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1.
O Bayrak I Seckiner S Erturhan I Duzgun F Yagci 《Pediatric surgery international》2012,28(10):1025-1029
Purpose
The aim of this study is to compare the efficiency and reliability of percutaneous nephrolithotomy (PCNL) and open surgery for pediatric urinary stone disease.Methods
The retrospective analysis included 116 patients (69 PCNL, 47 open stone surgery). The stone surface area, stone-free rates, hospitalization time, blood transfusion rates, and the D-J implantation rates of patients in each group in whom PCNL and open surgery were performed were analyzed.Results
The average age of the patients in the PCNL group was 10.01?±?0.51?years, and in the open surgery group 8.55?±?0.68?years. No statistically significant difference was observed between the two groups in average age, stone surface area or stone-free rates. However, hospitalization time (PCNL 2.31?±?0.46?days, open surgery 3.36?±?0.64?days), blood transfusion rate (PCNL 10.1?%, open surgery 42.5?%) and D-J catheter implantation rate (PNL 7.24?%, open surgery 42.5?%) of patients who underwent PCNL were determined to be statistically low.Conclusion
In light of the results, it is concluded that PCNL supersedes open surgery in terms of the use of advanced instruments and technological developments for modern pediatric surgery. 相似文献2.
Cece H Yetisgin A Abuhandan M Yildiz S Calik M Karakas O Karakas E Iscan A 《Pediatric radiology》2012,42(6):679-684
Background
Respiratory and cardiovascular diseases are the most common causes of death in children with cerebral palsy.Objective
To evaluate sonographic carotid intima-media thickness, an early marker of atherosclerosis, in children with cerebral palsy and in healthy controls.Materials and methods
One hundred children with cerebral palsy (65 boys), mean age 6.2 (SD, 2.1) years, and 35 age-matched and sex-matched healthy controls were included. Common carotid artery intima-media thickness was measured sonographically. Differences between patients and controls were evaluated with an independent samples t-test.Results
Age, sex distribution and levels of serum lipids were comparable between patients and controls. Average, right and left carotid artery intima-media were thicker in patients compared with controls (mean ± SD, 0.61?±?0.13 mm vs 0.40?±?0.03 mm; 0.61?±?0.14 mm vs 0.40?±?0.03 mm; 0.61?±?0.13 mm vs 0.40?±?0.03 mm, respectively; all P?0.001).Conclusion
Carotid intima-media is sonographically thicker in children with cerebral palsy compared with healthy controls, which may express an increased risk of atherosclerotic diseases. 相似文献3.
Yutaka Fukuda Nobuo Momoi Masaki Mitomo Yoshimichi Aoyagi Kisei Endo Ayumi Matsumoto Mitsuaki Hosoya 《Pediatric radiology》2010,40(12):1890-1894
Background
In children who have undergone a bidirectional Glenn procedure without antegrade or additional pulmonary blood flow, we have often noted a discrepancy between apparent lung perfusion on scintigraphy and superior vena cava angiography when evaluating right and left pulmonary blood flow. We found a tendency for radionuclide, tracer 99mTc-MAA, when administered through a single upper extremity vein, to preferentially accumulate in the ipsilateral lung.Objective
In the present study, we examined whether the ratio of right-to-left pulmonary flow varied when 99mTc-MAA was administered via either the right upper or the left upper extremity vein.Materials and methods
We studied six children (median age 1.3?±?0.23 years) who underwent a bidirectional Glenn before total cavopulmonary connection. Five children who underwent biventricular repair served as a control. Perfusion scintigraphy using 99mTc-labeled macroaggregated albumin (99mTc-MAA) was performed in all children. First, we injected radionuclide via the right upper extremity and calculated the pulmonary accumulation in both lungs (R-image). Second, we injected the same dose of radionuclide via the left upper extremity and calculated the pulmonary accumulation (B-image), which represented the resulting administration via both upper extremities. The lung accumulation that resulted from radionuclide administration via the left upper extremity (L-image) was determined by subtracting the R-image from the B-image. We evaluated the right-to-total pulmonary blood flow ratio (radionuclide accumulation in right lung / radionuclide accumulation in both lungs) in the R-, L- and B-images.Results
The right-to-total pulmonary blood flow ratios in the R-, L- and B-images were 815?±?15.3%, 39.8?±?11.7% and 61.3?±?11.8%, respectively, and there were significant differences among the three images (P?<?0.01). On the other hand, in the control group, the right-to-total pulmonary blood flow ratios in the R-, L- and B-images were 59.3?±?22.4%, 57.8?±?26.4% and 58.8?±?23.7%, respectively, and there was no significant difference.Conclusion
In children with bidirectional Glenn circulation without antegrade or additional pulmonary blood flow, the venous blood of each arm tends to flow into the ipsilateral lung. The administration of radionuclide via both arms is important for accurate evaluation of lung perfusion scintigraphy in children who have undergone a bidirectional Glenn procedure. 相似文献4.
