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1.
J Thorac Imaging ; 39(1): 3-17, 2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-37982525

RESUMEN

A multitude of lung disorders ranging from congenital and genetic anomalies to iatrogenic complications can affect the neonate or the infant within the first year of life. Neonatal and infant chest imaging, predominantly by plain radiography and computed tomography, is frequently employed to aid in diagnosis and management; however, these disorders can be challenging to differentiate due to their broad-ranging, and frequently overlapping radiographic features. A systematic and practical approach to imaging interpretation which includes recognition of radiologic patterns, utilization of commonly accepted nomenclature and classification, as well as interpretation of imaging findings in conjunction with clinical history can not only assist radiologists to suggest the diagnosis, but also aid clinicians in management planning. The contents of this article were endorsed by the leadership of both the World Federation of Pediatric Imaging (WFPI), and the International Society of Pediatric Thoracic Imaging (ISPTI).


Asunto(s)
Enfermedades Pulmonares , Lactante , Recién Nacido , Niño , Humanos , Enfermedades Pulmonares/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Pulmón/diagnóstico por imagen
3.
Pediatr Radiol ; 53(9): 1773-1781, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37081179

RESUMEN

Tuberculosis (TB) remains a global health problem and is the second leading cause of death from a single infectious agent, behind the novel coronavirus disease of 2019. Children are amongst the most vulnerable groups affected by TB, and imaging manifestations are different in children when compared to adults. TB primarily involves the lungs and mediastinal lymph nodes. Clinical history, physical examination, laboratory examinations and various medical imaging tools are combined to establish the diagnosis. Even though chest radiography is the accepted initial radiological imaging modality for the evaluation of children with TB, this paper, the first of two parts, aims to discuss the advantages and limitations of the various medical imaging modalities and to provide recommendations on which is most appropriate for the initial diagnosis and assessment of possible complications of pulmonary TB in children. Practical, evidence-based imaging algorithms are also presented.


Asunto(s)
COVID-19 , Tuberculosis Pulmonar , Tuberculosis , Adulto , Niño , Humanos , Tuberculosis/diagnóstico por imagen , Tuberculosis Pulmonar/diagnóstico por imagen , Diagnóstico por Imagen , Radiografía , Radiografía Torácica/métodos
4.
Pediatr Radiol ; 53(9): 1782-1798, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37074457

RESUMEN

Despite advances in diagnosis and treatment in recent years, tuberculosis (TB) remains a global health concern. Children are amongst the most vulnerable groups affected by this disease. Although TB primarily involves the lungs and mediastinal lymph nodes, it can affect virtually any organ system of the body. Along with clinical history combined with physical examination and laboratory tests, various medical imaging tools help establish the diagnosis. Medical imaging tests are also helpful for follow-up during therapy, to assess complications and exclude other underlying pathologies. This article aims to discuss the utility, strengths and limitations of medical imaging tools in the evaluation of suspected extrathoracic TB in the pediatric population. Imaging recommendations for the diagnosis will be presented along with practical and evidence-based imaging algorithms to serve as a guide for both radiologists and clinicians.


Asunto(s)
Tuberculosis , Niño , Humanos , Tuberculosis/diagnóstico por imagen , Diagnóstico por Imagen , Ganglios Linfáticos , Algoritmos
5.
Radiol Clin North Am ; 60(1): 15-40, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34836562

RESUMEN

Lower respiratory tract infection (LRTI) remains a major cause of morbidity and mortality in children. Various organisms cause LRTI, including viruses, bacteria, fungi, and parasites, among others. Infections caused by 2 or more organisms also occur, sometimes enhancing the severity of the infection. Medical imaging helps confirm a diagnosis but also plays a role in the evaluation of acute and chronic sequelae. Medical imaging tests help evaluate underlying pathology in pediatric patients with recurrent or long-standing symptoms as well as the immunocompromised.


