Pediatric radiology
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Pediatric radiology · Mar 2005
Long-term follow-up of pediatric sickle cell disease patients with abnormal high velocities on transcranial Doppler.
Cerebral arteriopathy can be detected in children with sickle cell disease (SCD) by transcranial Doppler (TCD). Abnormally high velocities are predictive of high stroke risk, which can be reduced by transfusion therapy. We report the results of the screening of 291 SCD children followed in our center, including the clinical and imaging follow-up of 35 children with abnormal TCDs who were placed on transfusion therapy. ⋯ Six other transplanted patients remain transfusion-free. Abnormal TCD velocities detect a high-risk group, justifying the research for suitable transplant donors. Multicenter studies comparing HU therapy to long-term transfusion might help identify which patients can avoid transfusion and its complications while avoiding vasculopathy.
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Pediatric radiology · Mar 2005
ReviewScreening children for sickle cell vasculopathy: guidelines for transcranial Doppler evaluation.
Cerebral infarction is a major cause of morbidity and mortality in children with sickle cell disease. Prevention of primary stroke might be feasible with a way to identify children at greatest risk. ⋯ The protocol for the stroke prevention trial in sickle cell anemia (STOP), including data acquisition and interpretation, is reviewed. Providing TCD to sickle cell patients can be a valuable service that results in a significant decrease in first stroke rates.
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Pediatric radiology · Mar 2005
Clinical and sonographic criteria of acute scrotum in children: a retrospective study of 172 boys.
Diagnosis of testicular torsion in children is challenging, as clinical presentation and findings may overlap with other diagnoses. ⋯ We suggest that all children with acute scrotal pain and a clinical score of 3 should undergo testicular exploration, and children with a lower probability of testicular torsion (score 1 or 2) should first undergo diagnostic ultrasound. Because the presence of testicular flow does not exclude torsion, the spermatic cord should be meticulously evaluated in all children with acute scrotum and normal or increased testicular blood flow.