Goo HW 《Pediatric radiology》2011,41(7):839-847
Background
A practical body-size adaptive protocol providing uniform image noise at various kV levels is not available for pediatric CT.Objective
To develop a practical contrast-enhanced pediatric chest CT protocol providing uniform image noise by using an individualized volume CT dose index (CTDIvol) determined by the cross-sectional area and density of the body at variable kV levels and with combined tube current modulation.Materials and methods
A total of 137 patients (mean age, 7.6?years) underwent contrast-enhanced pediatric chest CT based on body weight. From the CTDIvol, image noise, and area and mean density of the cross-section at the lung base in the weight-based group, the best fit equation was estimated with a very high correlation coefficient (??2?=?0.86, P?0.001). For the next study, 177 patients (mean age, 7.9?years; the CTDIvol group) underwent contrast-enhanced pediatric chest CT with the CTDIvol determined individually by the best fit equation. CTDIvol values on the dose report after CT scanning, noise differences from the target noise, areas, and mean densities were compared between these two groups.Results
The CTDIvol values (mean±standard deviation, 1.6?±?0.7?mGy) and the noise differences from the target noise (1.1?±?0.9?HU) of the CTDIvol group were significantly lower than those of the weight-based group (2.0?±?1.0?mGy, 1.8?±?1.4?HU) (P?0.001). In contrast, no statistically significant difference was found in area (317.0?±?136.8 cm2 vs. 326.3?±?124.8 cm2), mean density (?212.9?±?53.1?HU vs. ?221.1?±?56.3?HU), and image noise (13.8?±?2.3 vs. 13.6?±?1.7?HU) between the weight-based and the CTDIvol groups (P?>?0.05).Conclusion
Contrast-enhanced pediatric chest CT with the CTDIvol determined individually by the cross-sectional area and density of the body provides more uniform noise and better dose adaptation to body habitus than does weight-based CT at variable kV levels and with combined tube current modulation. 相似文献5.
Ieiri S Uemura M Konishi K Souzaki R Nagao Y Tsutsumi N Akahoshi T Ohuchida K Ohdaira T Tomikawa M Tanoue K Hashizume M Taguchi T 《Pediatric surgery international》2012,28(4):341-346
Purpose
In endoscopic surgery, limited views and lack of tactile sensation restrict the surgeon’s abilities and cause stress to the surgeon. Therefore, an intra-operative navigation system is strongly recommended. We developed an augmented reality (AR) navigation system based on preoperative CT imaging. The purpose of this study is to evaluate the usefulness, feasibility, and accuracy of this system using laparoscopic splenectomy in children.Methods
Volume images were reconstructed by three-dimensional (3D) viewer application. We used an optical tracking system for registration between volume image and body surface markers. The AR visualization was superimposed preoperative 3D CT images onto captured laparoscopic live images. This system was applied to six cases of laparoscopic splenectomy in children. To evaluate registration accuracy, distances from the marker position to the volume data were calculated.Results
The operator recognized the hidden vascular variation of the splenic artery and vein, accessory spleen, and pancreatic tail by overlaying an image onto a laparoscopic live image. The registration accuracy of six cases was 5.30?±?0.08, 5.71?±?1.70, 10.1?±?0.60, 18.8?±?3.56, 4.06?±?1.71, and 7.05?±?4.71.Conclusion
This navigation system provides real-time anatomical information, which cannot be otherwise visualized without navigation. The registration accuracy was acceptable in clinical operation. 相似文献6.
