Liver shear wave elastography and attenuation imaging coefficient measures: prospective evaluation in healthy children.

PURPOSE: Ultrasonographic quantitative measurements enable characterizing the stiffness and viscosity of liver parenchyma. Normal Shear Wave Elastography (SWE) values have been reported in adults and children. The Attenuation Imaging (ATI) coefficient is a measure of local sound energy loss thought to reflect steatosis in adults. The aim of our study was to provide normal SWE and ATI liver values in healthy children. METHODS: A prospective monocentric study was conducted recruiting 86 children (45 boys and 41 girls) from a single University Hospital between January 2019 and June 2020, having a clinically indicated ultrasound examination, without a known or documented history of liver disease. Examinations were performed using an Aplio i800 (Canon Medical Systems) ultrasound system with an i8CX1 transducer. SWE measurements were obtained using a color map showing an automated measurement area grid overlay. ATI coefficients were generated automatically for each region of interest in the right liver. RESULTS: Overall median age for the pediatric population was 106 months (1-180 months; SD 49 months). Children were normal weighted. Liver SWE was available for all children. The median liver SWE was 4.6 kPa [3.3-6.6]. ATI yielded valid measurements in 77 patients. The median ATI coefficient was 0.65 [0.5-0.81] dB/cm/MHz. No impact of age, sex, weight and Body Mass Index was observed. CONCLUSION: SWE and ATI liver values were provided in healthy children. The normative quantitative data might be useful to characterize liver parenchyma in children better.

Chronic recurrent multifocal osteomyelitis (CRMO): a longitudinal case series review.

BACKGROUND: Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory disorder that is currently diagnosed based on clinical, radiologic, pathological and longitudinal findings. OBJECTIVE: To provide detailed descriptions of CRMO lesion patterns seen on radiographs and MRI and to suggest clinical use of whole-body MRI and propose noninvasive diagnostic strategy. MATERIALS AND METHODS: Retrospective longitudinal study (1989-2010) of 31 children (22 girls, 9 boys) diagnosed with CRMO. Imaging data were evaluated by two pediatric radiologists. RESULTS: Mean age at diagnosis was 11 years (3-17). A total of 108 lesions were investigated. The most common sites were the long bone metaphyses (56 lesions in 24 children) especially femoral and tibial (20/24); pelvis (10/31); spine (9/31); clavicle (6/31) and mandible (3/31). In long bones, the radiologic appearance was normal (22/56), mixed lytic and sclerotic (20/56), sclerotic (8/56) or lytic (6/56) often juxtaphyseal (36/56), with hyperostosis or periosteal thickening (10/56). Vertebral involvement was often multifocal (6/9). Medullary edema was seen on MRI (42) with epiphyseal (23/42) or soft-tissue (22/42) inflammation and juxtaphyseal nodule-like appearance (7/42). Whole-body MRI (15/31) was key in detecting subclinical lesions. CONCLUSION: CRMO is a polymorphous disorder in which whole-body MRI is extremely useful for showing subclinical edema. Vertebral collapse requires long-term monitoring.

Postnatal clinical and imaging follow-up of infants with prenatal isolated mild ventriculomegaly: a series of 101 cases.

BACKGROUND: Postnatal imaging and clinical outcome of fetuses with isolated mild ventriculomegaly (IMV) have never been systematically analysed. OBJECTIVE: To evaluate the postnatal clinical outcomes of a large cohort of fetuses with IMV and to correlate them with pre- and postnatal imaging. MATERIALS AND METHODS: We report a prospective study of 101 fetuses with IMV (10-15 mm ventriculomegaly with otherwise normal US, MRI, karyotype and TORCH screening). IMV was divided into minor (10-11.9 mm) and moderate (12-15 mm) ventriculomegaly. Ventriculomegaly was considered uni- or bilateral, stable, progressive, regressive or resolved according to the prenatal US follow-up. Clinical follow-up was performed by a neuropaediatrician. Postnatal imaging included cranial US (n = 71) and MRI (n = 76). RESULTS: The outcome of minor and moderate IMV was excellent in 94% and 85% of infants, respectively. It was not different between uni- and bilateral IMV, and between stable, regressive and resolved IMV, and was independent of gestational age at diagnosis and gender. Fixed neurological abnormalities were observed in nine infants. Postnatal MRI showed white-matter abnormalities in 14 infants, including 6 of the 9 infants with a poor outcome. CONCLUSION: The prognosis was slightly better in minor IMV than in moderate IMV. Postnatal MRI showed white-matter abnormalities in two-thirds of the infants with a poor outcome.