Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 83
Filtrar
1.
Pediatr Radiol ; 2022 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-36333494

RESUMO

Paediatric computed tomography (CT) imaging has always been associated with challenges. Although the technical background of CT imaging is complex, it is worth considering the baseline aspects of radiation exposure to prevent unwanted excess radiation in paediatric patients. In this review, we discuss the most relevant factors influencing radiation exposure, and provide a simplified and practical approach to optimise paediatric CT.

2.
PLoS One ; 17(10): e0276503, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36264961

RESUMO

The use of artificial intelligence (AI) in image analysis is an intensively debated topic in the radiology community these days. AI computer vision algorithms typically rely on large-scale image databases, annotated by specialists. Developing and maintaining them is time-consuming, thus, the involvement of non-experts into the workflow of annotation should be considered. We assessed the learning rate of inexperienced evaluators regarding correct labeling of pediatric wrist fractures on digital radiographs. Students with and without a medical background labeled wrist fractures with bounding boxes in 7,000 radiographs over ten days. Pediatric radiologists regularly discussed their mistakes. We found F1 scores-as a measure for detection rate-to increase substantially under specialist feedback (mean 0.61±0.19 at day 1 to 0.97±0.02 at day 10, p<0.001), but not the Intersection over Union as a parameter for labeling precision (mean 0.27±0.29 at day 1 to 0.53±0.25 at day 10, p<0.001). The times needed to correct the students decreased significantly (mean 22.7±6.3 seconds per image at day 1 to 8.9±1.2 seconds at day 10, p<0.001) and were substantially lower as annotated by the radiologists alone. In conclusion our data showed, that the involvement of undergraduated students into annotation of pediatric wrist radiographs enables a substantial time saving for specialists, therefore, it should be considered.


Assuntos
Fraturas Ósseas , Radiologia , Humanos , Criança , Inteligência Artificial , Punho/diagnóstico por imagem , Radiologistas , Radiologia/métodos , Fraturas Ósseas/diagnóstico por imagem , Estudantes
3.
Cartilage ; : 19476035221126354, 2022 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-36254621

RESUMO

OBJECTIVE: Balloon kyphoplasty with polymethylmethacrylate (PMMA) represents the standard procedure for the treatment of thoracic and lumbar type A compression fractures. However, an increased degeneration in adjacent intervertebral disks following PMMA kyphoplasty has been demonstrated in elderly patients. Calcium phosphate cement (CPC) appears to be superior to PMMA for the intravertebral stabilization in younger patients. It remains unkown whether CPC kyphoplasty causes degeneration of adjacent disks in adolescents. DESIGN: Seven adolescents with thoracolumbar spine fractures underwent kyphoplasty at a mean age of 14.5 years (range 10-18). At a mean follow-up of 3.7 years (range 1 to 4.8) postoperatively, 3.0 Tesla magnetic resonance imaging (MRI) of the spine was performed to assess intervertebral disk degeneration by quantitative T2 relaxation maps and subjective ratings using modified Pfirrmann scores. A total of 56 intervertebral disks was analyzed. Initial computed tomography (CT) examinations served as basis to assess the severity of adjacent endplate injuries in terms of articular step-offs. RESULTS: Initial imaging detected 18 thoracolumbar vertebral body fractures of which 9 were treated with CPC kyphoplasty. Quantitative follow-up MRI revealed signs of degeneration in 10 (17.9%) of the examined 56 intervertebral disks, 7 of them adjacent to a previously fractured vertebral body. Signs of disk degeneration were significantly higher in caudal endplates with articular step-offs larger than 5 mm compared to fractured vertebral bodies without endplate step-offs. CONCLUSIONS: Quantitative MRI follow-ups did not suggest CPC-related intervertebral disk degradations following thoracolumbar kyphoplasty in adolescents, but indicated disk alterations correlating to adjacent endplate fracture severity.