Klee D Lanzman RS Blondin D Schmitt P Oh J Salgin B Mayatepek E Antoch G Schaper J 《Pediatric radiology》2012,42(7):785-790
Background
ECG-gated non-enhanced balanced steady-state free precession (bSSFP) MR angiography requires neither breath-holding nor administration of contrast material.Objective
To investigate the image quality of free-breathing ECG-gated non-enhanced bSSFP MR angiography of renal arteries in children.Materials and methods
Fourteen boys and seven girls (mean age, 9.7?years; range, 7?weeks–17?years) with no history of renovascular disease were included. MRI was performed at 1.5?T. Subjective image quality of axial and coronal maximum-intensity-projection reconstructions of four segments (I, aorta and renal artery ostium; II, main renal artery; III, segmental branches; IV, intrarenal vessels) was evaluated using a 4-point scale (4?=?excellent, 3?=?good, 2?=?acceptable, 1?=?non-diagnostic).Results
Image quality was excellent for segments I (mean ± SD, 3.9?±?0.3) and II (4.0?±?0.1), good for segment III (3.4?±?0.9) and acceptable for segment IV (2.3?±?1.1 ). Mean image quality did not differ between sedated and non-sedated children.Conclusion
bSSFP MR angiography enables visualisation of renal arteries in children. 相似文献7.
Purpose
To evaluate whether plasma white blood cell count (WBC), platelet count (PLT), and C-reactive protein level (CRP) can be used to differentiate surgical necrotizing enterocolitis (NEC) from medical NEC.Methods
Preterm infants admitted between January 1, 2011 and July 31, 2015 were stratified by the need of surgery as surgical NEC (n?=?41) and medical NEC (n?=?43). The values of WBC, PLT and CRP were collected at time before NEC occurred (T0), at onset of NEC (T1) and when surgical assessment was required (T2). Patients admitted between August 1, 2015 and March 1, 2018 (n?=?53) were collected for further verification.Results
Variables identified in logistic regression analysis predicting surgical NEC were WBC and PLT at T2 (WBC2 and PLT2). The predictive probability of surgery (P) could be calculated by the equation \(\ln (P/(1 - P))=2.801 - 0.207{\text{WB}}{{\text{C}}_{\text{2}}} - 0.008{\text{PL}}{{\text{T}}_{\text{2}}}\). The area under curve of P was 0.84 and the ideal cutoff value was 0.55, with sensitivity and specificity of 85 and 81%, respectively. This cutoff value got an sensitivity of 80% and specificity of 79% in the verification group.Conclusion
Combination of WBC and PLT can effectively differentiate surgical NEC from medical NEC infants when surgical assessment was required.8.
Johannes Boos Patric Kröpil Dirk Klee Philipp Heusch Lars Schimmöller Jörg Schaper Gerald Antoch Rotem S. Lanzman 《Pediatric radiology》2014,44(9):1065-1069
Background
Organ-specific dose reduction significantly reduces the radiation exposure of radiosensitive organs.Objective
The purpose of this study was to assess the impact of a novel organ-specific dose reduction algorithm on image quality of pediatric chest CT.Materials and methods
We included 28 children (mean age 10.9?±?4.8 years, range 3–18 years) who had contrast-enhanced chest CT on a 128-row scanner. CT was performed at 100 kV using automated tube current modulation and a novel organ-specific dose-reduction algorithm (XCare?; Siemens, Forchheim, Germany). Seven children had a previous chest CT performed on a 64-row scanner at 100 kV without organ-specific dose reduction. Subjective image quality was assessed using a five-point scale (1-not diagnostic; 5-excellent). Contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were assessed in the descending aorta.Results
Overall mean subjective image quality was 4.1?±?0.6. In the subgroup of the seven children examined both with and without organ-specific dose reduction, subjective image quality was comparable (score 4.4?±?0.5 with organ-specific dose reduction vs. 4.4?±?0.7 without it; P?>?0.05). There was no significant difference in mean signal-to-noise ratio and contrast-to-noise ratio with organ-specific dose reduction (38.3?±?10.1 and 28.5?±?8.7, respectively) and without the reduction (35.5?±?8.5 and 26.5?±?7.8, respectively) (P?>?0.05). Volume computed tomography dose index (CTDIvol) and size-specific dose estimates did not differ significantly between acquisitions with the organ-specific dose reduction (1.7?±?0.8 mGy) and without the reduction (1.7?±?0.8 mGy) (P?>?0.05).Conclusion
Organ-specific dose reduction does not have an impact on image quality of pediatric chest CT and can therefore be used in clinical practice to reduce radiation dose of radiosensitive organs such as breast and thyroid gland. 相似文献9.
