38 results on '"Peter J. Strouse"'
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2. Editors’ notebook: revisions — what does the editor want to see?
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Peter J. Strouse, Andrew T. Trout, and Amaka C. Offiah
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Pediatrics, Perinatology and Child Health ,Radiology, Nuclear Medicine and imaging - Published
- 2023
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Catalog
3. Too close to home
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Peter J. Strouse, Melissa A. Hilmes, Jeffrey E. Martus, and Kimberly A. Garver
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Pediatrics, Perinatology and Child Health ,Radiology, Nuclear Medicine and imaging - Published
- 2023
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4. Editors’ notebook: abbreviations
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Peter J. Strouse, Andrew T. Trout, Geetika Khanna, and Amaka C. Offiah
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Pediatrics, Perinatology and Child Health ,Radiology, Nuclear Medicine and imaging - Published
- 2023
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5. Editors' notebook: introduction
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Peter J. Strouse, Andrew T. Trout, and Amaka C. Offiah
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Publishing ,Pediatrics, Perinatology and Child Health ,Humans ,Radiology, Nuclear Medicine and imaging ,Editorial Policies - Published
- 2022
6. Sports injury of the pediatric musculoskeletal system
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Karen Rosendahl and Peter J. Strouse
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medicine.medical_specialty ,Sports injury ,Adolescent ,Injury control ,Poison control ,Suicide prevention ,Occupational safety and health ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Age Distribution ,0302 clinical medicine ,Risk Factors ,Injury prevention ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Child ,Musculoskeletal System ,030222 orthopedics ,Norway ,business.industry ,Incidence ,Human factors and ergonomics ,General Medicine ,United States ,Italy ,Extremity fractures ,Athletic Injuries ,Physical therapy ,business ,human activities - Abstract
Sports related injuries are common in children and adolescents, with a reported incidence of around one in ten children each year. Boys incur more and severer sports injuries than girls, and chance for injury is greater with contact or jumping sports. Sports injuries seen in children under 10-years of age are non-specific, including contusions, mild sprains, and extremity fractures, usually Salter fractures of the physes (growth plate) or plastic fractures. In the very young athlete, sports injury of the ligaments or muscle is rare as are spine or head injuries. With growth and adolescence, the intensity of sports involvement increases. Pre-pubertal children still have open physes that are prone to injury, both acute or due to stress from a repetitive activity. In addition to injury of the physes of the long bones, injuries to the physes of apophyses are common. Ligamentous injury is uncommon before physeal closure, but can occur. After the physes fuse, ligamentous injury is seen with patterns similar to adults. This review will include a description of sports related injuries seen in children and adolescents. We will concentrate on injuries that are specific for the growing skeleton, with a brief mention of those seen after fusion of the physes. more...
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- 2016
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7. ACR Appropriateness Criteria Vomiting in Infants up to 3 Months of Age
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Laura L. Hayes, Matthew D. Garber, Peter J. Strouse, Sjirk J. Westra, Sandra L. Wootton-Gorges, Christopher E. Dory, Cynthia K. Rigsby, Henry E. Rice, Abhaya V. Kulkarni, Molly Dempsey, Ramesh S. Iyer, Brian D. Coley, Molly E. Raske, John S. Myseros, Jonathan R. Dillman, Maura E. Ryan, and Boaz Karmazyn more...
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Diagnostic Imaging ,Male ,Pediatrics ,medicine.medical_specialty ,Vomiting ,Contrast Media ,Physical examination ,Diagnosis, Differential ,medicine ,Medical imaging ,Humans ,Radiology, Nuclear Medicine and imaging ,Guideline development ,Evidence-Based Medicine ,medicine.diagnostic_test ,business.industry ,Infant, Newborn ,Infant ,Evidence-based medicine ,Appropriateness criteria ,Female ,Radiopharmaceuticals ,Differential diagnosis ,medicine.symptom ,business ,Medical literature - Abstract
Vomiting is a commonly reported symptom in infants less than three months of age. There are a multitude of pathologies to consider, both within and outside the gastrointestinal tract. In addition to conducting a thorough history and physical examination, a clinician formulates a reasonable differential diagnosis by consideration of two main factors: the infant's age and the characterization of the vomit as bilious or nonbilious. In this endeavor, the clinician is able to determine if an imaging study is needed and, if so, the urgency of the request. A review of the appropriate imaging evaluation of vomiting infants in the newborn to three-month-old age group is provided by organizing the discussion around the following three clinical scenarios: bilious vomiting, intermittent nonbilious vomiting since birth, and new-onset bilious vomiting. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. more...
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- 2015
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8. A critical evaluation of US for the diagnosis of pediatric acute appendicitis in a real-life setting: how can we improve the diagnostic value of sonography?
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Maria Ladino-Torres, Andrew T. Trout, Peter J. Strouse, Deepa R. Pai, and Ramon Sanchez
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Male ,Michigan ,medicine.medical_specialty ,Adolescent ,Real life setting ,Sensitivity and Specificity ,Risk Factors ,Prevalence ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Child ,Intensive care medicine ,Ultrasonography ,Neuroradiology ,business.industry ,Infant ,Reproducibility of Results ,Image enhancement ,Appendicitis ,Image Enhancement ,medicine.disease ,stomatognathic diseases ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Acute appendicitis ,Female ,business - Abstract
We have observed that day-to-day use of US for acute appendicitis does not perform as well as described in the literature.Review the diagnostic performance of US in acute appendicitis with attention to factors that influence performance.Retrospective review of all sonograms for acute appendicitis in children from May 2005 to May 2010 with attention to the rate of identification of the appendix, training of personnel involved and diagnostic accuracy.The appendix was identified in 246/1,009 cases (24.4%), with identification increasing over time. The accuracy of US was 85-91% with 35 false-positives and 54 false-negatives. Pediatric sonographers were significantly better at identifying the appendix than non-pediatric sonographers (P 0.0001). Increased weight was the only patient factor that influenced identification of the appendix (P = 0.006). CT use was stable over the 5 years but declined in cases where the appendix was identified by US.In day-to-day use, US does not perform as purported in the literature. We do not visualize the appendix as often as we should and false-negative and false-positive exams are too common. To improve the diagnostic performance of this modality, involvement by experienced personnel and/or additional training is needed. more...
