Technical considerations of cardiac computed tomography in children.

Cardiac computed tomography angiography (CTA) is a valuable tool in the assessment of congenital and acquired cardiac disease in children. The goal of cardiac CTA is to produce images that are free of motion and provide sufficient characterization of the anatomy in question. Given the complexity of pediatric patient characteristics, including patient size, heart rate, breath-holding capability, and variant anatomy, cardiac CTA technique must be individualized to the patient as well as the indication to answer the clinical question while also minimizing radiation exposure.

Workflow Interruptions and Effect on Study Interpretation Efficiency.

Background: Interruptions have been shown to adversely impact efficiency, accuracy, and patient safety.

Objective: To analyze the frequency and types of interruptions and effect on report interpretation efficiency.

Materials And Methods: A business process improvement team was consulted to make detailed recordings of the activities of the radiologists.

Stroke in Middle Eastern children with cancer: prevalence and risk factors.

Objective: To determine the prevalence and to characterize the different types of strokes in children with cancer at the Children's Cancer Center of Lebanon (CCCL), in addition to assess the factors and clinical findings leading to stroke in children.

Methods: We retrospectively reviewed the medical records and brain images (MRIs and CTs) of children admitted to the CCCL and diagnosed with cancer between years 2008 and 2017. Brain images were reviewed for the strokes' onset, size, location, possible origin, its recurrence and type: intracranial hemorrhage (ICH), acute arterial ischemic stroke, and cerebral sinus venous thrombosis (CSVT) with and without venous infarct.

What provokes a disappearing arachnoid cyst? - Case study and literature review.

Objective: Intracranial Arachnoid cysts (AC) are stable cerebral spinal fluid (CSF)-filled sacs that can rarely undergo progressive shrinkage or disappearance throughout life. In this manuscript, we present a case of post-traumatic complete resolution of an AC, review the possible triggers of this phenomenon, and discuss the pathophysiological mechanisms behind them.

Methods: After presenting our case, we performed a literature review using the PubMed Database of all the reported cases of AC reduction or resolution (last updated in February 2021).

Acute soft head syndrome in a sickle cell disease patient.

Acute soft head syndrome is an extremely rare complication in children with sickle cell anemia. We present a 16-year old male patient known to have sickle cell anemia who presented to our emergency department with low grade fever, headache, skull pain and swelling. Magnetic Resonance of the brain was done demonstrating subgaleal collections overlying calvarial signal abnormalities.

Pituitary incidentalomas in paediatric population: Incidence and characteristics.

Objective: To determine the incidence of pituitary incidentalomas in the paediatric population and among its different age subgroups as well as to identify the characteristics of these lesions. Additionally, we aim to give a perspective on the management and follow-up of these patients.

Design And Patients: We retrospectively studied MRI of children aged 18 years or below who underwent MRI with sellar region within their field of view between January 2010 and December 2018.

Imaging Acute Non-Traumatic Abdominal Pathologies in Pediatric Patients: A Pictorial Review.

The dilemma of acute non-traumatic abdominal pathologies in the pediatric population depends on the age of the patients and symptoms. Surgical etiologies in patients younger than 2 years of age include intussusception, pyloric stenosis, malrotation and midgut volvulus. In older patients, considerations become closer to differential etiologies in adults including acute appendicitis.

Practice patterns in ordering a voiding cystourethrogram for pediatric patients among different specialties in a Middle Eastern tertiary care center.

Introduction: Voiding cystourethrogram (VCUG) is a very popular test performed to evaluate genitourinary tract anomalies. Nevertheless, this test can be overused and can lead to unnecessary patient discomfort, radiation exposure, and cost. We sought to study the practice patterns in ordering a VCUG in a Middle Eastern tertiary care center.

A rare case of pelvic bone duplication.

Iliac bone malformations are rare and result from early disturbance of the genetic and epigenetic processes that come together to form the pelvic girdle. We report the case of a 5-month-old boy found to have a duplication of the ilium and describe the likely causes of this very rare malformation.