Abdulaziz Al-Othman Sara Al-Musharaf Nasser M Al-Daghri Soundararajan Krishnaswamy Deqa S Yusuf Khalid M Alkharfy Yousef Al-Saleh Omar S Al-Attas Majed S Alokail Osama Moharram Shaun Sabico George P Chrousos 《BMC pediatrics》2012,12(1):1-6
Background
1) To evaluate calcium absorption in infants fed a formula containing prebiotics (PF) and one without prebiotics (CF). 2) To compare calcium absorption from these formulas with a group of human milk-fed (HM) infants.Methods
A dual tracer stable isotope method was used to assess calcium absorption in infants exclusively fed CF (n?=?30), PF (n?=?25) or HM (n?=?19). Analysis of variance was used to analyze calcium intake, fractional calcium absorption, and the amount of calcium absorbed.Results
Calcium intake (Mean ± SEM) for PF was 534?±?17?mg/d and 557?±?16?mg/d for CF (p?=?0.33). Fractional calcium absorption was 56.8?±?2.6?% for PF and 59.2?±?2.3?% for CF (p?=?0.49). Total calcium absorbed for PF was 300?±?14?mg/d and 328?±?13?mg/d for CF (p?=?0.16). For HM infants calcium intake was 246?±?20?mg/d, fractional calcium absorption was 76.0?±?2.9?% and total calcium absorbed was 187?±?16?mg/d (p <0.001, compared to either PF or CF).Conclusions
Despite lower fractional calcium absorption of CF and PF compared to HM, higher calcium content in both led to higher total calcium absorption compared to HM infants. No significant effect of prebiotics was observed on calcium absorption or other markers of bone mineral metabolism. 相似文献10.
Razieh Fallah Mohammad Saleh Divanizadeh Mehran Karimi Mehrdad Mirouliaei Ali Shamszadeh 《Indian journal of pediatrics》2013,80(11):920-924
Objective
To compare efficacy and safety of topiramate (TPM) and propranolol for migraine prophylaxis in children.Methods
In a parallel single-blinded randomized clinical trial, 5–15 y-old referred migraineurs to Pediatric Neurology Clinic of Shahid Sadoughi Medical Sciences University, Yazd, Iran from May through October 2011, were evaluated. Patients were distributed into two groups, 50 of whom were treated with 3 mg/kg/d of topiramate (TPM) and another group of 50, were treated with 1 mg/kg of propranolol for 3 mo. Primary endpoints were efficacy in reduction of monthly frequency, severity, duration and headache related disability. Secondary outcome was clinical side effects.Results
Fifty two girls and 48 boys with mean age of 10.34?±?2.31 y were evaluated. Monthly frequency, severity and duration of headache decreased with TPM, from 13.88?±?8.4 to 4.13?±?2.26 attacks, from 6.32?±?1.93 to 2.8?±?2.12, and from 2.36?±?1.72 to 0.56?±?0.5 h, respectively. Monthly frequency, severity and duration of headache also decreased with propranolol from 16.2?±?6.74 to 8.8?±?4.55 attacks, from 6.1?±?1.54 to 4.8?±?1.6 and from 2.26?±?1.26 to 1.35?±?1.08 h, respectively. Pediatric Migraine Disability Assessment score reduced from 31.88?±?9.72 to 9.26?±?7.21 with TPM and from 33.08?±?8.98 to 23.64?±?9.88 with propranolol. Transient mild side effects were seen in 18 % of TPM and in 10 % of propranolol (P?=?0.249) groups.Conclusions
Topiramate is more effective than propranolol for pediatric migraine prophylaxis. 相似文献11.
