Imaging In Pediatric Pulmonology
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Understanding of coronavirus disease 2019 is rapidly evolving with new articles on the subject daily. This flood of articles can be overwhelming for busy practicing clinicians looking for key pieces of information that can be applied in daily practice. This review article synthesizes the reported imaging findings in pediatric Coronavirus disease 2019 (COVID-19) across the literature, offers imaging differential diagnostic considerations and useful radiographic features to help differentiate these entities from COVID-19, and provides recommendations for requesting imaging studies to evaluate suspected cases of pediatric COVID-19.
Incidental pulmonary nodules are not infrequently identified on computed tomography imaging in the pediatric population and can be a challenge in suggesting appropriate follow-up recommendations. An evidence-based and practical imaging approach for diagnosis and appropriate directed management is essential for optimal patient care. This article provides an up-to-date review of the pediatric pulmonary nodule literature and suggests a practical algorithm to manage pulmonary nodules in the pediatric population.
This fully updated second edition is a definitive guide to imaging and differential diagnosis for pediatric pulmonary diseases and disorders. This edition is fully updated to include coverage of the latest imaging and diagnostic techniques, modalities, and best practices. Beginning with clinical algorithms, chapters provide a framework for clinical diagnosis. This image-based text presents a comprehensive, multi-modality approach, with an emphasis on plain film and cross-sectional imaging. The imaging sections, including a new chapter on pediatric thoracic MRI, are correlated with pathology and clinical findings to help readers learn what the modality of choice can enable them to see. This information and guidance is applied directly to diseases and disorders seen in everyday practice, including pleural effusion, focal lung disorders, pulmonary hypertension, cystic fibrosis, and asthma, as well as a new chapter on pediatric pulmonary embolism. In addition, a new chapter on the genetics of pediatric lung disorders has been added. This essential guide gives pediatric pulmonologists and radiologists the information to identify the differentials by symptom complex, accordingly determine what test would be effective, how to proceed, and to essentially provide the best care for their patients.
Subspecialized pediatric radiologists and technologists use the latest technology in CT, MRI, ultrasound, fluoroscopy and general radiography in the diagnosis of pediatric diseases and pathological conditions.
(a) Acute Langerhans cell histiocytosis (LCH): CXR shows mild nonspecific ILD suggesting bronchial wall thickening, which is often the first imaging evidence of LCH. (b) Acute LCH: axial lung window CT image reveals multiple small nodules (arrow), dominantly in the upper lobes
For the past 15 years, we have sponsored a weekly conference for pediatric pulmonologists from throughout New England. This forum lets doctors share information about unusual cases, and it gives parents access to second opinions upon request.
The chest radiograph is one of the most commonly requested radiographic examinations in the assessment of the pediatric patient. Depending on the patients' age, the difficulty of the examination will vary, often requiring a specialist trained radiographer familiar with a variety of distraction and immobilization techniques.
Contact lead shielding is no longer recommended for any pediatric examination, multiple radiological societies have released statements supporting the cessation of this practice 5-8 the most comprehensive guidance statement on this matter (86 pages) is a joint report found at this citation 9.Please see your local department protocols for further clarification as they may differ from these recommendations.
While attending medical school, a mentor inspired me to become a pediatric pulmonologist. I admired his interactions with patients and providers, and I knew I wanted to model my career after his. I'll never forget the day he took me to the operating room for the first time. I was able to look at the airway, and I have been in love with pulmonology medicine and bronchoscopy ever since. My specialties include bronchoscopy, bronchopulmonary dysplasia and chronic ventilation.
I am currently developing an imaging technique that evaluates airway motion without the need for sedation or radiation in children of all ages. For the first time, this will enable us to understand airway motion and its natural history in children with and without airway disease. This novel magnetic resonance imaging (MRI) provides a unique opportunity to evaluate the impact of airway motion on pediatric health and understand the response to therapeutic interventions.
I am honored to have received the Best in Pediatrics award at the American Thoracic Society (ATS) international conference in 2018. This award is given for the six best scientific abstracts annually. I obtained board certification in pediatrics in 2013 and pediatric pulmonology in 2018.
