Pediatric radiology
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Pediatric radiology · Feb 2019
Comparative StudyContrast-enhanced MRI compared to direct joint visualization at arthroscopy in pediatric patients with suspected temporomandibular joint synovitis.
Contrast-enhanced magnetic resonance imaging (MRI) has become the gold standard when assessing the temporomandibular joint (TMJ) in children. To our knowledge, no previous pediatric study has compared findings of TMJ MRI with direct visualization of the joint using arthroscopy. ⋯ Joint space width and subjective synovitis on TMJ MRI correlate with arthroscopic findings of chronic synovitis. Increased joint space width may be useful when evaluating the TMJ with less time-intensive modalities, such as ultrasound. However, MRI findings did not correlate well with findings of acute inflammation on arthroscopy.
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Pediatric radiology · Feb 2019
Susceptibility-weighted imaging of retinal hemorrhages in abusive head trauma.
Retinal hemorrhages are one of the most important supportive evidences for abusive head trauma (AHT). Susceptibility-weighted imaging (SWI) is highly suited to identify various forms of intracranial hemorrhage in AHT. However its utility in imaging retinal hemorrhage is not well established. ⋯ SWI is moderately sensitive and highly specific for identifying retinal hemorrhage in AHT. Further studies are needed to identify steps to improve the efficiency of SWI in detecting retinal hemorrhage.
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Pediatric radiology · Jan 2019
Ultrasound-guided cervical puncture for nusinersen administration in adolescents.
Spinal muscular atrophy (SMA) is an autosomal-recessive disease affecting motor neurons and is the most common genetic cause of death in infants. Intrathecal nusinersen is the only therapy approved by the U.S. Food and Drug Administration for SMA. Deformities and spinal instrumentation from orthopedic surgeries are common in children with SMA, complicating traditional intrathecal access for nusinersen delivery. Cervical punctures are routinely performed in adults for cervical myelograms and should be considered for children with SMA as a viable form of intrathecal access. ⋯ Our series describes a successful novel method of ultrasound-guided cervical spine access for intrathecal administration of nusinersen, adding to the armamentarium of procedures for delivering nusinersen to adolescents with challenging lumbar spine access caused by scoliosis and spinal instrumentation. This technique has the advantages of real-time ultrasound guidance and potential avoidance of general anesthesia in children.
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Pediatric radiology · Jan 2019
Performance of two--dimensional ultrasound shear wave elastography: reference values of normal liver stiffness in children.
Two-dimensional (2-D) shear wave elastography is a new sonographic elastography method for noninvasive measurement of liver stiffness. ⋯ Two-dimensional shear wave elastography is achievable in a wide range of age in children. We established the reference values of normal liver stiffness on 2-D shear wave elastography in children.
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Pediatric radiology · Dec 2018
Gauging potential risk for patients in pediatric radiology by review of over 2,000 incident reports.
Incident reporting can be used to inform imaging departments about adverse events and near misses. ⋯ Using incident report rates as a proxy for potential patient harm, the areas of our pediatric radiology service that are associated with the greatest potential for issues are interventional radiology, sedated patients, and inpatients. The areas associated with the least risk are ultrasound (US) and radiography. Safety improvement efforts should be focused on the high-risk areas.