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- 2012
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9. CT and MRI appearances and radiologic staging of pediatric renal cell carcinoma
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Peter J. Strouse, Maria Ladino-Torres, Peter F. Ehrlich, Ryan T. Downey, Jonathan B. McHugh, and Jonathan R. Dillman
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Male ,medicine.medical_specialty ,Adolescent ,Malignancy ,Sensitivity and Specificity ,Renal cell carcinoma ,Humans ,Medicine ,Pediatric Renal Cell Carcinoma ,Radiology, Nuclear Medicine and imaging ,Child ,Carcinoma, Renal Cell ,Neoplasm Staging ,Neuroradiology ,business.industry ,Reproducibility of Results ,Cancer ,medicine.disease ,Magnetic Resonance Imaging ,Primary tumor ,Kidney Neoplasms ,Pediatrics, Perinatology and Child Health ,T-stage ,Female ,Radiology ,Tomography, X-Ray Computed ,business ,Calcification - Abstract
Renal cell carcinoma (RCC) is an uncommon but noteworthy primary pediatric renal malignancy. There is a paucity of published data regarding the CT/MRI appearances and accuracy of pretreatment radiologic staging of this form of cancer in children. To review the various CT/MRI appearances of pediatric RCC and assess the accuracy of pretreatment radiologic staging using these imaging modalities. Institutional Departments of Pathology and Radiology records were searched from 1995 through 2010 for children (younger than 18 years of age) with RCC. Available pretreatment contrast-enhanced abdominopelvic CT and MRI examinations were reviewed by two radiologists. Pertinent imaging findings were documented by consensus, and correlation was made between radiologic and surgicopathological TNM staging. Pretreatment imaging studies from 10 RCCs in nine children (four girls and five boys; mean age 12.9 years) were reviewed. The mean size of the primary tumor was 6.2 cm (range, 1.5–12.6 cm). Ninety percent of RCCs demonstrated heterogeneous postcontrast enhancement. Fifty percent of masses had associated hemorrhage, while 40% contained internal calcification. Regarding TNM staging, N staging was correct for 10 of 10 tumors, while M staging was correct for 10 of 10 tumors. Imaging correctly staged only 4 of 10 tumors with respect to T stage. Radiologic and surgicopathological overall staging were concordant for 8 of 10 tumors. Pediatric RCCs typically present as large, heterogeneous masses, and they commonly hemorrhage and contain internal calcification. Radiologic and surgicopathological overall TNM staging are frequently concordant, although radiologic T staging is often incorrect. more...
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- 2012
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10. Accuracy of CT-guided percutaneous core needle biopsy for assessment of pediatric musculoskeletal lesions
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Peter J. Strouse, J. Sybil Biermann, and Anastasia L. Hryhorczuk
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Male ,Core needle ,medicine.medical_specialty ,Percutaneous ,Adolescent ,medicine.diagnostic_test ,business.industry ,Biopsy, Needle ,Ultrasound ,Bone Neoplasms ,Equipment Design ,Radiography, Interventional ,Diagnosis, Differential ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Biopsy ,Humans ,Medicine ,Female ,Radiology, Nuclear Medicine and imaging ,Radiology ,Child ,Tomography, X-Ray Computed ,business ,Neuroradiology - Abstract
CT-guided percutaneous core needle biopsy has been shown in adults to be an effective diagnostic tool for a large number of musculoskeletal malignancies.To characterize our experience with CT-guided percutaneous core needle biopsy of pediatric bone lesions and determine its utility in diagnosing pediatric osseous lesions, in a population where such lesions are commonly benign.From 2000 to 2009, 61 children underwent 63 CT-guided percutaneous biopsies. Radiological, pathological and clinical records were reviewed.Fourteen biopsies (22%) were performed on malignant lesions, while 49 biopsies (78%) were performed on benign lesions. Forty-nine of the 63 biopsies (78%) were adequate; these children underwent no further tissue sampling. Fourteen of the 63 biopsies (22%) were inadequate or non-conclusive. Of these patients, 12 underwent open biopsy. Retrospective analysis of percutaneous biopsies in these patients demonstrates that 9/12 provided clinically relevant information, and 4/12 patients received final diagnoses that confirmed initial core biopsy findings. No malignancies were diagnosed as benign on percutaneous biopsy. Overall, percutaneous core needle biopsy provided accurate diagnostic information in 84% (53/63) of biopsies.Our results demonstrate that CT-guided percutaneous biopsy is safe and beneficial in children. This study supports the use of CT-guided percutaneous core needle biopsy for primary diagnosis of pediatric bone lesions. more...
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- 2011
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11. Vertical expandable prosthetic titanium rib device insertion: does it improve pulmonary function?
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Robert A. Drongowski, Peter J. Strouse, Samir K. Gadepalli, Ronald B. Hirschl, Wan C. Tsai, Frances A. Farley, Kelly L. Vanderhave, and Michelle S. Caird
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Male ,Vital capacity ,medicine.medical_specialty ,Ellis-Van Creveld Syndrome ,Vital Capacity ,Ribs ,Scoliosis ,Prosthesis Design ,Pulmonary function testing ,law.invention ,Prosthesis Implantation ,Quality of life ,law ,Humans ,Medicine ,Lung volumes ,Child ,Lung ,Titanium ,business.industry ,Infant, Newborn ,Infant ,General Medicine ,Plastic Surgery Procedures ,medicine.disease ,Intensive care unit ,Respiratory Function Tests ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Child, Preschool ,Thoracic insufficiency syndrome ,Pediatrics, Perinatology and Child Health ,Female ,Respiratory Insufficiency ,Tomography, X-Ray Computed ,business - Abstract
Purpose Vertical expandable prosthetic titanium rib (VEPTR) insertion and expansion has been advocated to increase thoracic volume and pulmonary function in patients with thoracic insufficiency syndrome. We reviewed our experience with VEPTR implantation to determine if lung function and growth is augmented, to determine the children's functional status, and if the scoliosis is controlled. Methods From 2006 to 2010, 29 insertions and 57 expansions were performed in 26 patients at our institution. Demographic data were reviewed in conjunction with complications, scoliosis angles, pulmonary function tests (PFTs), and computed tomography–guided 3D reconstructions to determine lung volumes; and quality of life scores were determined using a modified Scoliosis Research Society (SRS) questionnaire preoperatively and postoperatively. The groups were also stratified by age (because of lung growth potential), disease (congenital or infantile scoliosis, Jeune syndrome, neuromuscular, other structural thoracic disorders), and sex. Analyses using SPSS (SPSS, Chicago, Ill) were performed with P Results Each patient underwent 3.03 ± 1.8 surgeries, spending 0.97 ± 1.8 days in the intensive care unit and 4.41 ± 6 days in the hospital for each procedure. Mean age was 90.7 ± 41 months. Of the 36 complications, most were because of infection (12), half requiring operative repair (hardware removal). The average PFT percent predicted values for forced expiratory volume in 1 second, forced vital capacity, and RV were 54.6 ± 22, 58.1 ± 24, and 145.3 ± 112, respectively, preoperatively and 51.8 ± 20, 55.9 ± 20, and 105.6 ± 31, respectively, postoperatively. The lung volumes measured by computed tomography when corrected for age do not increase significantly postoperatively. The mean Cobb measurement for the preoperative major curves was 64.7° and postoperatively was 46.1° for those curves measured preoperatively, for a 29% curve improvement. All postoperative curves had a mean of 56.4° and 58.1° at final follow-up, a 3% curve increase. The SRS scores for patients remained unchanged and no statistical difference was seen from preoperative to postoperative values. No statistically significant difference was seen in complications, PFT (forced expiratory volume in 1 second, forced vital capacity, RV), lung volumes, scoliosis angles, and SRS scores between sex, age, and disease categories. Conclusion There was mild improvement in scoliosis angles but no improvement in lung function and volume. Scoliosis Research Society scores indicate that the children have near normal function both before and after VEPTR placement. Pulmonary function, lung volume, and patient subjective assessments did not increase dramatically after VEPTR placement, although scoliosis angles improved. more...
