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Diagnostic value of diffusion-weighted MRI for imaging synovitis in pediatric patients with inflammatory conditions of the knee joint

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World Journal of Pediatrics 2020年第1期16卷 60-67页

作者： Mengxia Li Alexander Sauer Annette Holl-Wieden Thomas Pabst henning neubauer Department of Radiation Oncology University Hospital Würzburg97080 WürzburgGermany Department of Diagnostic and Interventional Radiology University Hospital Würzburg97080 WürzburgGermany Department of Pediatrics University Hospital Würzburg97080 WürzburgGermany Department of Diagnostic and Interventional Radiology University Hospital Ulm89081 UlmGermany SRH Clinic of Radiology Albert-Schweitzer-Str.298527 SuhlGermany

Background Diffusion-weighted imaging(DWI)of synovitis has been suggested as a possible non-invasive alternative to contrast-enhanced T1w imaging(ce-T1w).We aimed to study DWI for diagnosing synovitis in the knee joint of pediatric patients,to quantify inter-observer agreement on DWI and ce-T1w and to calculate quantitative measures of synovial diffusivity and *** Forty consecutive patients with known or suspected arthritis of the knee(25 girls,median age 12 years)underwent routine 1.5T MRI with ce-T1w and transverse DWI with b values 50 and 800 s/*** apparent diffusion coefficient(ADC)values and signal intensity of inflamed synovium,joint effusion and muscle were measured with regions of interest ***-contrast T1 w images(diagnostic standard)and diffusion-weighted images at b=800 s/mm2 with ADC map were separately rated by three independent and blinded readers with different levels of expertise for the presence and degree of synovitis along with the level of diagnostic *** Thirty-one(78%)patients showed at least some synovial contrast enhancement,17(43%)children were diagnosed with synovitis on *** by the 1st reader on ce-T1w and on DWI for synovitis showed very good agreement(kappa=0.90).Inter-observer agreement on DWI ranged from moderate to substantial with kappa values between 0.68 and 0.79(all P<0.001).Agreement and diagnostic confidence were generally lower in patients with mild and without synovial enhancement,compared to patients with *** yielded higher signal of inflamed synovium *** tissue,but lower signal *** effusion,compared to ce-T1 w(all P<0.001).Conclusions Diffusion-weighted imaging is a promising,though reader-dependent alternative to contrast-enhanced imaging in patients with arthritis of the knee,based on our preliminary *** holds potential for increasing patient safety and comfort.

关键词： Diffusion-weighted imaging Knee joint Magnetic resonance imaging Pediatric Synovitis

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CAIPIRINHA-accelerated T1w 3D-FLASH for small-bowel MR imaging in pediatric patients with Crohn's disease:assessment of image quality and diagnostic performance

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世界儿科杂志:英文版 2016年第4期12卷 455-462页

作者： Mengxia Li Anke Dick Nicole Hassold Thomas Pabst Thorsten Bley Herbert Köstler henning neubauer Department of Radiation Oncology University Hospital Wuerzburg97080 WuerzburgGermany Department of Pediatrics University Hospital Wuerzburg97080 WuerzburgGermany Department of Diagnostic and Interventional Radiology University Hospital Wuerzburg97080 WuerzburgGermany

Background:The“Controlled Aliasing In Parallel Imaging Results In Higher Acceleration”(CAPIRINHA)technique greatly accelerates T1w 3D fast low angle shot(FLASH)scans while maintaining high image *** studied image quality and conspicuity of inflammatory lesions on CAIPIRINHA-accelerated imaging for pediatric small-bowel magnetic resonance imaging(MRI).Methods:Forty-four consecutive patients(mean 14±3 years,18 girls)underwent small-bowel MRI(MR enterography,MRE)at 1.5 T including diffusion-weighted imaging(DWI),contrast-enhanced CAIPIRINHA 3D-FLASH and standard 2D-FLASH ***’s disease(CD)was confirmed in 26 patients,18 patients served as *** blinded readings were performed for grading of image quality and conspicuity of CD lesions on CAIPIRINHA FLASH and standard FLASH images in comparison to a reference standard comprising imaging and endoscopic ***:CAIPIRINHA FLASH yielded significantly higher image quality with good inter-observer agreement(κ=0.68)and showed better visual delineation in 40%of the assessed bowel lesions,as compared to standard *** was full agreement for identification of CD patients between CAIPIRINHA and standard *** FLASH detected two small-bowel lesions that were not seen on standard *** revealed additional inflammatory lesions inconspicuous on contrast-enhanced *** showed an overall diagnostic accuracy of 93%.Conclusion:We present first evidence that CAIPIRINHA greatly accelerates T1w imaging in paediatric MRE without trade-off in image quality or lesion conspicuity and is thus preferable to standard FLASH imaging.

关键词： CAIPIRINHA Crohn's disease FLASH pediatrics small-bowel MRI

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Off-label-use of sulfur-hexafluoride in voiding urosonography for diagnosis of vesicoureteral reflux in children:A survey on adverse events

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World Journal of Clinical Pediatrics 2017年第1期6卷 52-59页

作者： Alexander Sauer Clemens Wirth Isabel Platzer henning neubauer Simon Veldhoen Alexander Dierks Reinhard Kaiser Andreas Kunz Meinrad Beer Thorsten Bley Section of Pediatric Radiology Department of Diagnostic and Interventional RadiologyUniversity Hospital Wuerzburg Department of Diagnostic and Interventional Radiology University Hospital Wuerzburg Department of Pediatrics Hegau-Bodensee-Hospital Singen Department of Diagnostic and Interventional Radiology University Hospital Ulm

AIM To evaluate the risk profile of sulfur hexafluoride in voiding urosonography(VUS) based on a large cohort of *** Since 2011 sulfur hexafluoride(SH,SonoV ue?,Bracco,Italy) is the only ultrasound contrast available in the European Union and its use in children has not been *** a 4-year-period,531 children with suspected or proven vesicoureteral reflux(f/m = 478/53; mean age 4.9 years; 1 mo-25.2 years) following parental informed consent underwent VUS with administration of 2.6 ± 1.2 mL SH in a two-center study.A standardizedtelephone survey on adverse events was conducted three days *** No acute adverse reactions were *** survey revealed subacute,mostly self-limited adverse events in 4.1%(22/531).The majority of observed adverse events(17/22) was not suspected to be caused by an allergic reaction: Five were related to catheter placement,three to reactivated urinary tract infections,five were associated with perineal disinfection before voiding urosonography or perineal dermatitis and four with a common *** five patients(0.9%) hints to a potential allergic cause were noted: Perineal urticaria was reported in three interviews and isolated,mild fever in *** were minor self-limited adverse events with a subacute onset and no hospital admittance was ***-six point two percent of the parents would prefer future VUS examinations with use of *** No severe adverse events were observed and indications of self-limited minor allergic reactions related to intravesical administration of SH were reported in less than 1%.

关键词： Voiding urosonography Ultrasound contrast agent Vesicoureteral reflux SonoV ue Adverse events Sulfur hexafluoride

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