Pediatric radiology
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Congenital ocular motor apraxia (COMA) occasionally shares with Joubert syndrome (JS) and related disorders (JSRDs) a peculiar malformation, the 'molar tooth sign' (MTS). In JSRDs, the absence of superior cerebellar peduncles (SCP) decussation is reported. ⋯ MTS can be present in both COMA and JSRD but the underlying anatomy depicted by fibre tracking is distinct. The main difference is the integrity of the VTD in COMA.
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Pediatric radiology · Sep 2010
MR imaging of term infants with hypoxic-ischaemic encephalopathy as a predictor of neurodevelopmental outcome and late MRI appearances.
Morbidity attributable to hypoxic-ischaemic injury (HIE) in the perinatal period remains problematic, and timely and accurate assessment of the degree of injury is required for clinical management and prognosis. Conventional MR sequences typically appear normal in the first 48 h post HIE. While diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps register the injury earlier, perhaps within the first 24 h, it has been suggested that there may be a propensity at that early stage to underestimate the lesion severity or extent. ⋯ While early MRI performed better than cranial US, the sonography findings were useful. The pattern of ischaemia on early MRI was a good predictor of prognosis. All infants with watershed or atypical patterns had a favourable outcome. The majority of infants with central patterns of ischaemia had an unfavourable outcome and all infants with a diffuse pattern had an unfavourable outcome. DWI was predictive of outcome group, as were early T1- and T2-W sequences and cranial US.
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Pediatric radiology · Aug 2010
Association between linear skull fractures and intracranial hemorrhage in children with minor head trauma.
To determine whether skull fractures can be used to associate intracranial hemorrhage with minor head trauma (MHT). ⋯ The presence of a linear skull fracture is an independent risk factor for intracranial hemorrhage. However, all the intracranial hemorrhages associated with the skull fractures were small and did not require any neurosurgical interventions.
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Pediatric radiology · Jul 2010
Randomized Controlled TrialIntranasal fentanyl versus placebo for pain in children during catheterization for voiding cystourethrography.
Voiding cystourethrogram (VCUG) is a common procedure at pediatric tertiary care centres that can be painful as it involves a urinary catheter. Currently there are no widely utilized protocols for non-topical medications to decrease pain that children feel during catheterization. ⋯ Although we were unable to show a statistically significant difference between our study and control groups, we believe that this may be due to technique (positioning, delivery device) and timing of administration of IN fentanyl as well as multi-factorial causes of distress during VCUG. Future studies investigating alternative delivery techniques of IN fentanyl for analgesia during VCUG may yield more promising results.
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Pediatric radiology · Jul 2010
Pediatric chest CT after trauma: impact on surgical and clinical management.
Chest CT after pediatric trauma is frequently performed but its clinical impact, particularly with respect to surgical intervention, has not been adequately evaluated. ⋯ Most intrathoracic findings requiring surgical management in our population were identified in the lower chest and would be included in routine abdominopelvic CT exams; this information needs to be taken into consideration in the diagnostic algorithm of pediatric trauma patients.