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- 2011
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12. MRI of the knee: key points in the pediatric population
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Peter J. Strouse
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musculoskeletal diseases ,medicine.medical_specialty ,Knee Joint ,business.industry ,Knee Injuries ,Magnetic Resonance Imaging ,Surgery ,Pediatrics, Perinatology and Child Health ,medicine ,Physical therapy ,Humans ,Radiology, Nuclear Medicine and imaging ,Joint Diseases ,Child ,Knee injuries ,business ,human activities ,Pediatric population ,Neuroradiology - Abstract
The knee is the joint which is most commonly imaged by MRI in children. With increasing participation in competitive sports at younger ages, knee injuries are common in children. While older adolescents have patterns of injury similar to those seen in adults, injuries seen in skeletally immature patients differ. In this essay, the MR findings of injuries of the skeletally immature knee are highlighted. more...
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- 2010
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13. Validation of US as a first-line diagnostic test for assessment of pediatric ileocolic intussusception
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Peter J. Strouse and Anastasia L. Hryhorczuk
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Male ,Michigan ,medicine.medical_specialty ,Validation study ,First line ,Sensitivity and Specificity ,Intussusception (medical disorder) ,Prevalence ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Child ,Ultrasonography ,Neuroradiology ,Ileal Diseases ,business.industry ,General surgery ,Infant, Newborn ,Infant ,Reproducibility of Results ,Diagnostic test ,Ileocolic intussusception ,medicine.disease ,Surgery ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,business ,Intussusception - Abstract
From the early 1980s onward, US has been considered a possible primary modality to assess patients for ileocolic intussusception. Since 2001, our institution has routinely used US to assess patients for ileocolic intussusception.We analyzed 7 years of institutional experience to assess the value of US as a primary diagnostic test for intussusception.This study was IRB-approved. From 1 January 2001 through 16 December 2007 814 US examinations for intussusception were performed in children aged 10 years and younger. Clinical records and radiological reports were reviewed for each patient, and cases were classified as true-positive, true-negative, false-positive, or false-negative.Of the 814 US examinations, 112 (13.8%) were interpreted as positive for intussusception, and of these, 96 were confirmed by enema, 1 was confirmed by surgery, and 15 (13.4%) were false-positive. Of the 814 examinations, 700 (85.9%) were interpreted as negative for intussusception, and of these, 698 (99.7%) were true-negative, and 2 were false-negative. Less than 1% of studies were nondiagnostic. The overall sensitivity of US for detecting intussusception was 97.9% and specificity was 97.8%. The positive predictive value of the test was 86.6% and the negative predictive value was 99.7%.US is a sensitive and specific test for detecting ileocolic intussusception and should be utilized as a first-line examination for assessment of possible pediatric intussusception. more...
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- 2009
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14. Neuroimaging Evaluation of Non-accidental Head Trauma with Correlation to Clinical Outcomes: A Review of 57 Cases
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Doris D. M. Lin, Peter J. Strouse, Myria Petrou, Martha D. Carlson, Bradley R. Foerster, Majda M. Thurnher, and Pia C. Sundgren
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Male ,Child abuse ,Pediatrics ,medicine.medical_specialty ,Developmental Disabilities ,Poison control ,Risk Assessment ,Article ,Head trauma ,Neuroimaging ,Predictive Value of Tests ,medicine ,Humans ,Child Abuse ,Retrospective Studies ,Neuroradiology ,medicine.diagnostic_test ,business.industry ,Diffuse axonal injury ,Infant, Newborn ,Infant ,Magnetic resonance imaging ,Retrospective cohort study ,Prognosis ,medicine.disease ,Magnetic Resonance Imaging ,United States ,Brain Injuries ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,Tomography, X-Ray Computed ,business - Abstract
Objective To review the clinical presentation and neuroimaging findings in patients with high clinical suspicion for non-accidental trauma (NAT) of the head, to investigate associations between imaging findings and long-term neurologic outcome in abused children. Study design A retrospective review of 57 cases of NAT of the head from a single institution was performed. Neuroimaging studies (computed tomography [CT] and magnetic resonance imaging [MRI]) were reviewed by a senior neuroradiologist, a neuroradiology fellow, and a radiology resident. Clinical history and physical findings, including retinal examination, imaging, and follow-up assessment, were reviewed. Results The mean time between the patient's arrival at the hospital and CT and MRI imaging was 2.9 hours and 40.6 hours, respectively. The most common clinical presentation was mental status changes, seen in 47% of patients. The most common neuroimaging finding was subdural hematoma, seen in 86% of patients. In the 47 patients who underwent both MRI and CT, 1 case of suspected NAT was missed on head CT. CT detected signs of global ischemia in all 11 patients who died (mean time after arrival at the hospital until undergoing CT, 1.1 hours). MRI detected additional signs of injury in patients who developed mild to moderate developmental delay. Conclusion CT was able to detect evidence of NAT of the head in 56 of 57 abused children included in our cohort and predicted severe neurologic injury and mortality. MRI was useful in detecting additional evidence of trauma, which can be helpful in risk stratification for neurologic outcomes as well in providing confirming evidence of repeated injury. more...
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- 2009
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15. Pediatric renal leukemia: spectrum of CT imaging findings
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Peter J. Strouse, Jonathan R. Dillman, Melissa A. Hilmes, and Rajen Mody
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Male ,Pathology ,medicine.medical_specialty ,Adolescent ,Iohexol ,Contrast Media ,Renal function ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Child ,Retrospective Studies ,Neuroradiology ,Leukemia ,business.industry ,Ultrasound ,Infant ,Retrospective cohort study ,medicine.disease ,Kidney Neoplasms ,medicine.anatomical_structure ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Nephromegaly ,Abdomen ,Female ,Radiology ,medicine.symptom ,Tomography, X-Ray Computed ,business ,medicine.drug - Abstract
The kidneys are a site of extramedullary leukemic disease that can be readily detected by CT. To demonstrate the spectrum of CT findings in children with renal leukemic involvement. Twelve children were identified retrospectively as having renal leukemic involvement by contrast-enhanced CT of the abdomen. Contrast-enhanced CT images through the kidneys of each patient were reviewed by two pediatric radiologists. Pertinent imaging findings and renal lengths were documented. The electronic medical record was accessed to obtain relevant clinical and pathologic information. Five patients with renal leukemic involvement presented with multiple bilateral low-attenuation masses, while three patients demonstrated large areas of wedge-shaped and geographic low attenuation. Four other patients presented with unique imaging findings, including a solitary unilateral low-attenuation mass, solitary bilateral low-attenuation masses, multiple bilateral low-attenuation masses including unilateral large conglomerate masses, and bilateral areas of ill-defined parenchymal low attenuation. Two patients showed unilateral nephromegaly, while eight other patients showed bilateral nephromegaly. Two patients had normal size kidneys. Two patients had elevated serum creatinine concentrations at the time of imaging. Renal leukemic involvement in children can present with a variety of CT imaging findings. Focal renal abnormalities as well as nephromegaly are frequently observed. Most commonly, renal leukemic involvement does not appear to impair renal function. more...
