• 제목/요약/키워드: Pediatric imaging

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Catastrophic Intramedullary Abscess Caused by a Missed Congenital Dermal Sinus

  • Dho, Yun-Sik;Kim, Seung-Ki;Wang, Kyu-Chang;Phi, Ji Hoon
    • Journal of Korean Neurosurgical Society
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    • v.57 no.3
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    • pp.225-228
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    • 2015
  • Congenital dermal sinus (CDS) is a type of occult spinal dysraphism characterized by a midline skin dimple. A 12-month-old girl presented with fever and ascending quadriparesis. She had a midline skin dimple in the upper sacral area that had been discovered in her neonatal period. Imaging studies revealed a holocord intramedullary abscess and CDS. Overlooking CDS or misdiagnosing it as benign sacrococcygeal dimple may lead to catastrophic infection and cause serious neurological deficits. Therefore, further imaging work-up or consultation with a pediatric neurosurgeon is recommended following discovery of any atypical-looking dimples in the midline.

Normal Development and Variants in Pediatric Bone (소아 뼈의 정상 발달과 변이)

  • Hee Jung Kim;Sun Kyoung You
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.488-504
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    • 2024
  • Normal variants refer to imaging findings that are generally asymptomatic and discovered incidentally, yet may exhibit findings similar to those observed in pathological conditions. Recognizing normal variants in pediatric bone requires comprehension of the developmental process of long tubular bones and secondary ossification centers. Familiarity with various radiological findings of normal variants can prevent unnecessary follow-up imaging tests, as well as incorrect diagnosis and treatment. In this review, we will discuss the characteristic imaging findings of normal variants seen in growing pediatric bones, along with strategies for distinguishing them from pathologic conditions.

Adrenal Hemorrhage in a Neonate (신생아의 부신 출혈)

  • Cho, Kyung-Ah;Yoo, Soo-Young
    • Advances in pediatric surgery
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    • v.1 no.2
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    • pp.204-208
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    • 1995
  • Neonatal adrenal hemorrhage is frequently associated with birth trauma or perinatal hypoxia. Hemorrhagic necrosis of the adrenal glands is often found at autopsy and many small lesions are usually asymptomatic. A palpable abdominal mass and jaundice are the usual presenting signs. Ultrasound is very useful in the diagnosis of this lesion; however, if the mass has mixed echoic pattern, magnetic resonance imaging (MRl) is helpful for the differential diagnosis from neuroblastoma. We present the case of a female newborn who was found to have a abdominal mass on physical examination. The patient showed anemia and hyperbilirubinemia. An ultrasonogram disclosed a $3.8{\times}3.0$ cm suprarenal mass with mixed echoic pattern. The mass was initially suspected to be neuroblastoma. An abdominal computed tomogram was not able to differentiate the mass. Magnetic resonance imaging revealed markedly increased signal intensity on T1 and T2-weighted sequences. This finding was consistent with adrenal hemorrhage. Serial sonogram demonstrated the mass that resolved completely by 12 weeks of age.

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Noninvasive diagnosis of pediatric nonalcoholic fatty liver disease

  • Yang, Hye Ran
    • Clinical and Experimental Pediatrics
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    • v.56 no.2
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    • pp.45-51
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    • 2013
  • Because nonalcoholic steatohepatitis can progress towards cirrhosis even in children, early detection of hepatic fibrosis and accurate diagnosis of nonalcoholic fatty liver disease (NAFLD) are important. Although liver biopsy is regarded as the gold standard of diagnosis, its clinical application is somewhat limited in children due to its invasiveness. Noninvasive diagnostic methods, including imaging studies, biomarkers of inflammation, oxidative stress, hepatic apoptosis, hepatic fibrosis, and noninvasive hepatic fibrosis scores have recently been developed for diagnosing the spectrum of NAFLD, particularly the severity of hepatic fibrosis. Although data and validation are still lacking for these noninvasive modalities in the pediatric population, these methods may be applicable for pediatric NAFLD. Therefore, noninvasive imaging studies, biomarkers, and hepatic fibrosis scoring systems may be useful in the detection of hepatic steatosis and the prediction of hepatic fibrosis, even in children with NAFLD.

