Paediatric radiology is a subspecialty of radiology that covers all aspects of diagnostic imaging... more Paediatric radiology is a subspecialty of radiology that covers all aspects of diagnostic imaging and image-guided treatment for children. The pathologies encountered in children are often different than those found in adults and paediatric radiology therefore differs in its approach and findings. Every imaging modality used in adult radiology is also used in paediatric radiology but with more emphasis on those with either low or no radiation, and on using distraction and pleasant environments to ease the process of acquiring images. After completing this tutorial students should be able to describe some of the reasons for specific modality choices when imaging children, and the important imaging features in a number of key pathologies.
BackgroundNoninvasive hemodynamic monitoring of infants with neonatal encephalopathy (NE) undergo... more BackgroundNoninvasive hemodynamic monitoring of infants with neonatal encephalopathy (NE) undergoing therapeutic hypothermia (TH) would be a potentially useful clinical tool. We aimed to assess the feasibility and reliability of noninvasive cardiac output monitoring (NICOM) and near-infrared spectroscopy (NIRS) in this cohort.MethodsNICOM and NIRS were commenced to measure cardiac output (CO), systemic vascular resistance (SVR), blood pressure (BP), and cerebral regional oxygen saturations (SctO2) during TH and rewarming. NICOM measures of CO were also compared with simultaneous echocardiography-derived CO (echo-CO).ResultsTwenty infants with a median gestation of 40 weeks were enrolled. There was a strong correlation between NICOM- and echo-CO (r(2)=0.79, P<0.001). NICOM-CO was systematically lower than echo-CO with a bias of 27% (limits of agreement 3-51%). NICOM illustrated lower CO during TH, which increased during rewarming. SctO2 increased over the first 30 h of TH and stay...
... | Ayuda. Anatomía para el diagnóstico radiológico. Información general. Autores:Stephanie Rya... more ... | Ayuda. Anatomía para el diagnóstico radiológico. Información general. Autores:Stephanie Ryan, Michelle McNicholas, Stephen Eustace; Editores: Madrid : Marbán, 2005; Año de publicación: 2005; País: España; Idioma: Español; ...
AimCystic Fibrosis conductance Transmembrane Regulator (CFTR) protein modulators represent a majo... more AimCystic Fibrosis conductance Transmembrane Regulator (CFTR) protein modulators represent a major breakthrough in the pharmacological management of Cystic Fibrosis (CF). Previous studies report acute changes in lung function after first administration of lumacaftor/ivacaftor (LUM/IVA) without a clear underlying mechanism.1 2 Our aim was to explore links between changes in percent predicted forced expiratory volume in one second (ppFEV1) and a number of potentially influencing factors.MethodsWe conducted a retrospective review of all children with CF who were started on LUM/IVA treatment between September 2016 and August 2017 in our institution. Data was collected from patient charts, electronic laboratory and radiology records. CT Thorax images were reviewed for evidence of air trapping using the Brody score.3 Descriptive and statistical analyses were performed using SPSS. ResultsData was collected from 15 children with CF who were started on LUM/IVA treatment. The mean (±SD) age o...
Journal of pediatric hematology/oncology, Aug 17, 2016
A male preterm infant was born with dysmorphic features consistent with Rubinstein-Taybi syndrome... more A male preterm infant was born with dysmorphic features consistent with Rubinstein-Taybi syndrome (RTS). An undescended right testicle was noted on examination. At 5 months of age he developed a palpable right-sided abdominal mass and an elevated alpha-fetoprotein. Histology revealed a malignant germ cell neoplasm arising within the undescended testis. This is the first reported case of a germ cell tumor occurring in a pediatric patient with RTS. Urologic abnormalities occur in approximately 52% of RTS patients, of which cryptorchidism is the commonest. Given the frequency of undescended testes in this population, closer screening may be warranted.
The Journal of Maternal-Fetal & Neonatal Medicine, 2015
Abstract Objective: To correlate pattern of injury on neonatal brain magnetic resonance imaging (... more Abstract Objective: To correlate pattern of injury on neonatal brain magnetic resonance imaging (MRI) with outcome in infants ≥36 + 0 weeks gestation with hypoxic ischaemic encephalopathy. Methods: Prospective cohort study. Images were blindly reviewed. Children were assessed using a variety of standardised assessments. Results: MRI brain was performed on 88 infants. Follow up was available in 73(83%) infants. Eight of 25(32%) children with normal imaging had below normal assessment scores. Eight infants (12%) had isolated punctate white matter lesions and five of these had abnormal assessment scores. Death and cerebral palsy were seen only in children with imaging scores ≥3 on basal ganglia/thalami (BGT) score or ≥4 on watershed score. No developmental concerns were raised in 3/7(43%) infants with isolated watershed injury. Ten of 13(77%) infants with isolated BGT injury died or developed cerebral palsy. All 23 children with posterior limb of the internal capsule (PLIC) injury displayed developmental difficulties. Conclusions: Almost one-third of infants with a normal MRI brain may be at risk of developmental problems. Punctate foci of white matter injury are common and not always benign. PLIC involvement is usually associated with neurological sequelae including isolated cognitive deficits. Worst outcomes are associated with basal ganglia injury.
