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Human adenoviruses typically cause self-limited respiratory, gastrointestinal, and conjunctival infections in healthy children. In late 2021 and early 2022, several previously healthy children were identified with acute hepatitis and human adenovirus viremia.We usedA total of 15 children were identified with acute hepatitis - 6 (40%) who had hepatitis with an identified cause and 9 (60%) who had hepatitis without a known cause. Eight (89%) of the patients with hepatitis of unknown cause tested positive for human adenovirus. These 8 patients plus 1 additional patient referred to this facility for follow-up were included in this case series (median age, 2 years 11 months; age range, 1 year 1 month to 6 years 5 months). Liver biopsies indicated mild-to-moderate active hepatitis in 6 children, some with and some without cholestasis, but did not show evidence of human adenovirus on immunohistochemical examination or electron microscopy. PCR testing of liver tissue for human adenovirus was positive in 3 children (50%). Sequencing of specimens from 5 children showed three distinct human adenovirus type 41 hexon variants. Two children underwent liver transplantation; all the others recovered with supportive care.Human adenovirus viremia was present in the majority of children with acute hepatitis of unknown cause admitted to Children's of Alabama from October 1, 2021, to February 28, 2022, but whether human adenovirus was causative remains unclear. Sequencing results suggest that if human adenovirus was causative, this was not an outbreak driven by a single strain. (Funded in part by the Centers for Disease Control and Prevention.).

During October-November 2021, clinicians at a children's hospital in Alabama identified five pediatric patients with severe hepatitis and adenovirus viremia upon admission. In November 2021, hospital clinicians, the Alabama Department of Public Health, the Jefferson County Department of Health, and CDC began an investigation. This activity was reviewed by CDC and conducted consistent with applicable federal law and CDC policy.

The anatomical structure of the thalamus renders its segmentation on 3DT1 images harder due to its low tissue contrast, and not well-defined boundaries. We aimed to investigate the differences in the precision of publicly available segmentation techniques on 3DT1 images acquired at 1.5 T and 3 T machines compared to the thalamic manual segmentation in a pediatric population. Sixty-eight subjects were recruited between the ages of one and 18 years. Manual segmentation of the thalamus was done by three junior raters, and then corrected by an experienced rater. Automated segmentation was then performed with FSL Anat, FIRST, FreeSurfer, MRICloud, and volBrain. A mask of the intersections between the manual and automated segmentation was created for each algorithm to measure the degree of similitude (DICE) with the manual segmentation. The DICE score was shown to be highest using volBrain in all subjects (0.873 ± 0.036), as well as in the 1.5 T (0.871 ± 0.037), and the 3 T (0.875 ± 0.036) groups. FSL-Anat and FIRST came in second and third. MRICloud was shown to have the lowest DICE values. When comparing 1.5 T to 3 T groups, no significant differences were observed in all segmentation methods, except for FIRST (p = 0.038). Age was not a significant predictor of DICE in any of the measurements. When using automated segmentation, the best option in both field strengths would be the use of volBrain. This will achieve results closest to the manual segmentation while reducing the amount of time and computing power needed by researchers.

Diagnoses of thalamic atrophy in children are based on experts' judgments. No normative measures exist for aiding objective diagnoses. Our aim was to determine normative two-dimensions(2D) and volume measurements of the thalamus in normally developing children.MRI images of 245 patients were retrospectively collected. Only participants with normal brain MRIs were included in this cross-sectional study. Anterior-posterior (AP), transverse (T), and craniocaudal (C) diameters were measured. Volumetric masks of the thalamus were manually drawn, whereas volumetric measurements of the brain were automated.124 patients were male (50.6%). We tabulated our measurements from birth until 18 years old. No significant differences in the thalamus measurements are found between the two hemispheres nor between sexes. The most remarkable increase in the thalamus volume and AP dimension is noted in the first four years of life, following which the values seem to stabilize. Craniocaudal diameters seem to increase in the first year of life, whereas transverse diameters increase until the age of 14 before plateauing.We report normative values of the thalamus in 2D and 3D from birth until 18 years of age. A rapid increase in the thalamic size is noted during the first four years of life followed by stabilization.

BACKGROUND AND PURPOSE: Few articles in the literature have looked at the diameter of the optic nerve on MR imaging, especially in children, in whom observations are subjective and no normative data exist. The aim of this study was to establish a data base for optic nerve diameter measurements on MR imaging in the pediatric population. MATERIALS AND METHODS: This was a retrospective study on the MR imaging of pediatric subjects (younger than 18 years of age) at the Department of Diagnostic Radiology at the American University of Beirut Medical Center, Beirut, Lebanon. The optic nerve measurements were obtained by 3 raters on axial and coronal sections at 3 mm (retrobulbar) and 7 mm (intraorbital) posterior to the lamina cribrosa. RESULTS: Of 211 scans of patients (422 optic nerves), 377 optic nerves were measured and included. Ninety-four patients were female (45%) and the median age at MR imaging was 8.6 years (interquartile range, 3.9–13.3 years). Optic nerves were divided into 5 age groups: 0–6 months ( n = 18), 6 months–2 years ( n = 44), 2–6 years ( n = 86), 6–12 years ( n = 120), and 12–18 years ( n = 109). An increase in optic nerve diameter was observed with age, especially in the first 2 years of life. Measurements did not differ with eye laterality or sex. CONCLUSIONS: We report normative values of optic nerve diameter measured on MR imaging in children from birth to 18 years of age. A rapid increase in optic nerve diameter was demonstrated during the first 2 years of life, followed by a slower increase. This was independent of sex or eye laterality.