4.
BMC Res Notes ; 15(1): 206, 2022 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-35705999

RESUMO

OBJECTIVE: This study investigates the development of the thoracic cross-section at the nipple line level during the early stages of life. Unlike the descriptive awareness regarding chest development course, there exist no quantitative references concerning shape, circumference and possible dependencies to age, gender or body weight. The proposed mathematical relations are expected to help create guidelines for more realistic modelling and potential detection of abnormalities. One potential application is lung electrical impedance tomography (EIT) monitoring where accurate chest models are crucial in both extracting reliable parameters for regional ventilation function and design of EIT belts. Despite their importance, such reference data is not readily available for the younger age range due to insufficient data amid the regulations of neonatal imaging. RESULTS: Chest circumference shows the highest correlation to body weight following the relation [Formula: see text] where x is the body weight in grams and f(x) is the chest circumference in cm at the nipple line level. No statistically significant difference in chest circumference between genders was detected. However, the shape indicated signs of both age and gender dependencies with on average boys developing a more rectangular shape than girls from the age of 1 years and 9 months.


Assuntos
Pulmão , Tórax , Peso Corporal , Estudos Transversais , Impedância Elétrica , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Tórax/diagnóstico por imagem , Tomografia/métodos
5.
Sci Data ; 9(1): 222, 2022 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-35595759

RESUMO

Digital radiography is widely available and the standard modality in trauma imaging, often enabling to diagnose pediatric wrist fractures. However, image interpretation requires time-consuming specialized training. Due to astonishing progress in computer vision algorithms, automated fracture detection has become a topic of research interest. This paper presents the GRAZPEDWRI-DX dataset containing annotated pediatric trauma wrist radiographs of 6,091 patients, treated at the Department for Pediatric Surgery of the University Hospital Graz between 2008 and 2018. A total number of 10,643 studies (20,327 images) are made available, typically covering posteroanterior and lateral projections. The dataset is annotated with 74,459 image tags and features 67,771 labeled objects. We de-identified all radiographs and converted the DICOM pixel data to 16-Bit grayscale PNG images. The filenames and the accompanying text files provide basic patient information (age, sex). Several pediatric radiologists annotated dataset images by placing lines, bounding boxes, or polygons to mark pathologies like fractures or periosteal reactions. They also tagged general image characteristics. This dataset is publicly available to encourage computer vision research.


Assuntos
Algoritmos , Aprendizado de Máquina , Traumatismos do Punho , Criança , Humanos , Radiografia , Traumatismos do Punho/diagnóstico por imagem
6.
Sci Rep ; 12(1): 1883, 2022 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-35115619

RESUMO

Cause determination is challenging in fever or inflammation of unknown origin (FUO/IUO) despite today's diagnostic modalities. We evaluated the value of F-18 FDG PET/CT in an unselected patient collective. This retrospective nonrandomized single-center study enrolled 300 male and female patients with FUO/IUO. PET/CT findings were compared with final clinical outcomes to determine the sensitivity, specificity, clinical significance, etiological distribution of final diagnoses, impact on treatment, role of white-blood cell count (WBC), and C-reactive protein (CRP). In 54.0% (162/300) PET/CT was the decisive exanimation for establishing the final diagnosis, in 13.3% (40/300) the findings were equivocal and indecisive, in 3.3% (10/300) PET/CT findings were false positive, while in 29.3% (88/300) a normal F-18 FDG pattern was present. Statistical analysis showed a sensitivity of 80.2% and a specificity of 89.8% for the contribution of PET/CT to the final diagnosis. CRP levels and WBC were not associated with PET/CT outcome. PET/CT let to new treatment in 24.0% (72/300), treatment change in 18.0% (54/300), no treatment change in 49.6% (149/300), and in 8.3% (25/300) no data was available. Our study demonstrates the utility of F-18 FDG PET/CT for source finding in FUO/IUO if other diagnostic tools fail.