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- 2008
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16. FDG PET for the study of primary hepatic malignancies in children
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Judith A. Pohlen, Peter J. Strouse, Barry L. Shulkin, Rajen Mody, and Sachit Malde
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Hepatoblastoma ,Male ,Malignancy ,Sensitivity and Specificity ,Hepatic function ,Fluorodeoxyglucose F18 ,Humans ,Medicine ,Rhabdomyosarcoma, Embryonal ,Rhabdomyosarcoma ,medicine.diagnostic_test ,Adult patients ,business.industry ,Liver Neoplasms ,Infant ,Hematology ,medicine.disease ,Oncology ,El Niño ,Positron emission tomography ,Child, Preschool ,Positron-Emission Tomography ,Pediatrics, Perinatology and Child Health ,Female ,Sarcoma ,Radiopharmaceuticals ,business ,Nuclear medicine - Abstract
*INTRODUCTIONFDG PET is an important imaging modality in themanagement of adult patients with oncologic disorders,andhasbeenapprovedbytheCenterforMedicareServicefor multiple indications [1]. The role of FDG PET in theevaluation of pediatric malignancies is evolving [2,3].PET holds great promise in assisting the management ofchildhood tumors, but since these are relatively rare, theprecise roles of PET in individual malignancies have notyetbeenwelldefined.Thereislimitedliteratureontheroleof FDG PET in primary hepatic malignancies in adults.In children, who have a different spectrum of primaryliver tumors as compared to adults, the data are evensparser.Incontrasttoadults,childrenwithprimaryhepaticmalignancies typically have normal hepatic function andnormal hepatic structure in areas not involved with tumor[4–6]. Inview of themany differences between adult andpediatric hepatic malignancies, we sought to explore theuptake of FDG in pediatric patients with primary livertumorsandtoevaluatethepotentialclinicalutilityofFDGPETimaging in children with liver tumors.MATERIALS AND METHODSSeven patients, aged 11 months to 5 years 4 months,underwent FDG PET scanning. There were four boys,three girls. Diagnoses were hepatoblastoma (n¼5) andembryonal rhabdomyosarcoma (n¼2). In addition,patients also underwent CT scans, MRI and bone scansasclinicallyindicated.FDGPETscanwasobtainedwithin2 weeks of concurrent CT, MRI, or bone scan. The FDGPET scan procedurewas explained, and written informedconsent was obtained from a parent of the pediatricpatient.ParentswereinstructedtomaintainthechildNPOfor4hrforscans occurringintheafternoon,orNPOaftermidnightforscansoccurringinthemorning.Patients1–6received 370 MBq (10 mCi) FDG/1.7 m more...
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- 2006
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17. Parenteral Nutrition–Associated Cholestasis in Neonates: Multivariate Analysis of the Potential Protective Effect of Taurine
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Moustafa M. Aouthmany, Jonathan I. Groner, Peter J. Strouse, Marilyn R. Brown, Thomas F. Tracy, Adolfo Llanos, Morton B. Brown, Patricia A. DeRusso, Ronald B. Hirschl, Sunkyung Yu, Jean Cox, Daniel H. Teitelbaum, Robert J. Shulman, Jacqueline Dahlgren, and Ariel U. Spencer more...
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Parenteral Nutrition - Associated Cholestasis ,Cholagogues and Choleretics ,Parenteral Nutrition ,Taurine ,medicine.medical_specialty ,030309 nutrition & dietetics ,Critical Illness ,Medicine (miscellaneous) ,Gestational Age ,Infant, Premature, Diseases ,Placebo ,Enteral administration ,Gastroenterology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Double-Blind Method ,Cholestasis ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,0303 health sciences ,Nutrition and Dietetics ,business.industry ,Infant, Newborn ,Gestational age ,Bilirubin ,medicine.disease ,Parenteral nutrition ,Endocrinology ,chemistry ,Multivariate Analysis ,030211 gastroenterology & hepatology ,Cholecystokinin ,business ,Infant, Premature - Abstract
Neonates receiving parenteral nutrition (PN) are at risk for PN-associated cholestasis (PNAC); however, no preventive factors for PNAC have been clearly identified. Despite reports suggesting that taurine may prevent PNAC in neonates, such an effect of taurine has not yet been definitively demonstrated. We determined whether taurine supplementation reduces the incidence of PNAC in premature or critically ill neonates.This study was part of a prospective, randomized, multi-institutional trial designed to assess cholecystokinin vs placebo as a potential preventive therapy of PNAC. Taurine supplementation of PN varied between institutions. The presence or absence of taurine in PN was analyzed by multivariate analysis, with a primary outcome measure of serum conjugated bilirubin (CB) as a measure of PNAC.Taurine reduced PNAC in premature infants (estimated maximum CB [95% confidence interval] 0.50 mg/dL [-0.17 to 1.18] for those receiving taurine, vs 3.45 mg/dL [1.79-5.11] for neonates not receiving taurine, approaching significance, p = .07). Taurine significantly reduced PNAC in infants with necrotizing enterocolitis (NEC; estimated maximum CB 4.04 mg/dL [2.85-5.23], NEC infants receiving taurine, vs 8.29 mg/dL [5.61-10.96], NEC infants not receiving taurine, p.01). There were too few neonates with surgical anomalies to evaluate the effect of taurine in this group.Within specific subgroups of neonatal patients, taurine supplementation does offer a very significant degree of protection against PNAC. Patients with NEC or severe prematurity are most likely to benefit substantially from taurine supplementation. more...
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- 2005
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18. Use of Cholecystokinin-Octapeptide for the Prevention of Parenteral Nutrition-Associated Cholestasis
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Moustafa M. Aouthmany, Daniel H. Teitelbaum, Jonathan I. Groner, Peter J. Strouse, Robert J. Shulman, Jeanne M. Cox, Morton B. Brown, Adolfo Llanos, Thomas F. Tracy, Ronald B. Hirschl, Jacqueline Dahlgren, Patricia A. DeRusso, Sunkyung Yu, and Marilyn R. Brown more...
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Parenteral Nutrition - Associated Cholestasis ,medicine.medical_specialty ,Infant, Premature, Diseases ,Placebo ,Enteral administration ,Sincalide ,law.invention ,Double-Blind Method ,Cholestasis ,Randomized controlled trial ,law ,Internal medicine ,medicine ,Humans ,Infant, Very Low Birth Weight ,Treatment Failure ,Ultrasonography ,business.industry ,Mortality rate ,Infant, Newborn ,Gallbladder ,Bilirubin ,medicine.disease ,Surgery ,Low birth weight ,Parenteral nutrition ,Pediatrics, Perinatology and Child Health ,Parenteral Nutrition, Total ,medicine.symptom ,business ,Infant, Premature - Abstract
Objective. To determine whether cholecystokinin-octapeptide (CCK-OP) would prevent or ameliorate parenteral nutrition-associated cholestasis (PNAC) among high-risk neonates treated with total parenteral nutrition.Study Design. This was a multicenter, double-blind, randomized, controlled trial conducted between 1996 and 2001.Patients. Neonates at risk for the development of PNAC included very low birth weight neonates and those with major surgical conditions involving the gastrointestinal tract.Setting. Tertiary care hospitals.Intervention. Patients were randomized to receive CCK-OP (0.04 μg/kg per dose, twice daily) or placebo. Eligible infants were all Outcome Measures. The primary outcome measure was conjugated bilirubin (CB) levels, which were measured weekly. Secondary outcome measures included incidence of sepsis, times to achieve 50% and 100% of energy intake through the enteral route, number of ICU and hospital days, mortality rate, and incidences of biliary sludge and cholelithiasis.Results. A total of 243 neonates were enrolled in the study. CCK-OP administration did not significantly affect CB levels (1.76 ± 3.14 and 1.93 ± 3.31 mg/dL for CCK-OP and placebo groups, respectively; mean ± SD). Secondary outcome measures also were not significantly affected by the study drug.Conclusions. Use of CCK-OP failed to reduce significantly the incidence of PNAC or levels of CB. CCK-OP had no effect on other secondary measures and should not be recommended for the prevention of PNAC. more...
