Pediatric Radiology最新文献

Background: Neurogenic bladder is a frequent complication in newborns with myelomeningocele (MMC), increasing the risk of urinary dysfunction and renal injury. Although urodynamic studies are the standard for evaluation, their invasiveness limits their use in neonates and young infants. Dynamic ultrasound offers a potential non-invasive tool for assessing the morphology and function of the urinary tract in these patients.

Objective: To evaluate dynamic ultrasound findings in neonates and young infants with MMC compared to healthy controls.

Materials and methods: This cross-sectional study used dynamic ultrasound to examine the urinary tract characteristics of patients with MMC and controls. The parameters evaluated included bladder wall thickness, bladder capacity, post-void residual volume, detrusor activity, and signs of elevated intravesical pressure, such as urinary leakage, filling of pseudodiverticula, reduction in ureteral emptying, and enlargement of the pelvicalyceal system dimensions during detrusor contractions.

Results: Patients with MMC (n=41) had a mean age of 24.9±13.8 days old (56% males), while controls (n=45) had a mean age of 32.9±17.5 days old (73% males). Compared to healthy controls, MMC patients exhibited significantly higher post-void residual volume and bladder wall thickness, even after adjusting for body weight. Involuntary detrusor contractions were observed in 76% of MMC cases.

Conclusion: Newborns with MMC exhibited distinct bladder characteristics on dynamic ultrasound compared to healthy controls, suggesting potential usefulness of dynamic ultrasound for evaluating these patients. However, additional validation is needed because of the examiner-dependent nature of ultrasound, small sample size, and lack of comparison with urodynamic studies.

Artificial intelligence (AI) has potential to revolutionize radiology, yet current solutions and guidelines are predominantly focused on adult populations, often overlooking the specific requirements of children. This is important because children differ significantly from adults in terms of physiology, developmental stages, and clinical needs, necessitating tailored approaches for the safe and effective integration of AI tools. This multi-society position statement systematically addresses four critical pillars of AI adoption: (1) regulation and purchasing, (2) implementation and integration, (3) interpretation and post-market surveillance, and (4) education. We propose pediatric-specific safety ratings, inclusion of datasets from diverse pediatric populations, quantifiable transparency metrics, and explainability of models to mitigate biases and ensure AI systems are appropriate for use in children. Risk assessment, dataset diversity, transparency, and cybersecurity are important steps in regulation and purchasing. For successful implementation, a phased strategy is recommended, involving early pilot testing, stakeholder engagement, and comprehensive post-market surveillance with continuous monitoring of defined performance benchmarks. Clear protocols for managing discrepancies and adverse incident reporting are essential to maintain trust and safety. Moreover, we emphasize the need for foundational AI literacy courses for all healthcare professionals which include pediatric safety considerations, alongside specialized training for those directly involved in pediatric imaging. Public and patient engagement is crucial to foster understanding and acceptance of AI in pediatric radiology. Ultimately, we advocate for a child-centered framework for AI integration, ensuring that the distinct needs of children are prioritized and that their safety, accuracy, and overall well-being are safeguarded.

Palpable lymph nodes are among the most common indications for ultrasound evaluation in the pediatric population. Ultrasound provides valuable insight into nodal composition by assessing greyscale morphology, color Doppler vascularity, and vascular resistance, with emerging techniques such as elastography and contrast-enhanced ultrasound offering additional diagnostic potential. Although certain sonographic features may suggest a benign or malignant etiology, imaging overlap often exists posing diagnostic challenges. This review provides an overview of the sonographic appearance of the most common pediatric lymphadenopathies, including reactive hyperplasia, bacterial and viral lymphadenitis, necrotizing and granulomatous lymphadenitis, malignant and atypical entities. Characteristic and non-specific imaging features are discussed, along with practical approaches to interpretation and current strategies for diagnosis and management.

Background: Ultrasound-guided biopsies of the salivary glands in pediatric patients are uncommon and can target focal lesions or general parenchyma. Based on open surgical biopsy, 65% of focal lesions have been described as benign. Ultrasound-guided biopsy offers a less invasive initial diagnostic approach.

Objective: The aims of this study were to assess the diagnostic accuracy and describe indications for ultrasound-guided salivary gland core needle biopsy (CNB) and fine needle aspiration (FNA) in a pediatric cohort.

Materials and methods: Retrospective single-center study including children who underwent salivary gland biopsy at a tertiary care center from January 2018 to January 2025. Demographics, clinical information, imaging, lesion location, procedure details, adverse events, pathology, and clinical outcomes were reviewed. A descriptive statistical analysis was performed.

Results: The study included 31 children aged 5 months to 17-years-old. The parotid was targeted in 21/31 (68%) and the submandibular in 10/31 (32%). CNB was done in 19/31 patients, 11/31 had a CNB and FNA, and 1/31 FNA only. CNB was diagnostic in 29/30 and FNA in 8/12. When both techniques were used, pathological findings were the same in 7/11. The most common diagnosis was pleomorphic adenoma (n=6). All CNB in cases of malignancy (n=10) were diagnostic. The non-diagnostic case identified was a dermoid cyst in surgery. Nine patients had surgical resections, and the results were consistent with the ultrasound-guided biopsy. No adverse events were identified.

Conclusion: Ultrasound-guided CNB showed a high diagnostic performance, superior to FNA, in this salivary gland biopsies pediatric cohort.

We report a unique case of malignant transformation in a retinocytoma monitored using magnetic resonance imaging (MRI). This case is notable for a distinct drop in apparent diffusion coefficient (ADC) values that correlated with clinical transformation to retinoblastoma. This is the first report to highlight a change in ADC as a radiological marker of malignant conversion in retinocytoma. This finding suggests the potential role of ADC in prognostic assessment and risk stratification for patients with retinocytoma.