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Cox M.,DuPont Company | Cox M.,Thomas Jefferson University | Gould S.W.,DuPont Company | Podberesky D.J.,Nemours Childrens Health System Nemours Childrens Hospital | Epelman M.,Nemours Childrens Health System Nemours Childrens Hospital
Pediatric Radiology | Year: 2016

Transabdominal US remains the primary screening imaging modality of the pediatric female pelvis. However, MRI has become an invaluable adjunct to US in recent years. MRI offers superb soft-tissue contrast resolution that allows for detailed evaluation, particularly of the ovaries and their associated pathology. MRI can yield diagnostic information that is similar to or even better than that of US, especially in nonsexually active girls in whom transvaginal US would be contraindicated. MRI is generally a second-line examination and is preferred over CT because it does not involve the use of ionizing radiation. MRI might be underutilized in this population, particularly in differentiating surgical from nonsurgical conditions. This article reviews the relevant anatomy and discusses imaging of acquired conditions that involve the pediatric female genital tract, illustrating associated pathology with case examples. © 2016, Springer-Verlag Berlin Heidelberg.


PubMed | DuPont Company and Nemours Childrens Health System Nemours Childrens Hospital
Type: Journal Article | Journal: Pediatric radiology | Year: 2016

Transabdominal US remains the primary screening imaging modality of the pediatric female pelvis. However, MRI has become an invaluable adjunct to US in recent years. MRI offers superb soft-tissue contrast resolution that allows for detailed evaluation, particularly of the ovaries and their associated pathology. MRI can yield diagnostic information that is similar to or even better than that of US, especially in nonsexually active girls in whom transvaginal US would be contraindicated. MRI is generally a second-line examination and is preferred over CT because it does not involve the use of ionizing radiation. MRI might be underutilized in this population, particularly in differentiating surgical from nonsurgical conditions. This article reviews the relevant anatomy and discusses imaging of acquired conditions that involve the pediatric female genital tract, illustrating associated pathology with case examples.


Serai S.D.,Cincinnati Childrens Hospital Medical Center | Fleck R.J.,Cincinnati Childrens Hospital Medical Center | Quinn C.T.,Cincinnati Childrens Hospital Medical Center | Zhang B.,Cincinnati Childrens Hospital Medical Center | Podberesky D.J.,Nemours Childrens Health System Nemours Childrens Hospital
Pediatric Radiology | Year: 2015

Background: Serial surveillance of liver iron concentration (LIC) provides guidance for chelation therapy in patients with iron overload. The diagnosis of iron overload traditionally relies on core liver biopsy, which is limited by invasiveness, sampling error, cost and general poor acceptance by pediatric patients and parents. Thus noninvasive diagnostic methods such as MRI are highly attractive for quantification of liver iron concentration. Objective: To compare two MRI-based methods for liver iron quantification in children. Materials and methods: 64 studies on 48 children and young adults (age range 4–21 years) were examined by gradient recalled echo (GRE) R2* and spin-echo R2 MRI at 1.5T to evaluate liver iron concentration. Scatter plots and Bland–Altman difference plots were generated to display and assess the relationship between the methods. Results: With the protocols used in this investigation, Bland–Altman agreement between the methods is best when LIC is <20 mg/g dry tissue. Scatter plots show that all values with LIC <20 mg/g dry tissue fall within the 95% prediction limits. Conclusion: Liver iron concentration as determined by the R2* and R2 MR methods is statistically comparable, with no statistical difference between these methods for LIC <20 mg/g. © 2015, Springer-Verlag Berlin Heidelberg.


PubMed | Cincinnati Childrens Hospital Medical Center and Nemours Childrens Health System Nemours Childrens Hospital
Type: Comparative Study | Journal: Pediatric radiology | Year: 2015

Serial surveillance of liver iron concentration (LIC) provides guidance for chelation therapy in patients with iron overload. The diagnosis of iron overload traditionally relies on core liver biopsy, which is limited by invasiveness, sampling error, cost and general poor acceptance by pediatric patients and parents. Thus noninvasive diagnostic methods such as MRI are highly attractive for quantification of liver iron concentration.To compare two MRI-based methods for liver iron quantification in children.64 studies on 48 children and young adults (age range 4-21 years) were examined by gradient recalled echo (GRE) R2* and spin-echo R2 MRI at 1.5T to evaluate liver iron concentration. Scatter plots and Bland-Altman difference plots were generated to display and assess the relationship between the methods.With the protocols used in this investigation, Bland-Altman agreement between the methods is best when LIC is <20 mg/g dry tissue. Scatter plots show that all values with LIC <20 mg/g dry tissue fall within the 95% prediction limits.Liver iron concentration as determined by the R2* and R2 MR methods is statistically comparable, with no statistical difference between these methods for LIC <20 mg/g.

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