Does Mesenchymal Stem Cell Population in Umbilical Cord Blood Vary at Different Gestational Periods?
Ashish Jain Nitin Mathur M. Jeevashankar Asok Mukhopadhyay Ramesh Agarwal A. K Deorari V. K Paul 《Indian journal of pediatrics》2013,80(5):375-379
Objective
To identify and quantitatively determine Mesenchymal stem cells (MSCs) in the umbilical cord blood (UCB) of neonates born at different gestational periods.Methods
UCB was collected at birth in neonates of three different gestational groups. The mononuclear cells (MNCs) were phenotypically analyzed by flow cytometer.Results
The yield of total MNCs did not differ much with gestation; the average values were 22.6?±?6.48?×?106 cells/ml. The MSCs were significantly higher in the lower gestation group. These were 0.0219?±?0.012 %, 0.0044?±?0.003 % and 0.0022?±?0.003 % in 28 to 31 wk, 32 to 35 wk and >36 wk, respectively (P?=?0.00). There was a significant inverse correlation between the gestational age and the presence of MSCs with a correlation co-efficient of ?0.54 (P?=?0.0001).Conclusions
The MSCs population was significantly higher in infants born at lesser gestation than those born at term gestation. 相似文献12.
Rahşan Özcan Sebuh Kuruoğlu Sergülen Dervişoğlu Mehmet Eliçevik Haluk Emir Cenk Büyükünal 《Pediatric surgery international》2013,29(3):233-237
Aim
To share our experience in ovary-sparing surgery for teratomas in children.Patients and methods
The medical records of nine patients (mean age of 11.2 years, r 6–15 years) who had undergone ovary-sparing surgery for teratoma were analyzed retrospectively. Mean duration for follow-up was 29.5 months (r 15–75 months).Results
Five patients suffered from chronic abdominal pain; two had acute colicky abdominal pain. In two patients, there was no presenting clinical symptom. Two patients were operated on emergency basis due to symptoms related with acute abdomen. On the other hand, seven were operated electively. Ultrasonography was performed in all patients. Additionally, MRI and tumor markers were performed in all but two. Main radiologic findings consisted of heterogenous cystic and solid ovarian masses predictive of teratoma. The definitive diagnosis in emergency cases were as follows: perforated appendicitis plus teratoma [1]; torsion of the ovarian mass with teratoma [1]. The final diagnosis in electively treated seven patients were: unilateral ovarian teratoma [4], bilateral ovarian teratoma [1], bilateral teratoma plus appendiceal inflammatory mass [1], unilateral teratoma and contralateral corpus hemorrhagicum cyst [1]. The operations were performed by open conventional surgery in six and laparoscopy in three patients. The procedures were ovary-sparing surgery in 12 ovaries, appendectomy in 2 patients and detorsion of ovary in 1 patient. The main indication for ovary-sparing surgery was the “existence of a perfect dissection plane between the tumor margins and healthy ovarian tissue”. The remaining ovarian tissue was evaluated macroscopically for residual lesions. Frozen section was performed in three suspected patients and the ovarian margins were free of any tumor cell. The pathologic diagnosis was: mature cystic teratoma in 10, immature teratoma in 1 and corpus hemorrhagicum cyst in 1. The postoperative outcome and follow-up was uneventful.Conclusion
Heterogenous ovary mass containing solid and cystic portions with echogenic areas on ultrasound imaging is highly suggestive of ovarian teratomas. Emergent surgical intervention is indicated if there is any suspicion of ovarian torsion. Otherwise, MRI is performed for further radiological evaluation. Based on radiologic findings, ovary-sparing surgery can be safely performed if the preoperative diagnosis is teratoma and there is always a plane of dissection between the normal ovary and cyst wall. 相似文献13.