Assuntos
Febre de Causa Desconhecida/diagnóstico por imagem , Fluordesoxiglucose F18 , Inflamação/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Compostos Radiofarmacêuticos , Imagem Corporal Total , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Proteína C-Reativa/análise , Feminino , Febre de Causa Desconhecida/sangue , Humanos , Inflamação/sangue , Mediadores da Inflamação/sangue , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Adulto Jovem
7.
J Vasc Surg Venous Lymphat Disord ; 10(2): 430-435, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34171533

RESUMO

BACKGROUND: Mesenteric lymphatic malformations (LMs) represent rare congenital anomalies that can include chylous or nonchylous content. The pathologic mechanisms explaining this phenomenon are poorly understood and not yet described. Furthermore, the current management approach does not consider the contents of the mesenteric LMs. In the present study, we have defined the relationship between the lymphatic mesenteric cyst content and the histologic evidence of LMs within the bowel wall. METHODS: We retrospectively investigated all patients with mesenteric LMs treated surgically at our department from 1999 to 2018. RESULTS: A total of 11 patients (6 girls and 5 boys) were included in our analysis. Seven patients had presented with LMs located in the jejunal mesentery, three in the ileocecal region, and only one in the mesocolon transversum and omentum. Of the 11 children, 7 had had LMs with nonchylous content and 4 had presented with chylous content LMs. Intestinal resection was performed in all 4 patients with chylous content LMs and 4 patients with nonchylous content LMs. Histopathologic evaluation of the surgical specimens determined that only the LMs with chylous content displayed malformed lymphatic channels throughout the bowel wall. The resected small bowel of four patients with nonchylous content showed no LM extension throughout the intestinal wall. CONCLUSIONS: LMs with chylous content seem to develop from malformed lymphatic channels within the bowel wall. In such cases, segmental intestinal resection is mandatory. In contrast, mesenteric LMs with nonchylous content can potentially be treated without bowel resection if the blood supply can be preserved. This finding is, to the best of our knowledge, reported in the present study for the first time.


Assuntos
Ascite Quilosa/cirurgia , Anormalidades Linfáticas/cirurgia , Vasos Linfáticos/cirurgia , Cisto Mesentérico/cirurgia , Adolescente , Criança , Pré-Escolar , Ascite Quilosa/diagnóstico por imagem , Feminino , Humanos , Recém-Nascido , Anormalidades Linfáticas/diagnóstico por imagem , Vasos Linfáticos/anormalidades , Vasos Linfáticos/diagnóstico por imagem , Masculino , Cisto Mesentérico/diagnóstico por imagem , Mesentério , Complicações Pós-Operatórias/etiologia , Recidiva , Estudos Retrospectivos , Resultado do Tratamento
8.
J Matern Fetal Neonatal Med ; 35(5): 1003-1016, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34182870

RESUMO

Lung ultrasound (LUS) is now widely used in the diagnosis and monitor of neonatal lung diseases. Nevertheless, in the published literatures, the LUS images may display a significant variation in technical execution, while scanning parameters may influence diagnostic accuracy. The inter- and intra-observer reliabilities of ultrasound exam have been extensively studied in general and in LUS. As expected, the reliability declines in the hands of novices when they perform the point-of-care ultrasound (POC US). Consequently, having appropriate guidelines regarding to technical aspects of neonatal LUS exam is very important especially because diagnosis is mainly based on interpretation of artifacts produced by the pleural line and the lungs. The present work aimed to create an instrument operation specification and parameter setting guidelines for neonatal LUS. Technical aspects and scanning parameter settings that allow for standardization in obtaining LUS images include (1) select a high-end equipment with high-frequency linear array transducer (12-14 MHz). (2) Choose preset suitable for lung examination or small organs. (3) Keep the probe perpendicular to the ribs or parallel to the intercostal space. (4) Set the scanning depth at 4-5 cm. (5) Set 1-2 focal zones and adjust them close to the pleural line. (6) Use fundamental frequency with speckle reduction 2-3 or similar techniques. (7) Turn off spatial compounding imaging. (8) Adjust the time-gain compensation to get uniform image from the near-to far-field.