Asunto(s)
Diagnóstico por Imagen/métodos , Guías de Práctica Clínica como Asunto , Infecciones del Sistema Respiratorio/diagnóstico por imagen , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Sistema Respiratorio/diagnóstico por imagen
6.
Semin Musculoskelet Radiol ; 25(1): 167-175, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34020476

RESUMEN

Infants and children often present with a wide range of musculoskeletal (MSK) infections in daily clinical practice. This can vary from relatively benign superficial infections such as cellulitis to destructive osseous and articular infections and life-threatening deep soft tissue processes such as necrotizing fasciitis. Imaging evaluation plays an essential role for initial detection and follow-up evaluation of pediatric MSK infections. Therefore, a clear and up-to-date knowledge of imaging manifestations in MSK infections in infants and children is imperative for timely and accurate diagnosis that, in turn, can result in optimal patient management. This article reviews an up-to-date practical imaging techniques, the differences between pediatric and adult MSK infections, the spectrum of pediatric MSK infections, and mimics of pediatric MSK infections encountered in daily clinical practice by radiologists and clinicians.


Asunto(s)
Artritis Infecciosa , Sistema Musculoesquelético , Adulto , Artritis Infecciosa/diagnóstico por imagen , Niño , Diagnóstico por Imagen , Humanos , Lactante , Sistema Musculoesquelético/diagnóstico por imagen , Radiólogos
7.
J Comput Assist Tomogr ; 45(2): 253-262, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33186179

RESUMEN

ABSTRACT: Coronavirus disease 2019 (COVID-19) disease has spread worldwide since it was first discovered in China's Hubei province in December 2019. Respiratory illness is the primary manifestation of COVID-19 disease, and its pathophysiology as well as the clinical and cross-sectional imaging manifestations has been adequately reported. However, there is emerging evidence of its multisystemic nature, with associated extrapulmonary manifestations including gastrointestinal, cardiovascular, renal, and neurological findings. There is still limited understanding with regard to the extrapulmonary involvement in this disease. This review aims to put together the prevalence, proposed pathophysiology, and the spectrum of clinical and cross-sectional imaging manifestations of associated extrapulmonary findings in COVID-19 disease.


Asunto(s)
COVID-19/complicaciones , Enfermedades Cardiovasculares/diagnóstico por imagen , Diagnóstico por Imagen/métodos , Enfermedades Gastrointestinales/diagnóstico por imagen , Enfermedades Renales/diagnóstico por imagen , Enfermedades del Sistema Nervioso/diagnóstico por imagen , Enfermedades Cardiovasculares/etiología , Enfermedades Gastrointestinales/etiología , Humanos , Enfermedades Renales/etiología , Enfermedades del Sistema Nervioso/etiología , SARS-CoV-2
8.
Radiol Clin North Am ; 58(3): 549-568, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32276703

RESUMEN

End-stage organ failure is commonly treated with transplantation of the respective failing organ. Although outcomes have progressively improved over the decades, early and late complications do occur, and are often diagnosed by imaging. Given the increasing survival rates of transplant patients, the general radiologist may encounter these patients in the outpatient setting. Awareness of the normal radiologic findings after transplantation, and imaging findings of the more common complications, is therefore important. We review and illustrate the imaging assessment of complications from lung, liver, and renal transplantation, highlighting the key similarities and differences between pediatric and adult patients.


Asunto(s)
Diagnóstico por Imagen/métodos , Trasplante de Órganos/métodos , Complicaciones Posoperatorias/diagnóstico por imagen , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Factores de Riesgo , Tasa de Supervivencia
9.
Radiol Clin North Am ; 58(3): 569-582, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32276704

RESUMEN

Hematopoietic stem cell transplantation is an intravenous transfusion of pluripotent stem cells to repopulate the marrow and restore immunocompetence. However, before transplantation, the patient undergoes a conditioning regimen to eradicate the underlying disease, subsequently resulting in an immunocompromised state. Serious and some life-threatening complications involving any organ can occur. Currently, with advances in hematopoietic stem cell transplantation techniques and posttransplant management, more pediatric patients are now living longer and into their adulthood. The goal of this review article is to discuss the common neurologic, pulmonary, and abdominal complications associated with hematopoietic stem cell transplantation with emphasis on their imaging characteristics.