The Pediatric Pulmonology Fellowship Program at Indiana University School of Medicine and Riley Hospital for Children has a strong commitment to providing exceptional training of academic pediatric specialists. The program ensures fellows are well prepared to provide the best possible care for infants and children with lung disease, through diverse clinical and scientific inquiry. Strong mentorship is provided for each fellow in research, clinical care, and teaching skills, to foster a customized path in beginning a robust pulmonary career.
Your child's well-being is our priority. Part of ensuring your child's good health is having pediatric radiologists who specialize in providing physicians with the best possible X-rays, magnetic resonance imaging (MRI) and computed tomography (CT) to assist in the diagnosis of various illnesses, injuries and diseases. We use the lowest possible radiation needed to create the detailed imaging treating physicians need to assess your child's condition and formulate an individualized care plan for your little one.
Beyond basic screening chest radiographs, modern cross-sectional imaging with computed tomography and magnetic resonance imaging demonstrates more detailed anatomic and pathologic information than previously possible. This information is important if it influences decision-making during patient care and management and adds to the understanding of disease processes. In this article we review recent developments in computed tomography and magnetic resonance imaging, advantages and limitations of these techniques in the pediatric chest, and the role of cross-sectional imaging in a series of selected pulmonary topics. In the process, we provide a brief preview of future pediatric pulmonary imaging developments.
Our program parallels adult services at UMMC, home to the only Cystic Fibrosis Center in the state. Children in the pediatric program can seamlessly transition to the adult program between the ages of 18 and 21. This gives children with CF the advantage of consistent, expert care throughout childhood and beyond.
Pediatric COVID-19 is relatively mild and may vary from that in adults. This study was to investigate the epidemic, clinical, and imaging features of pediatric COVID-19 pneumonia for early diagnosis and treatment.
Children with COVID-19 have mild or moderate clinical and imaging presentations. A better understanding of the clinical and CT imaging helps ascertaining those with negative nucleic acid and reducing misdiagnosis rate for those with atypical and concealed symptoms.
This study was conducted to investigate the characteristics of COVID-19 infection in children so as to provide useful information for early diagnosis and treatment for children of this disease. This retrospective study was approved by the ethics committee of Affiliated Hospital of Hebe University with the reference number of 2020-TG-001, and the informed consent was obtained from the legal guardians of all participants. Between January and February 2020, children who had been infected with SARS-CoV-2 were enrolled. The inclusion criteria were children who had positive test of viral nucleic acid with or without pulmonary CT scanning since disease onset, and no other viral infection. The exclusion criteria were children with no infection of SARS-CoV-2. The clinical data were retrospective collected from electronic medical records, including age, sex, epidemic history, clinical symptoms, blood cell count, and imaging presentations of pulmonary lesions.
CT imaging analysis was performed by two imaging physicians independently. When in disagreement, a third physician would be involved to reach an agreement. The CT imaging presentations were analyzed with the following parameters: Disease distribution: right upper lobe, right middle lobe, right lower lobe, left upper lobe, left lower lobe; Lobes involved: one to five lobes involved, right, left and both lungs; Prevalence of lesion distribution: anterior portion, posterior, both anterior and posterior, peripheral, central, both peripheral and central areas; Within lungs: ground glass opacity, patchy high density lesion, consolidation, stripes, thickened bronchovascular bundles, along bronchus; Outside the lung: enlarged lymph nodes at the pulmonary hilum or inside the mediastinum, and pleural effusion. According to the line of axillary midline, the lung field in axial CT images was divided into anterior and posterior portion. The outer 1 / 3 of axial CT images was peripheral, and the rest was the central area.
Among 11 children with abnormal pulmonary CT imaging, one lobe was involved in five patients (45.5%), two lobes in four (36.4%), four lobes in one (9.1%) and five lobes in one (9.1%). No patients had the involvement of three lobes. Most patients had the involvement of one lobe followed by two and multiple lobes. 59ce067264
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