Assuntos
Doenças do Recém-Nascido , Pneumonia , Humanos , Recém-Nascido , Pulmão/diagnóstico por imagem , Reprodutibilidade dos Testes , Ultrassonografia
9.
Pediatr Radiol ; 52(11): 2074-2086, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-34664088

RESUMO

In medicine, particularly in radiology, there are great expectations in artificial intelligence (AI), which can "see" more than human radiologists in regard to, for example, tumor size, shape, morphology, texture and kinetics - thus enabling better care by earlier detection or more precise reports. Another point is that AI can handle large data sets in high-dimensional spaces. But it should not be forgotten that AI is only as good as the training samples available, which should ideally be numerous enough to cover all variants. On the other hand, the main feature of human intelligence is content knowledge and the ability to find near-optimal solutions. The purpose of this paper is to review the current complexity of radiology working places, to describe their advantages and shortcomings. Further, we give an AI overview of the different types and features as used so far. We also touch on the differences between AI and human intelligence in problem-solving. We present a new AI type, labeled "explainable AI," which should enable a balance/cooperation between AI and human intelligence - thus bringing both worlds in compliance with legal requirements. For support of (pediatric) radiologists, we propose the creation of an AI assistant that augments radiologists and keeps their brain free for generic tasks.


Assuntos
Inteligência Artificial , Radiologia , Criança , Humanos , Radiografia , Radiologistas , Radiologia/métodos
10.
Front Pediatr ; 10: 1005099, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36589159

RESUMO

It is an indisputable dogma in extremity radiography to acquire x-ray studies in at least two complementary projections, which is also true for distal radius fractures in children. However, there is cautious hope that computer vision could enable breaking with this tradition in minor injuries, clinically lacking malalignment. We trained three different state-of-the-art convolutional neural networks (CNNs) on a dataset of 2,474 images: 1,237 images were posteroanterior (PA) pediatric wrist radiographs containing isolated distal radius torus fractures, and 1,237 images were normal controls without fractures. The task was to classify images into fractured and non-fractured. In total, 200 previously unseen images (100 per class) served as test set. CNN predictions reached area under the curves (AUCs) up to 98% [95% confidence interval (CI) 96.6%-99.5%], consistently exceeding human expert ratings (mean AUC 93.5%, 95% CI 89.9%-97.2%). Following training on larger data sets CNNs might be able to effectively rule out the presence of a distal radius fracture, enabling to consider foregoing the yet inevitable lateral projection in children. Built into the radiography workflow, such an algorithm could contribute to radiation hygiene and patient comfort.

