 CF subjects received NAC or placebo orally thrice daily for 24 weeks.

Endpoints: primary, change in sputum human neutrophil elastase (HNE) activity; secondary, FEV(1) and other clinical lung function measures; and safety, the safety and tolerability of NAC and the potential of NAC to promote pulmonary hypertension in subjects with CF.

Cumulative medical radiation exposure throughout staged palliation of single ventricle congenital heart disease.

Patients with single ventricle heart disease undergoing staged palliation are exposed to ionizing radiation from multiple medical sources. We sought to quantify typical radiation burden in this population and identify risk factors for increased exposure. A retrospective review was performed of single ventricle patients surgically palliated at our institution, in which all studies utilizing ionizing radiation occurring from birth through Fontan completion were compiled.

Dynamic contrast-enhanced MR lymphangiography: feasibility study in swine.

Purpose: To demonstrate the feasibility of dynamic four-dimensional ( 4D four-dimensional ) intranodal contrast material-enhanced magnetic resonance (MR) lymphangiography with inguinal lymph node injection of gadopentetate dimeglumine.

Materials And Methods: All procedures were performed in accordance with the guidelines on the use of animals in research and were approved by the animal care and use committee. Five swine underwent nonenhanced MR lymphangiography with a heavily T2-weighted MR sequence, bilateral inguinal lymph node injection of 2 mL of undiluted gadopentetate at a rate of 1 mL/min, and 60 minutes of MR imaging with T1-weighted high-spatial- and high-temporal-resolution MR angiography.

Deep renal ectopia causing sciatic mononeuropathy.

Introduction: Sciatic mononeuropathy resulting from compression by an adjacent pelvic ectopic kidney has not been reported in the literature. Here, the authors present a case of a patient presenting with unilateral lower extremity paresthesia correlating to the sciatic nerve distribution.

Results: MRI examination demonstrated lumbosacral plexus compression by a very unusual deeply situated renal ectopia.

Radiation safety protocol using real-time dose reporting reduces patient exposure in pediatric electrophysiology procedures.

Radiation exposure during pediatric catheterization is significant. We sought to describe radiation exposure and the effectiveness of radiation safety protocols in reducing exposure during catheter ablations with electrophysiology studies in children and patients with congenital heart disease. We additionally sought to identify at-risk patients.

Common and uncommon applications of bowel ultrasound with pathologic correlation in children.

Objective: The purpose of this article is to describe the indications and techniques for bowel ultrasound for inflammatory bowel disease and other common and uncommon entities and describe and illustrate their imaging appearances, including endoscopic or surgical correlation.

Conclusion: Ultrasound is a useful tool for the evaluation of inflammatory bowel disease and many other bowel diseases. Radiologists must become familiar with the full potential of ultrasound in the evaluation of the bowel in children because the need for alternative radiation-free imaging techniques continues to grow.

Imaging findings of patients with metastatic neuroblastoma to the brain.

Rationale And Objectives: Metastatic involvement of brain is rare in neuroblastoma (NB). We retrospectively evaluated conventional and advanced imaging and clinical findings of seven patients with secondary intra-axial brain NB metastases.

Materials And Methods: Magnetic resonance imaging and computed tomography examinations of patients with metastatic brain NB were reviewed.

End-stage kidney disease after pediatric nonrenal solid organ transplantation.

Objectives: Adult solid organ transplant (SOT) recipients commonly develop advanced kidney disease; however, the burden of end-stage kidney disease (ESKD) in children after SOT is not well-described. The objectives of this study were to determine the incidence of ESKD after pediatric SOT and the relative risk by SOT type.

Methods: Retrospective multicenter cohort study of children, ages ≤ 18 years, who received SOTs from 1990 through 2010 using Scientific Registry of Transplant Recipients data linked to the US Renal Data System.

Morbidity in children and adolescents after surgical correction of interrupted aortic arch.

Previous studies of outcome after operative correction of interrupted aortic arch (IAA) have focused on mortality and rates of reintervention. We sought to investigate the clinical status of children and adolescents after surgery for IAA. A cross-sectional study of subjects with IAA between the ages of 8 and 18 years was performed with the subjects undergoing simultaneous genetic testing, electrocardiogram, cardiac magnetic resonance imaging, cardiopulmonary exercise testing, and assessment of health status and health-related quality of life as well as concurrent retrospective cohort study reviewing their postoperative use of medical care, including operative and transcatheter reinterventions, noncardiac surgeries, and hospitalizations.

Developmentally and culturally appropriate screening in primary care: development of the behavioral health checklist.

Objective: To evaluate the construct validity of the Behavioral Health Checklist (BHCL) for children aged from 4 to 12 years from diverse backgrounds.

Method: The parents of 4-12-year-old children completed the BHCL in urban and suburban primary care practices affiliated with a tertiary-care children's hospital. Across practices, 1,702 were eligible and 1,406 (82.

Neuromagnetic oscillations predict evoked-response latency delays and core language deficits in autism spectrum disorders.

Previous studies have observed evoked response latency as well as gamma band superior temporal gyrus (STG) auditory abnormalities in individuals with autism spectrum disorders (ASD). A limitation of these studies is that associations between these two abnormalities, as well as the full extent of oscillatory phenomena in ASD in terms of frequency and time, have not been examined. Subjects were presented pure tones at 200, 300, 500, and 1,000 Hz while magnetoencephalography assessed activity in STG auditory areas in a sample of 105 children with ASD and 36 typically developing controls (TD).

Development of heart and respiratory rate percentile curves for hospitalized children.

Objective: To develop and validate heart and respiratory rate percentile curves for hospitalized children and compare their vital sign distributions to textbook reference ranges and pediatric early warning score (EWS) parameters.

Methods: For this cross-sectional study, we used 6 months of nurse-documented heart and respiratory rates from the electronic records of 14,014 children on general medical and surgical wards at 2 tertiary-care children's hospitals. We developed percentile curves using generalized additive models for location, scale, and shape with 67% of the patients and validated the curves with the remaining 33%.

Improving adherence to otitis media guidelines with clinical decision support and physician feedback.

Objective: To assess the effects of electronic health record-based clinical decision support (CDS) and physician performance feedback on adherence to guidelines for acute otitis media (AOM) and otitis media with effusion (OME).

Methods: We conducted a factorial-design cluster randomized trial with primary care practices (n = 24) as the unit of randomization and visits as the unit of analysis. Between December 2007 and September 2010, data were collected from 139,305 otitis media visits made by 55,779 children aged 2 months to 12 years.

Osteoid osteomas: a pain in the night diagnosis.

Osteoid osteoma is a common benign bone-forming lesion that is composed of a nidus of vascular osteoid tissue and woven bone lined by osteoblasts. It is frequently associated with considerable surrounding inflammation. The diagnosis is usually straightforward when imaging reveals a radiolucent nidus surrounded by variable degrees of reactive sclerosis.

Complex genitourinary abnormalities on fetal MRI: imaging findings and approach to diagnosis.

Objective: The objective of this article is to present the fetal MRI patterns of complex genitourinary abnormalities including epispadias-exstrophy complex, cloacal malformation, urogenital sinus anomaly, posterior urethral valves, and other causes that result in lower urinary tract dilatation without oligohydramnios. Relevant embryology will be reviewed, and practical points will be provided that can aid in interpretation.

Conclusion: Complex genitourinary abnormalities have recognizable imaging findings on fetal MRI.