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- 2005
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19. AGGRESSIVE HEPATIC ANGIOMYOLIPOMA IN A CHILD
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Craig Arthur McKinney, Robert E. Ruiz, Peter J. Strouse, James D. Geiger, and Valerie P. Castle
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Pathology ,medicine.medical_specialty ,Kidney ,Angiomyolipoma ,Adolescent ,Hepatic Angiomyolipoma ,business.industry ,Liver Neoplasms ,Abnormal blood vessels ,Adipose tissue ,Hematology ,medicine.disease ,Resection ,medicine.anatomical_structure ,Oncology ,Smooth muscle ,Pediatrics, Perinatology and Child Health ,medicine ,Humans ,Female ,business ,Progressive disease - Abstract
Angiomyolipoma is a tumor of the kidney and, more rarely, the liver, which histologically consists of smooth muscle cells, adipose cells, and abnormal blood vessels in varying proportions. This tumor is generally benign and resection is curative, but here the authors present the case of a 14-year-old girl with an unusual primary hepatic angiomyolipoma that recurred following resection and behaved aggressively. Despite stabilization with a number of novel therapies, the child ultimately died of progressive disease. more...
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- 2005
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20. Non-contrast thin-section helical CT of urinary tract calculi in children
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Peter J. Strouse, Gregory D. Bates, David A. Bloom, and Mitchell M. Goodsitt
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Male ,medicine.medical_specialty ,Adolescent ,Urinary system ,Child Welfare ,Contrast Media ,Pain ,urologic and male genital diseases ,Asymptomatic ,Humans ,Medicine ,False Positive Reactions ,Radiology, Nuclear Medicine and imaging ,Medical diagnosis ,Child ,Hematuria ,Retrospective Studies ,Neuroradiology ,Genitourinary system ,business.industry ,Ultrasound ,Infant Welfare ,Infant ,Dose-Response Relationship, Radiation ,Retrospective cohort study ,medicine.disease ,female genital diseases and pregnancy complications ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,Urinary Calculi ,Radiology ,medicine.symptom ,Tomography, X-Ray Computed ,business ,Urinary tract obstruction ,Follow-Up Studies - Abstract
Background: Non-contrast thin-section helical CT has gained acceptance for the diagnosis of urinary tract calculi in adults, but experience with the technique in children is limited. Purpose: To evaluate the utility of non-contrast thin section helical CT for the diagnosis of urinary tract calculi in children. Materials and methods: Radiology databases at three pediatric institutions were searched to identify all pediatric patients evaluated by "renal stone" protocol CT scans (no oral or intravenous contrast, scans covering the entire urinary tract obtained in helical mode with narrow collimation (< 5 mm)). CT scans were reviewed for the primary finding of urinary tract calculi, for secondary signs of acute urinary tract obstruction and for evidence of alternative diagnoses. Medical records were reviewed to determine clinical presentation and to confirm the eventual diagnosis. Results: One hundred thirty-seven scans of 113 children (mean age: 11.2 years) were studied. Thirty-eight of 94 examinations (40%) performed on 82 children for acute pain and/or hematuria showed ureteral calculi. Alternative diagnoses were suggested by CT on 16 scans (17%). Twenty-eight scans were performed on 10 asymptomatic children with known calculus disease confirming renal stone burden on 21 scans (75%) and persistent ureteral calculi on 6 scans (21%). Upper tract calculi were demonstrated on 10 of 15 scans (67%) performed to evaluate for calculi in patients with known non-calculus genitourinary tract abnormalities. Conclusions: Non-contrast thin section helical CT is a useful method to diagnose urinary tract calculi in children. Radiation dose in this retrospective study may exceed the lowest possible radiation dose for diagnostic accuracy. Further research is needed to optimize CT imaging parameters, while maintaining diagnostic accuracy and minimizing radiation dose. more...
- Published
- 2002
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21. Gadolinium-enhanced MR angiography (Gd-MRA) of thoracic vasculature in an animal model using double-dose gadolinium and quiet breathing
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Frank J. Londy, Peter J. Strouse, Ramiro J. Hernandez, and Thomas W. Wakefield
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Gadolinium DTPA ,Aortic arch ,Thorax ,medicine.medical_specialty ,Contrast Media ,Aorta, Thoracic ,Pulmonary Artery ,Pulmonary vein ,medicine.artery ,Image Processing, Computer-Assisted ,medicine ,Animals ,Radiology, Nuclear Medicine and imaging ,Vein ,Brachiocephalic Veins ,Neuroradiology ,business.industry ,Respiration ,Ultrasound ,medicine.anatomical_structure ,Pulmonary Veins ,Coronal plane ,Models, Animal ,Pediatrics, Perinatology and Child Health ,cardiovascular system ,Radiology ,business ,Magnetic Resonance Angiography ,Papio ,Blood vessel - Abstract
Objective. To evaluate a gadolinium-enhanced MR angiography (Gd-MRA) imaging protocol for the assessment of thoracic vessels using double-dose gadolinium and quiet breathing. An animal model was used to simulate imaging in infants and young children. Material and methods. Six baboons (Papio anubis), mean weight 5.7 kg, were sedated and intubated. After the injection of double-dose Gd-DTPA (0.2 mmol/kg) through a peripheral vein, a coronal spoiled 3D gradient-echo volume acquisition was obtained during quiet breathing. Two radiologists reviewed the images for visualization of aortic arch, brachiocephalic vessel origins, pulmonary arteries (central, upper lobe and descending branches), and pulmonary veins (upper and lower). Results. Visualization was excellent for the aortic arch, brachiocephalic vessel origins, and pulmonary arteries, including the hilar branches. Visualization was excellent for the lower and right upper pulmonary veins and fair for the left upper pulmonary vein. There was excellent agreement between radiologists. Conclusion. Imaging of thoracic vessels with Gd-MRA using double gadolinium during quiet breathing was effective in our animal model. The advantages of this technique include a short imaging time and depiction of vascular segments – branches of pulmonary arteries and intraparenchymal segments of pulmonary veins – not optimally visualized with other non-invasive imaging techniques. more...
- Published
- 2001
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22. Fatal Lymphoproliferative Disease as a Complication of Evans Syndrome
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Rama Jasty, Valerie P. Castle, and Peter J. Strouse
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Male ,Hemolytic anemia ,Epstein-Barr Virus Infections ,Purpura, Thrombocytopenic, Idiopathic ,Pathology ,medicine.medical_specialty ,Evans syndrome ,Lung ,business.industry ,medicine.medical_treatment ,Hepatosplenomegaly ,Infant ,Immunosuppression ,Syndrome ,Lung biopsy ,Lymphocyte proliferation ,medicine.disease ,Lymphoproliferative Disorders ,medicine.anatomical_structure ,Immunopathology ,medicine ,Humans ,Anemia, Hemolytic, Autoimmune ,medicine.symptom ,business - Abstract
A 9-month-old boy had bruising and petechiae. Investigation revealed a Coombs-positive hemolytic anemia and immune-mediated thrombocytopenia. The infant was treated with intravenous immunoglobulin and steroids. The infant eventually had recurrent fevers, hepatosplenomegaly, pulmonary nodules, and parenchymal central nervous system (CNS) lesions develop. Results of a lung biopsy revealed a polyclonal lymphoproliferative disease. Polymerase chain reaction analysis showed the presence of the Epstein-Barr (EB) viral genome in the lung nodules. The infant died from progressive lung disease 6 months after the initial symptoms of Evans syndrome. Lymphoproliferative disease is known to occur in a variety of settings after immunosuppression, especially in solid organ transplant recipients. We report a case of polyclonal lymphocyte proliferation in a patient with Evans syndrome. more...