11.
Front Pediatr ; 9: 661025, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33791262

RESUMO

Introduction: Ewing sarcomas of the chest wall, historically known as "Askin tumors" represent highly aggressive pediatric malignancies with a reported 5-year survival ranging only between 40 and 60% in most studies. Multimodal oncological treatment according to specific Ewing sarcoma protocols and radical "en-bloc" resection with simultaneous chest wall repair are key factors for long-term survival. However, the surgical complexity depends on tumor location and volume and potential infiltrations into lung, pericardium, diaphragm, esophagus, spine and major vessels. Thus, the question arises, which surgical specialties should join their comprehensive skills when approaching a child with Ewing sarcoma of the chest wall. Patients and Methods: All pediatric patients with Ewing sarcomas of the chest wall treated between 1990 and 2020 were analyzed focusing on complete resection, chest wall reconstruction, surgical complications according to Clavien-Dindo (CD) and survival. Patients received neo-adjuvant chemotherapy according to the respective Ewing sarcoma protocols. Depending on tumor location and organ infiltration, a multi-disciplinary surgical team was orchestrated to perform radical en-bloc resection and simultaneous chest wall repair. Results: Thirteen consecutive patients (seven boys and six girls) were included. Median age at presentation was 10.9 years (range 2.2-21 years). Neo-adjuvant chemotherapy (n = 13) and irradiation (n = 3) achieved significant reduction of the median tumor volume (305.6 vs. 44 ml, p < 0.05). En-bloc resection and simultaneous chest wall reconstruction was achieved without major complications despite multi-organ involvement. Postoperatively, one patient with infiltration of the costovertebral joint and laminectomy required surgical re-intervention (CD IIIb). 11/13 patients were treated with clear resections margins (R1 resection in one patient with infiltration of the costovertebral joint and marginal resection <1 mm in one child with multiple pulmonary metastases). All patients underwent postoperative chemotherapy; irradiation was performed in four children. Two deaths occurred 18 months and 7.5 years after diagnosis, respectively. Median follow-up for the remaining patients was 8.8 years (range: 0.9-30.7 years). The 5-year survival rate was 89% and the overall survival 85%. Conclusion: EWING specific oncological treatment and multi-disciplinary surgery performing radical en-bloc resections and simultaneous chest wall repair contribute to an improved survival of children with Ewing sarcoma of the chest wall.

12.
J Surg Case Rep ; 2021(3): rjab047, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33777350

RESUMO

The perinatal management of newborns with giant omphaloceles requires careful suspicion concerning 'unexpected' associated malformations. We describe a newborn with a combination of incomplete Pentalogy of Cantrell consisting of giant omphalocele, anterior congenital diaphragmatic hernia (CDH) and pericardial absence complicated by a hepatic rapidly involuting congenital hemangioma (RICH). A giant omphalocele was detected prenatally. Postnatally, staged closure of the omphalocele was planned. A mass of the liver was noted and (mis-)taken for a hematoma. In the further course, the baby developed cardiorespiratory insufficiency due to a central CDH which was excised. Subsequently, staged closure of the omphalocele became impossible. Specific workup revealed a mass in the left liver lobe. The mass was resected and the abdominal wall defect repaired. Histology confirmed the diagnosis of an RICH. The surgical treatment of newborns with giant omphaloceles requires a multidisciplinary neonatal support and an elaborate pediatric surgical armamentarium to cope with additional malformations.

13.
Comput Biol Med ; 132: 104300, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33714842

RESUMO

BACKGROUND AND OBJECTIVES: Computer-aided diagnosis relies on machine learning algorithms that require filtered and preprocessed data as the input. Aligning the image in the desired direction is an additional manual step in post-processing, commonly overlooked due to workload issues. Several state-of-the-art approaches for fracture detection and disease-struck region segmentation benefit from correctly oriented images, thus requiring such preprocessing of X-ray images. Furthermore, it is desirable to have archived studies in a standardized format. Radiograph hanging protocols also differ from case to case, which means that images are not always aligned and oriented correctly. As a solution, the paper proposes XAOM, an X-ray Alignment and Orientation Method for images from 21 different body regions. METHODS: Typically, other methods are crafted for this purpose to suit a specific body region and form of usage. In contrast, the method proposed in this paper is comprehensive and easily tuned to align and orient X-ray images of any body region. XAOM consists of two stages. For the first stage of the method, aligning X-ray images, we experimented with the following approaches: Hough transform, Fast line detection algorithm, and Principal Component Analysis method. For the second stage, we have experimented with the adaptations of several well known convolutional neural network topologies for correctly predicting image orientation: LeNet5, AlexNet, VGG16, VGG19, and ResNet50. RESULTS: In the first stage, the PCA-based approach performed best. The average difference between the angle detected by the algorithm and the angle marked by the experts on the test set containing 200 pediatric X-ray images was 1.65∘, while the median value was 0.11∘. In the second stage, the VGG16-based network topology achieved the best accuracy of 0.993 on a test set containing 4,221 images. CONCLUSION: XAOM is highly accurate at aligning and orienting pediatric X-ray images of 21 common body regions according to a set standard. The proposed method is also robust and can be easily adjusted to the different alignment and rotation criteria. AVAILABILITY: The Python source code of the best performing implementation of XAOM is publicly available at https://github.com/fhrzic/XAOM.