Comparison of two single-breath-held 3-D acquisitions with multi-breath-held 2-D cine steady-state free precession MRI acquisition in children with single ventricles.

Background: Breath-held two-dimensional balanced steady--state free precession cine acquisition (2-D breath-held SSFP), accelerated with parallel imaging, is the method of choice for evaluating ventricular function due to its superior blood-to-myocardial contrast, edge definition and high intrinsic signal-to-noise ratio throughout the cardiac cycle.

Objective: The purpose of this study is to qualitatively and quantitatively compare the two different single-breath-hold 3-D cine SSFP acquisitions using 1) multidirectional sensitivity encoding (SENSE) acceleration factors (3-D multiple SENSE SSFP), and 2) k-t broad-use linear acceleration speed-up technique (3-D k-t SSFP) with the conventional 2-D breath-held SSFP in non-sedated asymptomatic volunteers and children with single ventricle congenital heart disease.

Materials And Methods: Our prospective study was performed on 30 non-sedated subjects (9 healthy volunteers and 21 functional single ventricle patients), ages 12.

CT angiography of neonates and infants: comparison of radiation dose and image quality of target mode prospectively ECG-gated 320-MDCT and ungated helical 64-MDCT.

OBJECTIVE. The purpose of this study was to evaluate the radiation dose and image quality of target mode prospectively ECG-gated volumetric CT angiography (CTA) performed with a 320-MDCT scanner compared with the radiation dose and image quality of ungated helical CTA performed with a 64-MDCT scanner. MATERIALS AND METHODS.

Clinical validation of free breathing respiratory triggered retrospectively cardiac gated cine balanced steady-state free precession cardiovascular magnetic resonance in sedated children.

Background: Cine balanced steady-state free precession (SSFP), the preferred sequence for ventricular function, demands uninterrupted radio frequency (RF) excitation to maintain the steady-state during suspended respiration. This is difficult to accomplish in sedated children. In this work, we validate a respiratory triggered (RT) SSFP sequence that drives the magnetization to steady-state before commencing retrospectively cardiac gated cine acquisition in a sedated pediatric population.

MR imaging of children and young adults with classic findings of osteonecrosis on unenhanced MR images: do contrast-enhanced sequences help?

Background: The added value of routine contrast-enhanced MR imaging in children with classic findings of osteonecrosis on unenhanced MR images has not been determined.

Objective: Our purpose was to determine the added value of routine contrast-enhanced MR sequences for identifying complications of osteonecrosis.

Material And Methods: Sixty-four patients who underwent 139 contrast-enhanced MR examinations were retrospectively identified.

Multimodality imaging of developmental dysplasia of the hip.

Developmental dysplasia of the hip (DDH) is a spectrum disorder resulting in underdevelopment of the acetabulum. Radiographs and ultrasound are the mainstays for screening, with CT and MRI playing important roles in assessing outcome after treatment. The purpose of this article is to illustrate the use of multimodality imaging in the diagnosis and management of DDH.

Unusual arterial pattern of the gastrointestinal tract: inferior mesenteric artery arising from the iliac artery and corkscrew external iliac.

Anatomical variations of the digestive system arteries are important due to their clinical significance. However, anomalies in the inferior mesenteric artery (IMA) are the least common compared with the celiac trunk and superior mesenteric artery. This report describes the case of a 67-year-old man with an extremely rare variant in which the IMA arises from the left common iliac artery, and the ipsilateral external iliac artery has a corkscrew pattern.

Acute NSAID-related transmural duodenitis and extensive duodenal ulceration.

Background: A 40-year-old previously healthy white man presented to the emergency department at American University of Beirut Medical Center, Beirut, Lebanon, with severe upper abdominal pain of 36-hour duration. The pain started a few hours after the intake of a single tablet of tiaprofenic acid and became more intense after the intake of another tablet 24 hours later. He had no other symptoms.