Pediatric radiology
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Pediatric radiology · Feb 2019
Comparative StudyContrast-enhanced MRI compared to direct joint visualization at arthroscopy in pediatric patients with suspected temporomandibular joint synovitis.
Contrast-enhanced magnetic resonance imaging (MRI) has become the gold standard when assessing the temporomandibular joint (TMJ) in children. To our knowledge, no previous pediatric study has compared findings of TMJ MRI with direct visualization of the joint using arthroscopy. ⋯ Joint space width and subjective synovitis on TMJ MRI correlate with arthroscopic findings of chronic synovitis. Increased joint space width may be useful when evaluating the TMJ with less time-intensive modalities, such as ultrasound. However, MRI findings did not correlate well with findings of acute inflammation on arthroscopy.
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Pediatric radiology · Feb 2019
Susceptibility-weighted imaging of retinal hemorrhages in abusive head trauma.
Retinal hemorrhages are one of the most important supportive evidences for abusive head trauma (AHT). Susceptibility-weighted imaging (SWI) is highly suited to identify various forms of intracranial hemorrhage in AHT. However its utility in imaging retinal hemorrhage is not well established. ⋯ SWI is moderately sensitive and highly specific for identifying retinal hemorrhage in AHT. Further studies are needed to identify steps to improve the efficiency of SWI in detecting retinal hemorrhage.
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Pediatric radiology · Feb 2019
MR angiography and 2-D phase-contrast imaging for evaluation of meso-rex bypass function.
The meso-Rex bypass restores blood flow to the liver in patients with extrahepatic portal vein thrombosis. Stenosis occurs in some cases, causing the reappearance of portal hypertension. Complications such as thrombocytopenia present on a spectrum and there are currently no guidelines regarding a threshold for endovascular intervention. While Doppler ultrasound (US) is common for routine evaluation, magnetic resonance (MR) angiography with two-dimensional phase-contrast MRI (2-D PC-MRI) may improve the assessment of meso-Rex bypass function. ⋯ Two-dimensional PC-MRI can quantify meso-Rex bypass blood flow relative to total systemic flow. In a cohort of 25 children, bypass flow correlated to minimum bypass area and platelet count. Two-dimensional PC-MRI may be valuable alongside MR angiography to assess bypass integrity.