- Published
- 2000
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23. Progressive esophageal leiomyomatosis with respiratory compromise
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Marjorie J. Arca, Peter J. Strouse, A. R. Guest, and Chee Chung Hiew
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medicine.medical_specialty ,Cachexia ,Adolescent ,Esophageal Neoplasms ,Esophageal Disorder ,Leiomyomatosis ,Bronchoscopy ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Esophagus ,Esophageal disease ,business.industry ,digestive, oral, and skin physiology ,Respiratory disease ,medicine.disease ,digestive system diseases ,Surgery ,Esophagectomy ,medicine.anatomical_structure ,Respiratory failure ,Pediatrics, Perinatology and Child Health ,Female ,Radiography, Thoracic ,Esophagoscopy ,Radiology ,Respiratory Insufficiency ,Tomography, X-Ray Computed ,Complication ,business - Abstract
Leiomyomatosis is a rare neoplastic condition of the pediatric esophagus. Presenting symptoms usually overlap with more common esophageal disorders, namely, gastroesophageal reflux. A patient is presented in whom leiomyomatosis progressed to the point of causing cachexia and respiratory compromise. more...
- Published
- 2000
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24. MRI evaluation of infectious and non-infectious synovitis: preliminary studies in a rabbit model
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Frank J. Londy, Peter J. Strouse, Eu Leong H.J. Teo, Michael A. DiPietro, Kei Doi, and Clarence E. Chrisp
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musculoskeletal diseases ,Staphylococcus aureus ,medicine.medical_specialty ,Pathology ,Arthritis ,Diagnosis, Differential ,Synovitis ,Arthropathy ,Image Processing, Computer-Assisted ,medicine ,Animals ,Knee ,Radiology, Nuclear Medicine and imaging ,medicine.diagnostic_test ,business.industry ,Osteomyelitis ,Synovial Membrane ,Magnetic resonance imaging ,Exudates and Transudates ,Staphylococcal Infections ,Joint effusion ,medicine.disease ,Magnetic Resonance Imaging ,Disease Models, Animal ,Talc ,Pediatrics, Perinatology and Child Health ,Histopathology ,Septic arthritis ,Rabbits ,medicine.symptom ,business ,human activities - Abstract
Background. Literature on magnetic resonance imaging (MR) evaluation of inflammatory joint effusions is sparse. Objective. To describe an animal model for studying infectious and non-infectious joint effusions with magnetic resonance imaging. Materials and methods. Ten rabbit knees with septic arthritis and four with talc synovitis were imaged with MR. Contralateral knees injected with saline served as controls. Fat saturation T2-weighted and gadolinium-enhanced T1-weighted images were assessed for joint effusion, and periarticular and adjacent intraosseous increased signal or enhancement. Each knee was cultured and underwent pathologic examination. Results. Both Staphylococcus aureus and talc produced effusions in all knees. The degree of periarticular signal and enhancement was greater in infected knees than talc-injected knees. No abnormal enhancement was seen within bone. Pathologic examination showed a greater degree of inflammation and joint destruction in the infected knees, but no evidence of osteomyelitis. Conclusion. A greater degree of abnormal signal and enhancement seen on MR suggests a more vigorous inflammatory process, as seen with septic arthritis. In spite of advanced septic arthritis, no enhancement was evident within bone, suggesting that enhancement within bone is not an expected finding in isolated septic arthritis and should raise concern for osteomyelitis. more...
- Published
- 1999
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25. Applications of magnetic resonance imaging and magnetic resonance angiography to evaluate the hepatic vasculature in the pediatric patient
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Eu Leong H.J. Teo, Martin R. Prince, and Peter J. Strouse
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Male ,medicine.medical_specialty ,Adolescent ,Magnetic resonance angiography ,Hypertension, Portal ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Child ,Neuroradiology ,medicine.diagnostic_test ,business.industry ,Liver Diseases ,Ultrasound ,Infant, Newborn ,Infant ,Magnetic resonance imaging ,equipment and supplies ,Magnetic Resonance Imaging ,eye diseases ,Liver Transplantation ,Pediatric patient ,Liver ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Hepatic vasculature ,Female ,Radiology ,business ,human activities ,Liver pathology ,Magnetic Resonance Angiography ,circulatory and respiratory physiology ,Pediatric population - Abstract
Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) offer several techniques to evaluate the hepatic vasculature. These techniques are briefly reviewed with reference to the pediatric population. Examples of MRI and MRA in the evaluation of the hepatic vasculature in pediatric patients are presented. more...
- Published
- 1999
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26. PET FDG Studies of Wilms Tumors
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Raymond J. Hutchinson, Eugenia Chang, Peter J. Strouse, Barry L. Shulkin, and David A. Bloom
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Fluorine Radioisotopes ,medicine.medical_specialty ,Renal function ,Deoxyglucose ,Wilms Tumor ,Resection ,Renal neoplasm ,Fluorodeoxyglucose F18 ,Biopsy ,medicine ,Humans ,medicine.diagnostic_test ,business.industry ,Wilms' tumor ,medicine.disease ,Kidney Neoplasms ,Functional imaging ,Positron emission tomography ,Child, Preschool ,Female ,Radiology ,Radiopharmaceuticals ,business ,Nuclear medicine ,Tomography, Emission-Computed ,Kidney disease - Abstract
Purpose Wilms tumor is the most common renal neoplasm in children. The diagnosis is usually suggested by anatomic imaging and established by biopsy or resection. The principal roles of functional imaging have been the search for skeletal metastases and evaluation of renal function. We hypothesized that, like many tumors, Wilms tumors could concentrate 18F-FDG and that evaluation of the metabolic activity of these neoplasms might prove clinically useful. Materials and methods Three patients with known or suspected Wilms tumors underwent positron emission tomography (PET) with 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) scanning (four scans). A patient with a single Wilms tumor was studied once at the time of diagnosis. The two patients with bilateral Wilms tumors were studied during therapy. Results Uptake of FDG was present in the Wilms tumor studied at diagnosis, and in one of the tumors in each of the patients with bilateral disease studied during therapy. In all three cases, the results of the PET scans influenced therapeutic decisions. Conclusion PET FDG scanning may be useful for the management of selected patients with Wilms tumors. more...