Paediatric radiology is a subspecialty of radiology that covers all aspects of diagnostic imaging... more Paediatric radiology is a subspecialty of radiology that covers all aspects of diagnostic imaging and image-guided treatment for children. The pathologies encountered in children are often different than those found in adults and paediatric radiology therefore differs in its approach and findings. Every imaging modality used in adult radiology is also used in paediatric radiology but with more emphasis on those with either low or no radiation, and on using distraction and pleasant environments to ease the process of acquiring images. After completing this tutorial students should be able to describe some of the reasons for specific modality choices when imaging children, and the important imaging features in a number of key pathologies.
BackgroundNoninvasive hemodynamic monitoring of infants with neonatal encephalopathy (NE) undergo... more BackgroundNoninvasive hemodynamic monitoring of infants with neonatal encephalopathy (NE) undergoing therapeutic hypothermia (TH) would be a potentially useful clinical tool. We aimed to assess the feasibility and reliability of noninvasive cardiac output monitoring (NICOM) and near-infrared spectroscopy (NIRS) in this cohort.MethodsNICOM and NIRS were commenced to measure cardiac output (CO), systemic vascular resistance (SVR), blood pressure (BP), and cerebral regional oxygen saturations (SctO2) during TH and rewarming. NICOM measures of CO were also compared with simultaneous echocardiography-derived CO (echo-CO).ResultsTwenty infants with a median gestation of 40 weeks were enrolled. There was a strong correlation between NICOM- and echo-CO (r(2)=0.79, P<0.001). NICOM-CO was systematically lower than echo-CO with a bias of 27% (limits of agreement 3-51%). NICOM illustrated lower CO during TH, which increased during rewarming. SctO2 increased over the first 30 h of TH and stay...
... | Ayuda. Anatomía para el diagnóstico radiológico. Información general. Autores:Stephanie Rya... more ... | Ayuda. Anatomía para el diagnóstico radiológico. Información general. Autores:Stephanie Ryan, Michelle McNicholas, Stephen Eustace; Editores: Madrid : Marbán, 2005; Año de publicación: 2005; País: España; Idioma: Español; ...
AimCystic Fibrosis conductance Transmembrane Regulator (CFTR) protein modulators represent a majo... more AimCystic Fibrosis conductance Transmembrane Regulator (CFTR) protein modulators represent a major breakthrough in the pharmacological management of Cystic Fibrosis (CF). Previous studies report acute changes in lung function after first administration of lumacaftor/ivacaftor (LUM/IVA) without a clear underlying mechanism.1 2 Our aim was to explore links between changes in percent predicted forced expiratory volume in one second (ppFEV1) and a number of potentially influencing factors.MethodsWe conducted a retrospective review of all children with CF who were started on LUM/IVA treatment between September 2016 and August 2017 in our institution. Data was collected from patient charts, electronic laboratory and radiology records. CT Thorax images were reviewed for evidence of air trapping using the Brody score.3 Descriptive and statistical analyses were performed using SPSS. ResultsData was collected from 15 children with CF who were started on LUM/IVA treatment. The mean (±SD) age o...
Journal of pediatric hematology/oncology, Aug 17, 2016
A male preterm infant was born with dysmorphic features consistent with Rubinstein-Taybi syndrome... more A male preterm infant was born with dysmorphic features consistent with Rubinstein-Taybi syndrome (RTS). An undescended right testicle was noted on examination. At 5 months of age he developed a palpable right-sided abdominal mass and an elevated alpha-fetoprotein. Histology revealed a malignant germ cell neoplasm arising within the undescended testis. This is the first reported case of a germ cell tumor occurring in a pediatric patient with RTS. Urologic abnormalities occur in approximately 52% of RTS patients, of which cryptorchidism is the commonest. Given the frequency of undescended testes in this population, closer screening may be warranted.
The Journal of Maternal-Fetal & Neonatal Medicine, 2015
Abstract Objective: To correlate pattern of injury on neonatal brain magnetic resonance imaging (... more Abstract Objective: To correlate pattern of injury on neonatal brain magnetic resonance imaging (MRI) with outcome in infants ≥36 + 0 weeks gestation with hypoxic ischaemic encephalopathy. Methods: Prospective cohort study. Images were blindly reviewed. Children were assessed using a variety of standardised assessments. Results: MRI brain was performed on 88 infants. Follow up was available in 73(83%) infants. Eight of 25(32%) children with normal imaging had below normal assessment scores. Eight infants (12%) had isolated punctate white matter lesions and five of these had abnormal assessment scores. Death and cerebral palsy were seen only in children with imaging scores ≥3 on basal ganglia/thalami (BGT) score or ≥4 on watershed score. No developmental concerns were raised in 3/7(43%) infants with isolated watershed injury. Ten of 13(77%) infants with isolated BGT injury died or developed cerebral palsy. All 23 children with posterior limb of the internal capsule (PLIC) injury displayed developmental difficulties. Conclusions: Almost one-third of infants with a normal MRI brain may be at risk of developmental problems. Punctate foci of white matter injury are common and not always benign. PLIC involvement is usually associated with neurological sequelae including isolated cognitive deficits. Worst outcomes are associated with basal ganglia injury.
Uploads