Assuntos
Diagnóstico por Computador , Redes Neurais de Computação , Algoritmos , Criança , Computadores , Humanos , Processamento de Imagem Assistida por Computador , Aprendizado de Máquina
14.
Pediatr Radiol ; 51(4): 532-543, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33743037

RESUMO

Medical imaging is foundational in the care of children, and much of the medical imaging province depends on ionizing radiation: radiography, fluoroscopy, CT and nuclear imaging. Many considerations for this imaging in children are distinct in the domains of appropriate radiation use, other factors that determine examination quality, the opportunities to engage and educate through networking, and the translation of research efforts. Given these needs, it is worth approaching the contributions and their impact by the pediatric radiology community, especially to the enhancement of this value in the care of children.


Assuntos
Radiologia , Criança , Fluoroscopia , Humanos , Doses de Radiação , Radiação Ionizante , Radiografia
15.
J Hand Surg Eur Vol ; 46(9): 954-960, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33459137

RESUMO

The purpose of this study is to determine the normal ranges of radioulnar (i.e. medial-lateral) finger deviations during growth. We retrospectively measured radioulnar interphalangeal joint angles in 6236 properly aligned thumbs and fingers in trauma radiographs of 4720 patients aged 0 to 19 years. The mean interphalangeal joint angle of the thumb was 0.2° (standard deviation 1.5°). The average proximal interphalangeal joint angles were ulnar deviation of 2.5° (1.7°) for the index, ulnar deviation 1.7° (1.5°) for the middle, radial deviation 1.3° (1.8°) for the ring, radial deviation 2.0° (2.8°) for the little fingers. The distal interphalangeal joint angles were ulnar deviation of 2.5° (1.7°), ulnar deviation 2.1° (1.7°), radial deviation 2.1° (1.7°), radial deviation 5.1° (2.8°) from index to the little fingers. Thumbs were typically straight, whereas the index and middle fingers deviated ulnarly, and ring and little fingers radially. There were no relevant differences in sex or laterality.


Assuntos
Deformidades da Mão , Polegar , Adolescente , Criança , Articulações dos Dedos/diagnóstico por imagem , Dedos , Humanos , Estudos Retrospectivos
16.
IEEE Trans Biomed Eng ; 68(9): 2752-2763, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33476264

RESUMO

This paper presents a new method for selecting a patient specific forward model to compensate for anatomical variations in electrical impedance tomography (EIT) monitoring of neonates. The method uses a combination of shape sensors and absolute reconstruction. It takes advantage of a probabilistic approach which automatically selects the best estimated forward model fit from pre-stored library models. Absolute/static image reconstruction is performed as the core of the posterior probability calculations. The validity and reliability of the algorithm in detecting a suitable model in the presence of measurement noise is studied with simulated and measured data from 11 patients. The paper also demonstrates the potential improvements on the clinical parameters extracted from EIT images by considering a unique case study with a neonate patient undergoing computed tomography imaging as clinical indication prior to EIT monitoring. Two well-known image reconstruction techniques, namely GREIT and tSVD, are implemented to create the final tidal images. The impacts of appropriate model selection on the clinical extracted parameters such as center of ventilation and silent spaces are investigated. The results show significant improvements to the final reconstructed images and more importantly to the clinical EIT parameters extracted from the images that are crucial for decision-making and further interventions.


