| 1. |
- Doria, Andrea S., et al.
(författare)
-
Quantitative versus semiquantitative MR imaging of cartilage in blood-induced arthritic ankles: preliminary findings
- 2014
-
Ingår i: Pediatric Radiology. - : Springer Science and Business Media LLC. - 1432-1998 .- 0301-0449. ; 44:5, s. 576-586
-
Tidskriftsartikel (refereegranskat)abstract
- Recent advances in hemophilia prophylaxis have raised the need for accurate noninvasive methods for assessment of early cartilage damage in maturing joints to guide initiation of prophylaxis. Such methods can either be semiquantitative or quantitative. Whereas semiquantitative scores are less time-consuming to be performed than quantitative methods, they are prone to subjective interpretation. To test the feasibility of a manual segmentation and a quantitative methodology for cross-sectional evaluation of articular cartilage status in growing ankles of children with blood-induced arthritis, as compared with a semiquantitative scoring system and clinical-radiographic constructs. Twelve boys, 11 with hemophilia (A, n = 9; B, n = 2) and 1 with von Willebrand disease (median age: 13; range: 6-17), underwent physical examination and MRI at 1.5 T. Two radiologists semiquantitatively scored the MRIs for cartilage pathology (surface erosions, cartilage loss) with blinding to clinical information. An experienced operator applied a validated quantitative 3-D MRI method to determine the percentage area of denuded bone (dAB) and the cartilage thickness (ThCtAB) in the joints' MRIs. Quantitative and semiquantitative MRI methods and clinical-radiographic constructs (Hemophilia Joint Health Score [HJHS], Pettersson radiograph scores) were compared. Moderate correlations were noted between erosions and dAB (r = 0.62, P = 0.03) in the talus but not in the distal tibia (P > 0.05). Whereas substantial to high correlations (r range: 0.70-0.94, P < 0.05) were observed between erosions, cartilage loss, HJHS and Pettersson scores both at the distal tibia and talus levels, moderate/borderline substantial (r range: 0.55-0.61, P < 0.05) correlations were noted between dAB/ThCtAB and clinical-radiographic constructs. Whereas the semiquantitative method of assessing cartilage status is closely associated with clinical-radiographic scores in cross-sectional studies of blood-induced arthropathy, quantitative measures provide independent information and are therefore less applicable for that research design.
|
|
| 2. |
- Frasier, Lori D., et al.
(författare)
-
International issues in abusive head trauma
- 2014
-
Ingår i: Pediatric Radiology. - : Springer Science and Business Media LLC. - 0301-0449 .- 1432-1998. ; 44:S4, s. 647-653
-
Tidskriftsartikel (refereegranskat)abstract
- In the decades since Dr. John Caffey described a series of children with chronic subdural hematoma and long bone fractures, there has been a substantial increase in the medical recognition of various forms child abuse. In the United States, the term shaken baby syndrome was coined to explain a constellation of injuries assumed to be the result of violent shaking of infants. After improved understanding of the variety of mechanisms that occur when children are abused, abusive head trauma (AHT) has become the recommended terminology. AHT is a more comprehensive term that reflects the brain injuries that children suffer as the result of abuse. AHT continues to include shaking as a mechanism of injury as well as shaking with impact, impact alone, crushing injuries or combinations of several mechanisms. The medical community in the United States has led the way in developing new terminology and research to describe this unique and devastating form of abuse. The globalization of medicine and rapid information transfer has resulted in AHT becoming well-recognized internationally as a form of serious and fatal child abuse. This paper will review the historical basis in the United States for the diagnosis of AHT. We will also review some of the current international issue in epidemiology, diagnosis, legal processes and outcomes in selected countries/regions where child abuse physicians are actively involved in the evaluation of AHT.
|
|
| 3. |
- Precht, Helle, et al.
(författare)
-
Digital radiography: optimization of image quality and dose using multi-frequency software
- 2012
-
Ingår i: Pediatric Radiology. - : Springer Science and Business Media LLC. - 1432-1998 .- 0301-0449. ; 42:9, s. 1112-1118
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: New developments in processing of digital radiographs (DR), including multi-frequency processing (MFP), allow optimization of image quality and radiation dose. This is particularly promising in children as they are believed to be more sensitive to ionizing radiation than adults. OBJECTIVE: To examine whether the use of MFP software reduces the radiation dose without compromising quality at DR of the femur in 5-year-old-equivalent anthropomorphic and technical phantoms. MATERIALS AND METHODS: A total of 110 images of an anthropomorphic phantom were imaged on a DR system (Canon DR with CXDI-50 C detector and MLT[S] software) and analyzed by three pediatric radiologists using Visual Grading Analysis. In addition, 3,500 images taken of a technical contrast-detail phantom (CDRAD 2.0) provide an objective image-quality assessment. RESULTS: Optimal image-quality was maintained at a dose reduction of 61% with MLT(S) optimized images. Even for images of diagnostic quality, MLT(S) provided a dose reduction of 88% as compared to the reference image. Software impact on image quality was found significant for dose (mAs), dynamic range dark region and frequency band. CONCLUSION: By optimizing image processing parameters, a significant dose reduction is possible without significant loss of image quality.