Asunto(s)
Diagnóstico por Imagen/métodos , Trasplante de Células Madre Hematopoyéticas/métodos , Complicaciones Posoperatorias/diagnóstico por imagen , Adulto , Niño , Humanos
10.
Pediatr Radiol ; 47(10): 1237-1248, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29052771

RESUMEN

There is a lack of standardized approach and terminology to classify the diverse spectrum of manifestations in tuberculosis. It is important to recognize the different clinical and radiographic patterns to guide treatment. As a result of changing epidemiology, there is considerable overlap in the radiologic presentations of primary tuberculosis and post-primary tuberculosis. In this article we promote a standardized approach in clinical and radiographic classification for children suspected of having or diagnosed with childhood tuberculosis. We propose standardized terms to diminish confusion and miscommunication, which can affect management. In addition, we present pitfalls and limitations of imaging.


Asunto(s)
Radiografía Torácica/normas , Enfermedades Torácicas/clasificación , Enfermedades Torácicas/diagnóstico por imagen , Tuberculosis/clasificación , Tuberculosis/diagnóstico por imagen , Niño , Diagnóstico Diferencial , Progresión de la Enfermedad , Humanos , Terminología como Asunto , Tuberculosis Ganglionar/clasificación , Tuberculosis Ganglionar/diagnóstico por imagen , Tuberculosis Pulmonar/diagnóstico por imagen
11.
Pediatr Radiol ; 47(10): 1260-1268, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29052772

RESUMEN

Tuberculosis continues to be an important cause of morbidity and mortality worldwide. It is the leading cause of infection-related deaths worldwide. Children are amongst the high-risk groups for developing tuberculosis and often pose a challenge to the clinicians in making a definitive diagnosis. The newly released global tuberculosis report from World Health Organization reveals a 50% increase in fatality from tuberculosis in children. Significantly, diagnostic and treatment algorithms of tuberculosis for children differ from those of adults. Bacteriologic confirmation of the disease is often difficult in children; hence radiologists have an important role to play in early diagnosis of this disease. Despite advancing technology, the key diagnostic imaging modalities for primary care and emergency services, especially in rural and low-resource areas, are chest radiography and ultrasonography. In this article, we discuss various diagnostic imaging modalities used in diagnosis and treatment of tuberculosis and their indications. We highlight the use of US as point-of-care service along with mediastinal US and rapid MRI protocols, especially in mediastinal lymphadenopathy and thoracic complications. MRI is the ideal modality in high-resource areas when adequate infrastructure is available. Because the prevalence of tuberculosis is highest in lower-resource countries, we also discuss global initiatives in low-resource settings.


Asunto(s)
Diagnóstico por Imagen , Enfermedades Torácicas/diagnóstico por imagen , Tuberculosis/diagnóstico por imagen , Niño , Diagnóstico Diferencial , Humanos
13.
Radiol Clin North Am ; 55(4): 845-867, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28601182

RESUMEN

Foreign bodies (FBs) may be unintentionally ingested, inhaled, or inserted into a body cavity or tissue, or may be due to traumatic or iatrogenic injury. They are frequently detected in clinical practice and emergency rooms. Early detection and prompt management are mandatory to avoid severe and life-threatening complications. Imaging plays an important role in confirming the presence and characterization of the FB, and its relationship with any affected organs. This article reviews commonly encountered FBs with regard to incidence, risk factors, mechanisms of entry, clinical presentation, associated complications, and typical imaging appearance in children.


Asunto(s)
Diagnóstico por Imagen/métodos , Cuerpos Extraños/diagnóstico por imagen , Niño , Preescolar , Diagnóstico Diferencial , Cuerpos Extraños/complicaciones , Cuerpos Extraños/epidemiología , Humanos , Incidencia , Lactante , Factores de Riesgo
14.
Eur J Radiol ; 95: 409-417, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27377573

RESUMEN

Chest radiographs are very helpful tool not only in the evaluation of respiratory and/or cardiac pathologies, but also to help clinicians in the assessment of various tubes and catheters inserted in pediatric patients. This review article focuses on the indications, contraindications, ideal locations of the tips of these tubes and catheters, as well as the consequences of malpositioning. Clinical outcomes of pediatric patients can be affected by the placement of these medical devices. The radiologist therefore has a critical role in detecting and relaying such malpositioned devices for prompt revisions or removal.