- Published
- 1997
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27. Pediatric Renal Pelvic Fullness: An Ultrasonographic Dilemma
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Michael A. DiPIETRO, Peter J. Strouse, David A. Bloom, Harry P. Koo, and Caroline E. Blane
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Male ,medicine.medical_specialty ,Adolescent ,Urology ,Asymptomatic ,medicine ,Humans ,Kidney Pelvis ,Prospective Studies ,Child ,Prospective cohort study ,Hydronephrosis ,Ultrasonography ,Kidney ,business.industry ,Ultrasound ,Infant ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Child, Preschool ,Female ,medicine.symptom ,business ,Nuclear medicine ,Renal pelvis ,Dilatation, Pathologic ,Pyelogram ,Kidney disease - Abstract
We conducted a prospective study to define normal renal pelvic size in children.Institutional Review Board approved consent was obtained to perform renal ultrasound during excretory urography (IVP) scheduled for medical management. Mean patient age (17 females, 11 males) was 5.2 years. Renal ultrasound was conducted concurrent with 10-minute IVP.Fifty kidneys were imaged with 51 collecting systems. IVP defined 44 collecting systems as normal. Mean anteroposterior pelvic diameter on sonography for these 44 systems was 3.3 mm. One normal collecting system on IVP had a diameter greater than 10 mm on ultrasound (14 mm). No sonographic caliceal dilatation was seen in any kidney appearing normal on IVP. The 7 dilated systems on IVP had a mean ultrasound diameter of 17.1 mm. Two dilated collecting systems smaller than 10 mm in diameter on sonography had caliceal distention on ultrasound.Normal renal pelvis threshold diameter was 10 mm in asymptomatic children. We recommend further evaluation in children with caliceal dilatation and/or dilatation of the anteroposterior renal pelvis greater than 10 mm. Using these criteria, no system appearing abnormal on IVP would have been missed. more...
- Published
- 2003
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28. CT appearance of the spleen following conservative management of traumatic injury
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Robert A. Drongowski, Peter J. Strouse, Caroline E. Blane, and Daniel H. Teitelbaum
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medicine.medical_specialty ,Splenic trauma ,medicine.diagnostic_test ,Conservative management ,business.industry ,Severity of injury ,Spleen ,Computed tomography ,medicine.disease ,medicine.anatomical_structure ,Traumatic injury ,Emergency Medicine ,medicine ,Ct technique ,Radiology, Nuclear Medicine and imaging ,Radiology ,business ,Pediatric trauma - Abstract
Objective: To describe the long-term changes in the traumatized spleen following conservative man- agement in pediatric patients. Methods: Between 1991 and 1997, 92 children were imaged with splenic trauma. The study population includes the 25 boys and 11 girls with follow-up computed tomography (CT) imaging at our institution. The follow-up CT studies were evalu- ated to determine the evolution of splenic injury. Re- sults: On initial CT there were 6 grade I, 12 grade II, 9 grade III, and 9 grade IV-V splenic injuries. In follow- up 11 spleens were normal (30 %), including at least one in each grade of severity of injury. Splenic abnor- malities were identified on follow-up in 25 children. These findings comprised clefts in 8 children, small cysts in 4, and devascularized segments involving less than 1c m 3 in 6, 1-2 cm 3 in 2, and 2-4 cm 3 in 5 children. Con- clusions: All grades of splenic injury can resolve com- pletely on subsequent CT imaging. In this series 30 % of patients had a normal follow-up CT. The most com- mon persistent abnormalities included clefts and devas- cularized areas less than 4 cm 3 . more...
- Published
- 1999
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29. Aortic dissection presenting as spinal cord ischemia with a false-negative aortogram
- Author
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Gregory E. Guy, John T. Santinga, Peter J. Strouse, and Michael J. Shea
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medicine.medical_specialty ,Aortography ,Ischemia ,Computed tomography ,medicine.artery ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Diagnostic Errors ,False Negative Reactions ,Aortic dissection ,Aorta ,medicine.diagnostic_test ,business.industry ,Ultrasound ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Spinal cord ,Magnetic Resonance Imaging ,Aortic Aneurysm ,Aortic Dissection ,medicine.anatomical_structure ,Spinal Cord ,Echocardiography ,Female ,Radiology ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business - Abstract
This article presents a case of type III aortic dissection presenting as a spinal cord syndrome with a prospectively negative initial aortogram. The patient serendipitously illustrates a multimodality approach to aortic dissection imaging. The advantages and disadvantages of conventional radiography, aortography, computed tomography, echocardiography, and magnetic resonance imaging are discussed. more...
- Published
- 1990
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30. Extracranial soft-tissue swelling: a normal postmortem radiographic finding or a sign of trauma?
- Author
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Clyde L. Owings, Michael J. Caplan, and Peter J. Strouse
- Subjects
Child abuse ,medicine.medical_specialty ,Soft Tissue Injuries ,Skeletal survey ,Radiography ,Autopsy ,Central nervous system disease ,medicine ,Craniocerebral Trauma ,Edema ,Humans ,Radiology, Nuclear Medicine and imaging ,Child Abuse ,Neuroradiology ,business.industry ,Infant ,Soft tissue ,medicine.disease ,Surgery ,Skull ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,Radiology ,business - Abstract
Objective. To determine if extracranial soft-tissue swelling is an expected postmortem finding or a sign of trauma. Materials and methods. Extracranial soft-tissue thickness was measured at 5 standardized locations on postmortem skull films obtained of 18 infants with no evidence of trauma on autopsy. The same measurements were performed on the skull films of 100 living children, all less than 3 years old and without clinical history of trauma. Results. Extracranial soft tissues measured only slightly greater in the postmortem group than on films of living children; however, the difference did achieve statistical significance. Conclusion. Minimal extracranial soft-tissue swelling is a normal finding on a postmortem skeletal survey. The presence of substantial or asymmetric extracranial soft-tissue swelling should be viewed with suspicion for trauma. more...
- Published
- 1998
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31. Pitfall: anomalous umbilical vein and absent ductus venosus in association with right congenital diaphragmatic hernia
- Author
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Peter J. Strouse, Mason Barr, and Michael A. Di Pietro
- Subjects
Adult ,Male ,Umbilical Veins ,medicine.medical_specialty ,Umbilical vein ,Diagnosis, Differential ,Fatal Outcome ,Pregnancy ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Hernia ,Hernia, Diaphragmatic ,Fetus ,business.industry ,Infant, Newborn ,Congenital diaphragmatic hernia ,medicine.disease ,Diaphragm (structural system) ,Surgery ,Catheter ,Liver ,Agenesis ,Pediatrics, Perinatology and Child Health ,cardiovascular system ,Female ,Radiography, Thoracic ,Hernias, Diaphragmatic, Congenital ,business ,Ductus venosus - Abstract
Congenital abnormalities of the umbilical venous system are rare. A case of fatal right congenital diaphragmatic hernia (CDH) in association with an anomalous umbilical vein bypassing the liver and directly entering the right atrium is presented. The ductus venosus was absent. Although much of the liver was within the right hemithorax, radiographs showed an apparently normal umbilical venous catheter (UVC) course, suggesting a normally positioned liver and mitigating against the diagnosis of CDH. Aberrant umbilical drainage, yielding a falsely normal appearing UVC course, may delay the diagnosis of CDH. more...