Objective
To evaluate the changes in the LV systolic and diastolic function in children with beta-thalassemia major (β-TM) using pulsed wave tissue doppler (TD) echocardiography.Methods
Clinical, conventional echo doppler and pulsed wave tissue doppler imaging parameters were compared in 40 beta-thalassemia major patients (mean age, 6.52?±?3.5 y) and 25 age and sex matched normal subjects (mean age, 6.5?±?2.7 y).Results
There were no significant statistical differences between mean fractional shortening (FS) and ejection fraction (EF) of left ventricle (LV) of the patients and control group. Children with beta-thalassemia had significantly lower E′ wave velocities measured at the left ventricular septal annulus (8.1?±?3.3 vs. 13?±?2.5, P?<?0.001), lateral margin of the mitral annulus (9.1?±?5.4 vs. 13.3?±?2.5, P?<?0.001) and lateral margin of the tricuspid annulus (9.3?±?3.9 vs. 13.3?±?2.5, P?<?0.001) when compared to the control group. Furthermore children with beta-thalassemia had significantly lower E′/A′ wave ratio at the left ventricular septal annulus (0.76?±?0.34 vs. 1.36?±?0.23), lateral margin of the mitral annulus (0.83?±?0.17 vs. 1.28?±?0.22), and lateral margin of the tricuspid annulus ((0.90?±?0.27 vs. 1.26?±?0.23, (P?<?0.05) when compared to the control group.Conclusions
This study showed that patients with beta-thalassemia major and normal conventional echo doppler parameters had statistically significant changes detected by pulsed wave tissue doppler imaging. 相似文献14.
Gianluca Lista Francesca Castoldi Silvia Bianchi Enrica Lupo Francesco Cavigioli Andrea Farolfi Chiara Bersanini Emiliana Ferrerio 《Indian journal of pediatrics》2014,81(3):275-278
Objective
To investigate respiratory health and lung function in school-aged children without broncho-pulmonary dysplasia (BPD), who were very low birth weight (VLBWi) and randomized at birth to high frequency oscillatory ventilation (HFOV) or volume guarantee (VG) ventilation for severe respiratory distress syndrome (RDS).Methods
In this observational study, 7-y-old ex-preterm infants with severe RDS, randomly assigned at birth to receive assisted/control ventilation?+?VG (Vt?=?5 mL/kg, PEEP?=?5 cmH2O)(VG group; mean GA 27?±?2 wk; mean BW 1086?±?158 g) or HFOV (HFOV group; mean GA: 27?±?2; mean BW: 1090?±?139 g) (both groups were ventilated with Drager Babylog 8000 plus) were recalled. Neonatal clinical data and outcome were known. Actual outcomes were investigated with an interview; lung function was measured by whole-body plethysmography.Results
Twenty five children were studied (VG group, n?=?13 vs. HFOV group, n?=?12). There were no differences in anthropometric data, drugs (steroids/bronchodilators and antibiotics) or hospital readmission for respiratory disorders. Compliance to the test was adequate. The authors found a similar obstructive deficit (elevated values: airway resistance (RAW), residual volume (RV), total lung capacity (TLC) with near-normal spirometry) in both groups suggesting a persistent airflow limitation even in absence of BPD.Conclusions
VLBW infants even in absence of BPD, need long term respiratory follow-up, because they frequently show an impairment of lung function, independent from initial respiratory support, even if at birth the choice is a lung protective approach (e.g., HFOV or VG ventilation). 相似文献15.