Assuntos
Processamento de Imagem Assistida por Computador , Tomografia , Algoritmos , Impedância Elétrica , Humanos , Recém-Nascido , Reprodutibilidade dos Testes
17.
18.
J Surg Case Rep ; 2020(8): rjaa252, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32874540

RESUMO

Abdominal lymphatic malformations in neonates require sophisticated management. In symptomatic cases, acute complications may necessitate immediate surgery. We present the case of a giant abdominal lymphatic malformation diagnosed in the 18th gestational week. Sonographic concerns about intestinal hypoperfusion in the 33rd week of gestation indicated caesarean section. Postnatal imaging confirmed a macrocystic lymphatic malformation occupying almost the complete abdominal cavity; the intestinal perfusion was normal. Clinical deterioration on Day 13 of life required laparotomy. Intraoperatively, the lymphatic mass was located in the ileocecal mesentery. Two major cysts showed recent hemorrhage explaining the onset of abdominal compartment syndrome. The malformation was completely removed. An ileocecal resection with an ileocolic anastomosis was performed. The postoperative course was uneventful. In neonates with abdominal lymphatic malformations, an onset of abdominal compartment syndrome requires surgical exploration. If feasible, the complete removal of the lesion represents a curative option.

19.
Skeletal Radiol ; 49(12): 1939-1949, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32535775

RESUMO

INTRODUCTION: Novel dedicated extremity cone beam computed tomography (CBCT) devices, recently introduced to the market, raised attention as a possible alternative in advanced diagnostic pediatric trauma imaging, today usually performed by multidetector computed tomography (MDCT). This work aimed to compare image quality and radiation dose of CBCT and MDCT. MATERIALS AND METHODS: Fifty-four CBCT-MDCT examination pairs, containing nine MDCTs acquired in parallel prospectively and 45 MDCTs matched in retrospect, were included in this study. Image quality was analyzed semi-objectively by measuring noise, contrast-to-noise ratio (CNR), and signal-to-noise ratios (SNR) and subjectively by performing image impression ratings. CT dose records were readout. RESULTS: Image noise was significantly lower in CBCT compared with MDCT, both semi-objectively and subjectively (both p < 0.001). CNR and SNRs were also in favor of CBCT, though CBCT examinations exhibited significantly more beam hardening artifacts that diminished the advantages of the superior semi-objective image quality. These artifacts were believed to occur more often in children due to numerous bone-cartilage transitions in open growth plates and may have led to a better subjective diagnostic certainty rating (p = 0.001). Motion artifacts were infrequently, but exclusively observed in CBCT. CT dose index (CTDIvol) was substantially lower in CBCT (p < 0.001). CONCLUSION: Dedicated extremity CBCT could be an alternative low-dose modality in the diagnostic pathway of pediatric fractures. At lower doses compared with MDCT and commonly affected by beam hardening artifacts, semi-objective CBCT image quality parameters were generally better than in MDCT.


Assuntos
Tomografia Computadorizada Multidetectores , Tomografia Computadorizada de Feixe Cônico Espiral , Criança , Tomografia Computadorizada de Feixe Cônico , Extremidades , Humanos , Imagens de Fantasmas , Doses de Radiação
20.
J Vis Exp ; (157)2020 03 12.
Artigo em Inglês | MEDLINE | ID: mdl-32225145

RESUMO

Pneumothorax (PTX) represents accumulation of the air in the pleural space. A large or tension pneumothorax can collapse the lung and cause hemodynamic compromise, a life-threatening disorder. Traditionally, neonatal pneumothorax diagnosis has been based on clinical images, auscultation, transillumination, and chest X-ray findings. This approach may potentially lead to a delay in both diagnosis and treatment. The use of lung US in diagnosis of PTX together with US-guided thoracentesis results in earlier and more precise management. The recommendations presented in this publication are aimed at improving the application of lung US in guiding neonatal PTX diagnosis and management.


Assuntos
Pneumotórax/diagnóstico por imagem , Pneumotórax/cirurgia , Toracentese/métodos , Ultrassonografia/métodos , Consenso , Feminino , Humanos , Recém-Nascido , Masculino
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...