- Published
- 1997
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32. Computed tomographic diagnosis of unsuspected pyelonephritis in children
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Katherine E, Maturen, Caroline E, Blane, and Peter J, Strouse
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Male ,Adolescent ,Pyelonephritis ,Child, Preschool ,Humans ,Female ,Child ,Kidney ,Tomography, X-Ray Computed ,Retrospective Studies - Abstract
To emphasize the utility of computed tomography (CT) in the diagnosis of pyelonephritis in children with complex comorbidities.We retrospectively reviewed the CT imaging studies and medical records of 12 patients (8 girls, 4 boys; aged 2-18 years [mean 8.6 yr]) who did not have a classic presentation of pyelonephritis but were diagnosed by CT. All patients had fever at clinical presentation, and pyelonephritis was not suspected in any case. Two children had negative urine cultures before imaging.All 12 patients had wedge-shaped areas of hypoattenuation on CT, 7 bilaterally; 10 had enlargement of an involved kidney; 5 had perinephric fat stranding; and 3 had focal abscesses.Although classic and uncomplicated pyelonephritis is a clinical diagnosis that does not require imaging, sometimes the presentation may be equivocal and the diagnosis unsuspected. Pyelonephritis is one of several potential sources of fever that can be simultaneously evaluated using CT. Using. CT, the unsuspected diagnosis of pyelonephritis can be made and therapy initiated before the urine culture is positive. more...
- Published
- 2002
33. Magnetic resonance imaging of the pediatric knee
- Author
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Peter J. Strouse and Khaldoun Koujok
- Subjects
musculoskeletal diseases ,Male ,medicine.medical_specialty ,Adolescent ,Interventional magnetic resonance imaging ,Articular cartilage ,Knee Injuries ,Diagnosis, Differential ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Child ,medicine.diagnostic_test ,business.industry ,Soft tissue ,Infant ,Magnetic resonance imaging ,musculoskeletal system ,Neurovascular bundle ,Magnetic Resonance Imaging ,Child, Preschool ,Female ,Radiology ,Mr images ,business ,human activities ,Pediatric population - Abstract
Magnetic resonance imaging (MRI) is an excellent modality for imaging the pediatric knee because of its superb soft-tissue contrast, multiplanar capability, and lack of ionizing radiation. The knee is the most common joint imaged by MRI in the pediatric population. The majority of studies are performed on older children or adolescents with pain and/or known trauma. There are variations of injury and patterns of injury that are unique to children. The knee of a child also may be studied by MRI for other indications, including tumor, inflammatory disease, and developmental abnormalities. It is important to have a systematic approach to analysis of the knee MR images. Analysis should include individual attention to bones, articular cartilage, muscles and tendons, soft tissues, neurovascular bundle, joint space, fluid collections, ligaments, and menisci. more...
- Published
- 2002
34. Musculoskeletal ultrasonography in children
- Author
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Eu-Leong Harvey, Teo, Peter J, Strouse, and Rethy Kieth, Chhem
- Subjects
Male ,Adolescent ,Child, Preschool ,Infant Welfare ,Infant, Newborn ,Child Welfare ,Humans ,Infant ,Female ,Child ,Musculoskeletal System ,Musculoskeletal Abnormalities ,Ultrasonography - Published
- 2002
35. MR of physeal fractures of the adolescent knee
- Author
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Bradley J. Close and Peter J. Strouse
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Knee Injuries ,Periosteal elevation ,Proximal tibia ,Physeal fracture ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Child ,Physis ,Epiphyseal Fracture ,Neuroradiology ,medicine.diagnostic_test ,business.industry ,Soft tissue ,Magnetic resonance imaging ,Magnetic Resonance Imaging ,Tibial Fractures ,Pediatrics, Perinatology and Child Health ,Female ,Radiology ,business ,Epiphyses ,Femoral Fractures - Abstract
The aim of this study was to assess physeal fractures of the pediatric knee identified by MR imaging and to describe the MR findings of such fractures. The authors reviewed 315 consecutive pediatric knee MR examinations done to assess for traumatic injury. The MR images were reviewed for evidence of physeal fracture. Fractures were classified by the Salter-Harris system, and associated findings and injuries were noted. Plain radiographs and medical records were reviewed. Seven distal femoral physeal fractures (Salter II, n = 6; Salter III, n = 1) and two proximal tibia physeal fractures (Salter III, n = 1; complex Salter IV, n = 1) were identified. Magnetic resonance demonstrated widening of a portion of the physis with visualization of a metaphyseal/epiphyseal fracture line. Periosteal elevation was observed in six cases. Four patients had associated ligamentous or meniscal injuries. Plain radiographs were available for review in eight patients. Bone abnormalities suggesting fracture were evident in six of eight patients; however, the fracture was fully delineated in only one patient. The diagnosis or confirmation of fracture by MR changed clinical management in seven of eight patients in whom follow-up was available. Physeal fractures of the pediatric knee are occasionally diagnosed by MR. Magnetic resonance provides improved delineation of non-displaced physeal fractures of the knee, while simultaneously allowing for evaluation of soft tissue structures. more...
- Published
- 2000
36. Power Doppler evaluation of joint effusions: investigation in a rabbit model
- Author
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Peter J. Strouse, Michael A. DiPietro, Clarence E. Chrisp, Eu Leong H.J. Teo, and Kei Doi
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,Staphylococcus aureus ,medicine.medical_treatment ,Arthritis ,Sensitivity and Specificity ,symbols.namesake ,Synovitis ,Arthropathy ,medicine ,Image Processing, Computer-Assisted ,Animals ,Radiology, Nuclear Medicine and imaging ,Knee ,Saline ,Arthritis, Infectious ,business.industry ,Ultrasound ,Synovial Membrane ,Ultrasonography, Doppler ,Exudates and Transudates ,Staphylococcal Infections ,medicine.disease ,Surgery ,Disease Models, Animal ,Effusion ,Talc ,Pediatrics, Perinatology and Child Health ,symbols ,Septic arthritis ,Rabbits ,business ,Nuclear medicine ,Doppler effect - Abstract
Objective. To study the power Doppler findings of septic arthritis and noninfectious synovitis in an animal model. Materials and methods. The right knees of 10 rabbits were inoculated with an aqueous suspension of Staphylococcus aureus. The right knees of 5 rabbits were injected with talc suspension. The right knees of 5 rabbits were injected with saline. All 20 left knees were injected with saline. Serial power Doppler images were obtained using constant-imaging parameters. Images were reviewed by blinded observers who assessed for increased power Doppler signal. Results. All 10 knees inoculated with S. aureus developed septic arthritis. Each infected rabbit knee demonstrated increased signal on power Doppler on at least one examination, ranging from 1–6 days after inoculation. Only 23 of 45 examinations of infected knees were unequivocally positive by power Doppler on examinations performed 1 to 6 days after inoculation. No knee with talc synovitis demonstrated increased power Doppler signal. No control knee demonstrated increased power Doppler signal. Conclusion. Increased power Doppler signal may be seen with septic arthritis; however, its intensity and timing may vary from subject to subject. A normal power Doppler examination does not exclude septic arthritis. more...
- Published
- 1999
37. High resolution computerized tomography of the chest and pulmonary function testing in evaluating the effect of tobramycin solution for inhalation in cystic fibrosis patientsPresented in part at the European Respiratory Society Annual Congress, Glasgow, Scotland from September 4 to 8, 2004, and at North American Cystic Fibrosis Conference, St. Louis, MO from October 14 to 18, 2004.
- Author
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Samya Z. Nasr, Diane Gordon, Ermelinda Sakmar, Xin Yu, Emmanuel Christodoulou, Boris P. Eckhardt, and Peter J. Strouse
- Published
- 2006
- Full Text
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38. Late migration of a Sideris buttoned device for occlusion of atrial septal defect.
- Author
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Timothy Cotts, Peter J. Strouse, and Joseph N. Graziano
- Published
- 2006
- Full Text
- View/download PDF
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