RESUMEN
Purpose: To investigate the spectrum, applicability and diagnostic capacity of intravenous contrast-enhanced ultrasound imaging (CEUS) in a pediatric population. Materials and Methods: From 08/2005 to 11/2015, nâ=â40 pediatric patients and young adults from 0â-â26 years (Øâ11.4â±â7.5) and 3.0â-â85.3âkg (Øâ40.8â± 25.6) with nâ=â55 investigations received nâ=â79 IV applications of ultrasound contrast agent (UCA). UCA dose and side effects were documented. Scanned organs were the liver (nâ=â42), spleen (nâ=â9), kidney (nâ=â3), and testis (nâ=â1). Histology, surgery or reference imaging was compared to CEUS and clinical follow-up. Results: The UCA dose <â20âkg was 0.4â±â0.3âml, (0.05â±â0.02âml/kg) and >â20âkg was 1.0â±â0.4âml (p<â0.0001) (0.02â±â0.01âml/kg, p<â0.0001). Adverse effects occurred in 2/79 applications (2.5â%). Agreement CEUS/gold standard resulted in 32/34 investigations. For liver diagnostics (gold standard: MRI, CT, histology, serology), nâ=â11 malignant and nâ=â15 benign focal liver lesions were included. The specificity was 100â% (95â% CI: 0.77â-â1.00), the sensitivity was 82â% (95â% CI: 0.48â-â0.98), the positive predictive value was 100â% (95â% CI: 0.69â-â1.00) and the negative predictive value was 88â% (95â% CI: 0.62â-â0.98, p<â0.0001). In nâ=â2 reference imaging misdiagnosed and CEUS was in accordance with clinical follow-up. All splenic/renal lesions were diagnosed correctly. In nâ=â1 an insufficient testicular perfusion was ruled out. The observation time was 30.4â±â30.5 months. Conclusion: CEUS is a well-tolerated and diagnostically equivalent modality in pediatric care, providing fundamental advantages compared to currently approved imaging modalities for these age groups.
Asunto(s)
Medios de Contraste/administración & dosificación , Medios de Contraste/farmacocinética , Riñón/diagnóstico por imagen , Hígado/diagnóstico por imagen , Bazo/diagnóstico por imagen , Testículo/diagnóstico por imagen , Adolescente , Niño , Preescolar , Medios de Contraste/efectos adversos , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Estudios Retrospectivos , Sensibilidad y Especificidad , Adulto JovenRESUMEN
Diuresis, the excretion of aldosterone-18-glucuronide and the excretion of sodium and potassium were measured before and during two periods of immersion in four male athletes in training and four untrained male subjects (age 20-27 years). The increase in diuresis during immersion was accompained by a concomitant decrease of aldosterone excretion and increase of sodium excretion in urine. These changes were more pronounced in untrained subjects than in trained subjects. From these results it may be concluded that trained subjects react more sensitive to slight changes in aldosterone secretion than untrained subjects.