Pediatric radiology
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Paediatric palliative care is a distinct subspecialty that offers treatment to children with many types of illness, including oncological, neurological and respiratory problems. Paediatric interventional radiologists can make a useful contribution to symptom management as part of a multidisciplinary team. Interventions for pain management include local ablation or other treatment of painful lesions, image-guided nerve blocks and the insertion of devices for the delivery of analgesic drugs. Various techniques are also available for the management of ascites, pleural effusions and other symptomatic complications of the underlying disease process.
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Pediatric radiology · Dec 2013
Multiplanar CT assessment of femoral head displacement in slipped capital femoral epiphysis.
With recent changing approaches to the management of slipped capital femoral epiphysis (SCFE), the accurate radiographic assessment of maximum extent of displacement is crucial for planning surgical treatment. ⋯ Axial-oblique and sagittal planes best represent the maximum SCFE displacement while biplanar radiograph may underestimate the extent of the displacement, thereby potentially altering the management between in situ pinning and capital realignment.
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Pediatric radiology · Dec 2013
Case ReportsTwiddler syndrome with a twist: a cause of vagal nerve stimulator lead fracture.
Twiddler syndrome is uncommon in children and most commonly described as causing lead retraction with implanted cardiac pacemakers and defibrillators. We report an uncommon case of a child repeatedly "twiddling" a vagal nerve stimulator to the point of lead fracture. The findings of Twiddler syndrome illustrated here apply to all implanted devices and show the complication of lead fracture in addition to the more commonly reported complication of lead retraction. This case highlights the need to be aware of the radiographic findings of this phenomenon in children with implanted vagal nerve stimulators due to the perceived increased risk of "twiddling" in pediatric and developmentally delayed patients.
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We analyze the potential use of ultrasound in the study of the thorax in children. The physical limitations imposed on sonography by the ventilated lung and thoracic cage are well known. ⋯ These specialists take information from physical acoustic phenomena that is not directly convertible into images of the human body, starting with the interpretation and handling of artifacts. We give a critical assessment from a radiologic viewpoint that is both necessary and important.
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Pediatric radiology · Nov 2013
Comparative StudyClinically useful dilution factors for iodine and gadolinium contrast material: an animal model of pediatric digital subtraction angiography using state-of-the-art flat-panel detectors.
Iodinated and gadolinium contrast agents pose some risk for certain pediatric patients, including allergic-like reactions, contrast-induced nephropathy (CIN) and nephrogenic systemic fibrosis (NSF). Digital flat-panel detectors enhance image quality during angiography and might allow use of more dilute contrast material to decrease risk of complications that might be dose-dependent, such as CIN and NSF. ⋯ Knowledge of the relationship between image quality and contrast material dilution might allow a decrease in overall contrast load while maintaining appropriate image quality when using digital flat-panel detectors.