Accuracy and Precision of Three-dimensional Imaging System of Children's Facial Soft Tissue (소아 얼굴 연조직의 3차원 입체영상의 정확성 및 재현성 평가)

  • Choi, Kyunghwa;Kim, Misun;Lee, Koeun;Nam, Okhyung;Lee, Hyo-seol;Choi, Sungchul;Kim, Kwangchul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.1
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    • pp.17-24
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    • 2020
  • The purpose of this study was to evaluate the accuracy and precision of the three-dimensional (3D) imaging system of children's facial soft tissue by comparing linear measurements. The subjects of the study were 15 children between the ages of 7 and 12. Twenty-three landmarks were pointed on the face of each subject and 16 linear measurements were directly obtained 2 times using an electronic caliper. Two sets of 3D facial images were made by the 3D scanner. The same 16 measurements were obtained on each 3D image. In the accuracy test, the total average difference was 0.9 mm. The precision of 3D photogrammetry was almost equivalent to that of direct measurement. Thus, 3D photogrammetry by the 3D scanner in children had sufficient accuracy and precision to be used in clinical setting. However, the 3D imaging system requires the subject's compliance for exact images. If the clinicians provide specific instructions to children while obtaining 3D images, the 3D device is useful for investigating children's facial growth and development. Also the device can be a valuable tool for evaluating the results of orthodontic and orthopedic treatments.

Photon-Counting Detector CT: Key Points Radiologists Should Know

  • Andrea Esquivel;Andrea Ferrero;Achille Mileto;Francis Baffour;Kelly Horst;Prabhakar Shantha Rajiah;Akitoshi Inoue;Shuai Leng;Cynthia McCollough;Joel G. Fletcher
    • Korean Journal of Radiology
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    • v.23 no.9
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    • pp.854-865
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    • 2022
  • Photon-counting detector (PCD) CT is a new CT technology utilizing a direct conversion X-ray detector, where incident X-ray photon energies are directly recorded as electronical signals. The design of the photon-counting detector itself facilitates improvements in spatial resolution (via smaller detector pixel design) and iodine signal (via count weighting) while still permitting multi-energy imaging. PCD-CT can eliminate electronic noise and reduce artifacts due to the use of energy thresholds. Improved dose efficiency is important for low dose CT and pediatric imaging. The ultra-high spatial resolution of PCD-CT design permits lower dose scanning for all body regions and is particularly helpful in identifying important imaging findings in thoracic and musculoskeletal CT. Improved iodine signal may be helpful for low contrast tasks in abdominal imaging. Virtual monoenergetic images and material classification will assist with numerous diagnostic tasks in abdominal, musculoskeletal, and cardiovascular imaging. Dual-source PCD-CT permits multi-energy CT images of the heart and coronary arteries at high temporal resolution. In this special review article, we review the clinical benefits of this technology across a wide variety of radiological subspecialties.

Operative Management of Complicated Meckel's Diverticulum Laparotomy and versus Laparoscopic Assisted Surgery (소아 멕켈씨 게실 합병증에서 시행한 개복 수술과 복강경 보조 수술의 비교)

  • Lee, Yu-Ra;Cho, Min-Jeng;Kim, Tae-Hoon;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.17 no.1
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    • pp.45-50
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    • 2011
  • Meckel's diverticulum (MD) has various clinical presentations and due to the limitation of imaging studies, pre-operative diagnosis is a challenge in pediatric patients. Recently, laparoscopic exploration has been suggested as a favorable method for the diagnosis and treatment of complicated MD. We investigated the results of laparoscopic-assisted surgery compared with open technique. We retrospectively studied patients who underwent resection of complicated MD at our institute from 1997 to 2010 and compared 11 treated by laparoscopic-assisted diverticulectomy (LD) with 11 treated by open diverticulectomy (OD) for complicated MD. Operation time was not significantly different in the two groups. Hospital stay and time to diet were not significantly different. Two patients were re-admitted due to mechanical ileus in the LD group. None of patients in either group needed re-operation. Considering the possibility of false-positive results with imaging studies and the cosmetic benefit, laparoscopic-assisted surgery is a safe and effective treatment modality to diagnose and treat complicated Meckel's diverticulum.