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
- Vult von Steyern, Kristina, et al.
(författare)
-
Visualisation of the rectoanal inhibitory reflex with a modified contrast enema in children with suspected Hirschsprung disease.
- 2013
-
Ingår i: Pediatric Radiology. - : Springer Science and Business Media LLC. - 1432-1998 .- 0301-0449. ; 43:8, s. 950-957
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patients with Hirschsprung disease lack the normal rectoanal inhibitory reflex, which can be studied with anorectal manometry or US. OBJECTIVE: To see whether the rectoanal inhibitory reflex could be visualised with a modified contrast enema, thereby increasing the diagnostic accuracy of the contrast enema and reducing the number of rectal biopsies. MATERIALS AND METHODS: Fifty-nine boys and 42 girls (median age, 12 months) with suspected Hirschsprung disease were examined with a modified contrast enema, supplemented with two injections of cold, water-soluble contrast medium, to induce the reflex. Two paediatric radiologists evaluated the anonymised examinations in consensus. The contrast enema findings were correlated with the results of rectal biopsy or clinical follow-up. RESULTS: Five boys and one girl (median age, 7.5 days) were diagnosed with Hirschsprung disease. The negative predictive value of the rectoanal inhibitory reflex was 100%. A contrast enema with signs of Hirschsprung disease in combination with an absent rectoanal inhibitory reflex had the specificity of 98% and sensitivity of 100% for Hirschsprung disease. CONCLUSION: The modified contrast enema improves the radiological diagnosis of Hirschsprung disease. By demonstrating the rectoanal inhibitory reflex in children without Hirschsprung disease, we can reduce the proportion of unnecessary rectal biopsies.
|
|
| 7. |
|
|
| 8. |
- Sundbom, Magnus, et al.
(författare)
-
Trends in use of upper abdominal procedures in sweden 1998-2011 : a population-based study
- 2014
-
Ingår i: World Journal of Surgery. - : Springer Science and Business Media LLC. - 0364-2313 .- 1432-2323. ; 38:1, s. 33-39
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Surgical care is constantly developing as demographic shifts occur and indications change when new techniques are introduced. The purpose of this study was to describe trends of in-hospital upper abdominal procedures in Sweden during 1998-2011.METHODS:Data were collected from the National Patient Register containing annual number of procedures and procedures per 100,000 inhabitants. Comparisons were made between the first 3 years (1998-2000) and last 3 years (2009-2011). High-volume procedures and resectional surgery were studied in particular.RESULTS:During the study period, a total of 435,394 upper abdominal procedures were performed in 318,991 individuals. The number of procedures increased 44.9 % between the early and late period. Bariatric surgery increased almost sixfold, with a substantial increase in laparoscopic gastric bypass to 58.2/100,000/year. The most common operation was cholecystectomy, 144.9/100,000/year. Liver resections tripled and, in total, major resectional surgery, performed on the esophagus, stomach, liver, and pancreas, increased by 36.3 %. Per 100,000 adult inhabitants and year, resections of the esophagus was performed in 2.3 patients, stomach in 5.9, liver in 9.0, and pancreas in 5.7, in late time period. An increase in all types of endoscopic work was observed.CONCLUSIONS:In total, the number of upper abdominal procedures performed per inhabitant increased. Laparoscopic gastric bypass increased substantially and became the second most common procedure after laparoscopic cholecystectomy. An increase in resectional surgery was observed.
|
|
| 9. |
|
|
| 10. |
- Balleyguier, Corinne, et al.
(författare)
-
Staging of uterine cervical cancer with MRI : guidelines of the European Society of Urogenital Radiology
- 2011
-
Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 21:5, s. 1102-1110
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To design clear guidelines for the staging and follow-up of patients with uterine cervical cancer, and to provide the radiologist with a framework for use in multidisciplinary conferences. Methods: Guidelines for uterine cervical cancer staging and follow-up were defined by the female imaging subcommittee of the ESUR (European Society of Urogenital Radiology) based on the expert consensus of imaging protocols of 11 leading institutions and a critical review of the literature. Results: The results indicated that high field Magnetic Resonance Imaging (MRI) should include at least two T2-weighted sequences in sagittal, axial oblique or coronal oblique orientation (short and long axis of the uterine cervix) of the pelvic content. Axial T1-weighted sequence is useful to detect suspicious pelvic and abdominal lymph nodes, and images from symphysis to the left renal vein are required. The intravenous administration of Gadolinium-chelates is optional but is often required for small lesions (< 2 cm) and for follow-up after treatment. Diffusion-weighted sequences are optional but are recommended to help evaluate lymph nodes and to detect a residual lesion after chemoradiotherapy. Conclusions: Expert consensus and literature review lead to an optimized MRI protocol to stage uterine cervical cancer. MRI is the imaging modality of choice for preoperative staging and follow-up in patients with uterine cervical cancer.
|
|