Huang MP Liang CH Zhao ZJ Liu H Li JL Zhang JE Cui YH Yang L Liu QS Ivanc TB Vembar M 《Pediatric radiology》2011,41(7):858-866
Background
There are a limited number of reports on the technical and clinical feasibility of prospective electrocardiogram (ECG)-gated multi-detector computed tomography (MDCT) in infants with congenital heart disease (CHD).Objective
To evaluate image quality and radiation dose at weight-based low-dose prospectively gated 256-slice MDCT angiography in infants with CHD.Materials and methods
From November 2009 to February 2010, 64 consecutive infants with CHD referred for pre-operative or post-operative CT were included. All were scanned on a 256-slice MDCT system utilizing a low-dose protocol (80?kVp and 60?C120?mAs depending on weight: 60?mAs for ??3?kg, 80?mAs for 3.1?C6?kg, 100?mAs for 6.1?C10?kg, 120?mAs for 10.1?C15?kg).Results
No serious adverse events were recorded. A total of 174 cardiac deformities, confirmed by surgery or heart catheterization, were studied. The sensitivity of MDCT for cardiac deformities was 97.1%; specificity, 99.4%; accuracy, 95.9%. The mean heart rate during scan was 136.7?±?14.9/min (range, 91?C160) with a corresponding heart rate variability of 2.8?±?2.2/min (range, 0?C8). Mean scan length was 115.3?±?11.7?mm (range, 93.6?C143.3). Mean volume CT dose index, mean dose-length product and effective dose were 2.1?±?0.4?mGy (range, 1.5?C2.8), 24.7?±?5.9?mGy·cm (range, 14.7?C35.8) and 1.6?±?0.3?mSv (range, 1.1?C2.5), respectively. Diagnostic-quality images were achieved in all cases. Satisfactory diagnostic quality for visualization of all/proximal/distal coronary artery segments was achieved in 88.4/98.8/80.0% of the scans.Conclusion
Low-dose prospectively gated axial 256-slice CT angiography is a valuable tool in the routine clinical evaluation of infants with CHD, providing a comprehensive three-dimensional evaluation of the cardiac anatomy, including the coronary arteries. 相似文献16.
Sayed Nour Gang Dai Daniel Carbognani Minze Feng Daya Yang Nermine Lila Juan Carlos Chachques Guifu Wu 《Pediatric cardiology》2012,33(8):1332-1342
Objective
Pulmonary arterial hypertension (PAH) is a dysfunctional endothelium disease with increased pulmonary vascular resistance (PVR) and poor prognosis. Current therapies are still insufficient. Here we propose a new pulsatile device as a more effective tool for PAH management compared with traditional treatments.Materials and Methods
Twelve piglets (10.3?±?3.8?kg) were given either intrapulmonary pulsatile [P (n?=?6)] or nonpulsatile [NP (n?=?6)] tadalafil treatment. After median sternotomy and heparin injection (250?IU/kg), both groups underwent aorto-pulmonary surgical shunt for 1?h. During a second 1?h period in group P, a catheter prototype, driven by a small ventilator, was introduced into the pulmonary trunk and pulsated intermittently at 110?bpm irrespective of heart rate (90.6?±?10.74 bpm). In group NP, tadalafil was given orally (1?mg/kg).Results
Hemodynamics and cardiac output (CO) were significantly (p?<?0.05) improved in group P compared with group NP: CO was 0.56?±?0.0.26 versus 0.54?±?0.11 (L/min), respectively. Mean pulmonary artery pressure (PAP) was decreased in group P compared with group NP: PAP was 9.6?±?2.97 versus 32.2?±?5.07, respectively. Vascular resistances (dynes.s.cm?5/kg) were significantly lower in group P versus group NP: pulmonary resistance was 85?±?42.12 versus 478?±?192.91 and systemic resistance was 298.8?±?172.85 versus 1301?±?615.79, respectively. Using Western blot analysis, endogenous NO synthase expression in PA segments was nonsignificantly (p?>?0.05) greater in group P (0.81?±?0.78) versus (0.62?±?0.35) group NP.Conclusion
Induced with an appropriate device, intrapulmonary shear stress?Cmediated endothelial function enhancement provides a more effective nearly physiological therapy for PAH. 相似文献17.
