First name
Anilawan
Last name
Smitthimedhin

Title

Mimics of malrotation on pediatric upper gastrointestinal series: a pictorial review.

Year of Publication

2018

Date Published

2018 Mar 03

ISSN Number

2366-0058

Abstract

<p>Intestinal malrotation is a continuum of congenital anomalies due to lack of rotation or incomplete rotation of the fetal intestine around the superior mesenteric artery axis. The abnormal bowel fixation (by mesenteric bands) or absence of fixation of portions of the bowel increases the risk of bowel obstruction, acute or chronic volvulus, and bowel necrosis. The clinical presentation of patients with malrotation without, with intermittent, or with chronic volvulus can be problematic, with an important minority presenting late or having atypical or chronic symptoms, such as intermittent vomiting, abdominal pain, duodenal obstruction, or failure to thrive. The diagnosis is heavily reliant on imaging. Upper GI series remain the gold standard with the normal position of the duodenojejunal junction lateral to the left-sided pedicles of the vertebral body, at the level of the duodenal bulb on frontal views and posterior (retroperitoneal) on lateral views. However, a variety of conditions might influence the position of the duodenojejunal junction, potentially leading to a misdiagnosis of malrotation. Such conditions include improper technique, gastric over distension, splenomegaly, renal or retroperitoneal tumors, liver transplant, small bowel obstruction, the presence of properly or malpositioned enteric tubes, and scoliosis. All of these may cause the duodenojejunal junction to be displaced. We present a series of cases highlighting conditions that mimic malrotation without volvulus to increase the practicing radiologist awareness and help minimize interpretation errors.</p>

DOI

10.1007/s00261-018-1537-9

Alternate Title

Abdom Radiol (NY)

PMID

29500650

Title

MRI determination of volumes for the upper airway and pharyngeal lymphoid tissue in preterm and term infants.

Year of Publication

2017

Number of Pages

51-56

Date Published

2017 Dec 16

ISSN Number

1873-4499

Abstract

<p>We aim to determine average volumes of the upper airway, adenoids and tonsils in preterm and term infants and assess for the differences according to weight, sex and ethnicity. The volumes of the upper airways, tonsils and adenoids were measured from brain MR images in 96 (49 preterm and 47 term) infants and compared using a two-tailed t-test (significant at p&lt;0.05). The average volumes are reported for both groups. Term infants showed larger naso- and oropharyngeal volumes (independent of weight, sex, and ethnicity). No differences in hypopharyngeal, adenoidal or tonsillar volumes were found.</p>

DOI

10.1016/j.clinimag.2017.12.010

Alternate Title

Clin Imaging

PMID

29276961

Title

Scimitar-like ossification of patellae led to diagnosis of Zellweger syndrome in newborn: a case report.

Year of Publication

2018

Number of Pages

128-130

Date Published

2018 Feb 01

ISSN Number

1873-4499

Abstract

<p>Zellweger syndrome is the most severe form of a group of autosomal recessive disorders with defective peroxisomes. We report a case of Zellweger syndrome in a newborn baby, which was first suspected by the presence of scimitar-like patella seen on skeletal survey. The subsequent brain MRI showed germinolytic cysts and polymicrogyria, which furthered the suspicion. Laboratory and genetic results confirmed the diagnosis. To date, there are a limited number of case reports of this rare disease. We emphasize skeletal findings that can lead to targeted genetic and laboratory testing and hence earlier diagnosis.</p>

DOI

10.1016/j.clinimag.2018.01.008

Alternate Title

Clin Imaging

PMID

29414506

Title

Case based simulation in MRI for suspected appendicitis in children.

Year of Publication

2018

Number of Pages

12-16

Date Published

2018 Mar - Apr

ISSN Number

1873-4499

Abstract

<p><strong>PURPOSE: </strong>To establish the effect on diagnostic confidence of a simulation setting, in which radiologists re-interpret anonymized pediatric MRI cases.</p>

<p><strong>MATERIALS: </strong>In this IRB-approved study, participants completed surveys rating confidence before and after interpreting 10 MRI cases for suspected appendicitis in children.</p>

<p><strong>RESULTS: </strong>18 radiologists (4 faculty, 5 fellows, and 9 residents) correctly identified an average of 7.44 cases (range 5-9). Self-described confidence regarding technique and interpretation increased from 2.0 (SD 0.77) and 2.33 (SD 0.69) to 2.83 (SD 0.71) and 2.94 (SD 0.73), respectively.</p>

<p><strong>CONCLUSION: </strong>Simulated interpretation of pediatric MRI in suspected appendicitis results in increased self-describe confidence without requiring additional capital/equipment expenses.</p>

DOI

10.1016/j.clinimag.2017.09.012

Alternate Title

Clin Imaging

PMID

28963916

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