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The study about usefulness of utilizing self-development jaw lift tool in pediatric Revers water's view (자체 개발한 하악거상 기구를 활용한 소아 REVERS WATER'S View의 유용성)

  • Kim, Kang-Hwan;Son, Soon-Lyong;Kim, Kwang-Soo;Hong, Sun-Suk;Lee, Kwan-Sup
    • Korean Journal of Digital Imaging in Medicine
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    • v.15 no.2
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    • pp.1-6
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    • 2013
  • This study is to provide clinical data when reverse-water's-view was carried out about pediatric who did not communicate by applying self-development jaw lift tool. This study were conducted in a subject of 23 children who examined revers-water's-view from 2013 July 6 to 2013 August 5 at our hospital. Two group time which were carried out revers-water's with tool and without tool were measured. also, Image of two group were evaluated. Evaluation data obtained by measuring the average difference were analyzed by independent-t-test. After apply self-development-jaw-lift-tool, time was reduced by 35.2%(36.6sec). the results indicated significant differences(p< .05). Image evaluation was increase 43.5%(1.03point), It was statistically highly significant difference (p< .01). If apply self-development-jaw-lift-tool in pediatric revers-water's-view, operator can provide fast, convenience, high quality image to pediatric.

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Oribicularis Oris Muscle Defects in Philtral Deformities in the Repaired Cleft Lip (구순열 수술 후 인중의 변형과 구륜근 결손)

  • Kim, Suk-Wha;Jeong, Yeon-Woo;Cheon, Jung-Eun;Park, Chan-Young;Oh, Myung-June;Kim, Jung-Hong;Choi, Tae-Hyun
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.427-432
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    • 2010
  • Purpose: The purpose of this study is to estimate muscle defect by ultrasonography in the patients with secondary deformities of the lip. We investigated the association between the muscle defect in the repaired cleft lip and the philtral appearance not only at resting state but also maximal puckering. Methods: From December 2006 to November 2007, 52 children were evaluated after primary or secondary cheiloplasty. Digital photographs were taken both from the front and both three quarter views in repose and at maximal pucker. Video clips were also taken in repose and at maximal pucker. A panel of four, scored the philtral ridge and dimple seen on these photographs and videos by using two visual analog scales. Eminence of the philtral ridge was scored by a 5 point grading scale, from "conspicuous groove" to "normal philtral ridge" and the philtral dimple was scored by 3 point grading scale, from "no dimple" to "prominent dimple". Ultrasound images of the upper lip were made using a linear array transducer at the resting position of the lip and evaluated by a single radiologist. Results: The philtral ridge eminence scored $2.79{\pm}0.54$ and $1.40{\pm}0.53$ at resting and maximal pucker, correlating with "flat" and "conspicous groove". The philtral dimpling scored $1.44{\pm}0.53$ and $2.27{\pm}0.66$ at resting and maximal pucker, correlating with "no dimple" and "slight dimple". Ultrasound imaging showed the average muscle dehiscence to be $3.78{\pm}2.14$ mm at resting position. Correlation between the muscle defect in ultrasound imaging and philtral ridge eminence at rest was statistically significant (p<0.050), but was not significant (p=0.756) at maximal pucker using Spearman's rank correlation. Correlation between the muscle defect in ultrasound imaging and philtral dimpling was not statistically significant both at rest (p=0.920) and at maximal pucker (p=0.815) using Spearman's rank correlation. Conclusion: Quantitative assessment of the muscle defect using ultrasonography correlates with the static philtral appearance, but does not correlate with the dynamic appearance. Also, the size of the muscle defect does not show any correlation with the philtral dimpling. Our findings reveal that ultrasound imaging partially reflect static appearance of philtrum but cannot reflect dynamic appearance and suggest the need for further research to evaluate dynamic appearance.