Asunto(s)
Cateterismo Venoso Central/instrumentación , Cateterismo Venoso Central/métodos , Tubos Torácicos , Drenaje/instrumentación , Pediatría/métodos , Radiografía Torácica/métodos , Niño , Humanos
18.
Pediatr Radiol ; 36(7): 677-81, 2006 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-16547698

RESUMEN

BACKGROUND: Congenital heart disease (CHD) is a significant cause of morbidity and mortality in pediatric patients. Traditional teaching holds that specific types of CHD can be diagnosed on the chest radiograph (CXR) through pattern recognition. OBJECTIVE: To determine the accuracy of radiologists in detecting CHD on the CXR. MATERIALS AND METHODS: This study was a blinded retrospective review of chest radiographs from 281 patients (<12 years) by five pediatric radiologists from three institutions. Thirteen groups were evaluated that included 12 categories of CHD and a control group of patients without heart disease. Radiographs were assessed for heart size, heart and mediastinal shape and vascularity. Clinical information, angiography, echocardiograms and surgery were used as the gold standard for definitive diagnosis. RESULTS: The average accuracy of the five readers in distinguishing normal from CHD patients was 78% (range of 72% to 82%). The overall measure of accuracy in distinguishing specific congenital cardiac lesions among 13 groups of patients was 71% (range of 63% to 79%). CONCLUSION: CXR alone is not diagnostic of specific cardiac lesions, with a low accuracy of only 71%. We believe that less emphasis should be placed on the use of radiographs alone in diagnosing specific congenital cardiac lesions.


Asunto(s)
Cardiopatías Congénitas/diagnóstico por imagen , Niño , Preescolar , Angiografía Coronaria , Diagnóstico Diferencial , Ecocardiografía , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Curva ROC , Estudios Retrospectivos
19.
Pediatr Blood Cancer ; 44(3): 226-31, 2005 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-15503293

RESUMEN

BACKGROUND: 6-Thioguanine (TG) was recently studied to determine whether TG in maintenance therapy achieves better event free survival than 6-mercaptopurine (MP) for standard risk acute lymphoblastic leukemia (ALL) on the clinical trial, CCG-1952 (5/1996-1/2000). Veno-occlusive disease was previously recognized as a complication of TG on CCG-1952. We report a newly recognized pediatric complication of TG: splenomegaly and portal hypertension (PH) developing during maintenance or after completion of therapy. PROCEDURE: Twelve patients (3-10 years) had been randomized to receive a targeted dose of 50 mg/m(2)/day of TG during maintenance phases. Actual TG dose ranged from 25 to 77 mg/m(2)/day (median 34 mg/m(2)/day). RESULTS: The initial patient, a boy who had marked thrombocytopenia and intermittent splenomegaly during maintenance therapy, was evaluated for persistent pancytopenia and progressive splenomegaly 3 months after completion of therapy. Dilated splenic vein and collaterals consistent with PH were documented by MRI/MRA. Esophagogastroduodenoscopy found esophageal varices. Liver biopsy showed periportal fibrosis and marked dilatation of veins and venules. Of the other 12 patients, 9 patients studied had abnormal MRI/MRAs with evidence of varices in 4. Eight patients had splenomegaly on physical examination. Liver biopsies in a girl after 3.3 courses of TG and a boy after 4.6 courses of TG showed periportal fibrosis and dilatation of venules and sinusoids and minimal focal fatty changes. Subsequent MRI/MRAs have been stable or improved. CONCLUSIONS: The evaluations of these 12 patients suggest that treatment with TG causes injury to the liver leading to PH and that thrombocytopenia and splenomegaly are clinical hallmarks of this toxicity.


Asunto(s)
Antimetabolitos Antineoplásicos/toxicidad , Hipertensión Portal/inducido químicamente , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológico , Tioguanina/toxicidad , Administración Oral , Niño , Preescolar , Várices Esofágicas y Gástricas/inducido químicamente , Femenino , Humanos , Hipertensión Portal/patología , Angiografía por Resonancia Magnética , Imagen por Resonancia Magnética , Masculino , Mercaptopurina/toxicidad , Pancitopenia/inducido químicamente , Esplenomegalia/inducido químicamente , Trombocitopenia/inducido químicamente
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