Emmanuel Yakoumakis Helen Kostopoulou Triantafilia Makri Anastastios Dimitriadis Evaggelos Georgiou Ioannis Tsalafoutas 《Pediatric radiology》2013,43(3):339-346
Background
Children diagnosed with congenital heart disease often undergo cardiac catheterization for their treatment, which involves the use of ionizing radiation and therefore a risk of radiation-induced cancer.Objective
The purpose of this study was to calculate the effective and equivalent organ doses (HT) in those children and estimate the risk of exposure-induced death.Materials and methods
Fifty-three children were divided into three groups: atrial septal defect (ASD), ventricular septal defect (VSD) and patent ductus arteriosus (PDA). In all procedures, the exposure conditions and the dose-area product meters readings were recorded for each individual acquisition. Monte Carlo simulations were run using the PCXMC 2.0 code and mathematical phantoms simulating a child's anatomy. The HT values to all irradiated organs and the resulting E and risk of exposure-induced death values were calculated.Results
The average dose-area product values were, respectively, 40?±?12 Gy·cm2 for the ASD, 17.5?±?0.7 Gy·cm2 for the VSD and 9.5?±?1 Gy·cm2 for the PDA group. The average E values were 40?±?12, 22?±?2.5 and 17?±?3.6 mSv for ASD, VSD and PDA groups, respectively. The respective estimated risk of exposure-induced death values per procedure were 0.109, 0.106 and 0.067%.Conclusion
Cardiac catheterizations in children involve a considerable risk for radiation-induced cancer that has to be further reduced. 相似文献18.
Emile Christian Arie Nyns Andreea Dragulescu Shi-Joon Yoo Lars Grosse-Wortmann 《Pediatric radiology》2014,44(12):1532-1540
Background
Cardiac magnetic resonance using the Simpson method is the gold standard for right ventricular volumetry. However, this method is time-consuming and not without sources of error. Knowledge-based reconstruction is a novel post-processing approach that reconstructs the right ventricular endocardial shape based on anatomical landmarks and a database of various right ventricular configurations.Objective
To assess the feasibility, accuracy and labor intensity of knowledge-based reconstruction in repaired tetralogy of Fallot (TOF).Materials and methods
The short-axis cine cardiac MR datasets of 35 children and young adults (mean age 14.4?±?2.5 years) after TOF repair were studied using both knowledge-based reconstruction and the Simpson method. Intraobserver, interobserver and inter-method variability were assessed using Bland-Altman analyses.Results
Knowledge-based reconstruction was feasible and highly accurate as compared to the Simpson method. Intra- and inter-method variability for knowledge-based reconstruction measurements showed good agreement. Volumetric assessment using knowledge-based reconstruction was faster when compared with the Simpson method (10.9?±?2.0 vs. 7.1?±?2.4 min, P?0.001).Conclusion
In patients with repaired tetralogy of Fallot, knowledge-based reconstruction is a feasible, accurate and reproducible method for measuring right ventricular volumes and ejection fraction. The post-processing time of right ventricular volumetry using knowledge-based reconstruction was significantly shorter when compared with the routine Simpson method. 相似文献19.
Juliana C. Eloi Matias Epifanio José V. N. Spolidoro Pablo Camargo Juliana Krebs Mariana D. Mizerkowski Matteo Baldisserotto 《Pediatric radiology》2012,42(12):1465-1470
Background
Blood flow volume in the superior mesenteric artery (SMA) measured by pulsed Doppler has been used in adults to evaluate Crohn disease but has not been utilized in children and adolescents.Objective
To establish a cutoff point for normal SMA blood flow using pulsed Doppler US measurement in healthy children and adolescents.Materials and methods
The study included healthy volunteers from an urban community, divided into two age groups, children (5–9?years) and adolescents (10–17?years). Anthropometric measurements included waist circumference and body surface area classified according to the z-score of body mass index. Heart rate, blood pressure, oxygen saturation and temperature were measured immediately before US evaluation.Results
The average age of the 60 participants was 12.2?years. Of these, 21 (35%) were ages 5–9?years and 39 (65%) were ages 10–17?years; 21 (35%) were boys. Findings of the two examiners coincided for 58 of the 60 (96.7%) participants. SMA blood flow was significantly lower in the children (mean ± SD?=?556?±?122?ml/min) than in adolescents (mean ± SD 775?±?311?ml/min) (P?<?0.001). SMA blood flow showed statistically significant positive associations with body surface area.Conclusion
We found that superior mesenteric artery blood flow is significantly lower in children than in adolescents and is associated with body surface area. 相似文献20.
Waricha Janjindamai Anucha Thatrimontrichai Gunlawadee Maneenil Maneerat Puwanant 《Indian journal of pediatrics》2013,80(10):809-813