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Objective:To summarize the clinical and imaging features of pediatric neuroglial heterotopia (NGH) in different locations.Methods:The clinical and preoperative imaging data of 9 patients (6 boys and 3 girls, median age 3 months, range from 1 to13 months) with NGH confirmed by pathology were retrospectively reviewed in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science and Technology from October 2009 to December 2020. All patients underwent preoperative CT or/and MR examination. Follow-up was performed in 12 to 60 months after operation, with a median follow-up time of 24 months. The location, range, size, density/signal intensity of the lesions were reviewed.Results:Of all 9 cases, three cases were located in nose (2 extranasal type and 1 mixed type), with the maximum diameter of 13, 13 and 15 mm; there were 3 lesions in tongue, all of which were located on the dorsum of tongue, with the maximum diameter of 13, 18 and 23 mm; there were also 2 cases located in nasopharynx, maximum diameter of 15 and 22 mm, respectively. One case was in sacrococcygeal area, with the maximum diameter as 18 mm. All lesions presented as solid masses with well-defined margins, displaying slightly low density compared to grey matter. The CT value ranged from 25 to 47 HU. Compared to grey matter or spinal cord, MRI demonstrated isointense or slight hypointense on T 1WI and slight hyperintense on T 2WI. All masses presented homogenous density or signal intensity, with mild homogenous enhancement. During postoperative follow-up, no recurrence was found in 8 cases. One case of nasal NGH with gradeⅡcleft lip recurred at 1 month follow-up after surgery, and no recurrence was found after the second surgery. Conclusions:The NGH in children has typical imaging features, and is mostly located at the extracranial midline structure.It presents as solid mass, with quasi-circular morphology, well-defined margins and homogeneous density or signal intensity similar to gray matter or spinal cord. The postoperative recurrence rate is low.
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Objective:To investigate the clinical value of magnetic resonance imaging (MRI) in the early diagnosis of ankylosing spondylitis involving hip joint.Methods:One hundred and twenty-eight patients with ankylosing spondylitis involved in the hip joint were selected who were treated in the People′s Hospital of Longhua District from January 2017 to February 2020. The patients were divided into computed tomography(CT) group (64 cases) and MRI group (64 cases) according to the examination method of CT and MRI were performed respectively, and the incidence of abnormal hip joints were analyzed, and the prognostic treatment effects of the two groups were compared after following up.Results:Twenty-seven cases of fat deposition, 43 cases of subchondral bone marrow edema and 31 cases of inflammatory changes of tendon and ligament attachment were detected in MRI group, while CT didn′t showed these changes. Thirty-four cases of hip joint lesions were detected in CT group, the detection rate was 53.1%(34/64), and 56 cases of hip joint lesions were detected in MRI group, the detection rate was 87.50(56/64), the difference was statistically significant ( P<0.05). After treated for 3 months, the cure rate of the MRI group was higher than that of the CT group: 65.6%(42/64) vs. 34.4% (22/64), the difference was statistically significant ( χ2=18.11, P<0.05). Conclusions:MRI is an important imaging method for the early diagnosis of ankylosing spondylitis involving the hip joint, and its diagnostic sensitivity is better than that of CT.
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Objective To investigate the clinical manifestations and genetic features of children with papillorenal syndrome caused by PAX2 gene mutation.Methods Clinical manifestations,imaging changes and sequencing data were collected and analyzed from a family with papillorenal syndrome who were diagnosed in Wuhan Children's Hospital in February 2018."PAX2","papillorenal syndrome" and "renal coloboma syndrome" were used as key words to search in China National Knowledge Infrastructure,Wangfang Data Knowledge Service Platform,PubMed and Human Gene Mutation Database up to April 2018.Results A ten years old girl was admitted due to "edema and urine output decreased for one week".Lab showed BUN 25.30 mmol/L,Scr 766.5 μmol/L,Urine protein 3.6 g/24 h.Imaging examination showed bilateral vesical and ureter reflux combined with left duplex kidney and duplication of ureter.Developmental dysplasia of the left hip was also found.The father of the patient had been diagnosed with chronic kidney disease for 10 years and on hemodialysis for 6 years.Next generation sequencing revealed that both the father and daughter carried a heterozygous nonsense mutation in the exon3 c.219C ＞ G(p.Y73X) of PAX2.No Chinese literature ever was reported about papillorenal syndrome.Ninety-four articles in English were retrieved and 177 patients with papillorenal syndrome were confirmed by gene analysis with a total of 92 PAX2 variants.Ten nonsense mutations had been reported.Developmental dysplasia of the hip (DDH) never be reported before.Conclusion Papillorenal syndrome caused by PAX2 mutation can mainly manifest as abnormal development of both kidney and optic nerve,which may be accompanied by other systemic abnormalities,it is rarely reported in China.DDH may be a new phenotype of papillorenal syndrome.
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According to the characteristics of postgraduates of clinical medicine and features of radiology and based on traditional teaching, picture archiving and communicating system (PACS), tutorial system, lecture and modernized tests with the help of problem-based learning (PBL) were ap-plied so that the effect of students' rotation internship was improved.
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According to the characteristics of pediatric resident training, the situation in clinic practice of medical imageology are analyzed and the major problems are pointed out.This article empha sizes significance of standardized resident training of medical imageology, presents detailed requirement which the residents must meet and aims to improve the training effect by the solutions summarized after years of experience.
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Objective:To explore the value of direct coronal CT scan for airway disease in children. Methods:The clinical and imaging data of the lung and airway disease of eighty-seven cases were retrospectively analyzed.Chest film(48 with chest fluo- roscopy) the cross and coronal CT scan were performed and confirmed by tracheal endoscopy operation in all cases. Results: The main X-ray signs on chest film(fluoroscopy) and the cross CT were obstructive emphysema obstructive pneumonia or at- electasis. The coronal CT displayed 68(78.2%) cases with foreign body of which 64 cases were positive and 4 cases nega- tive;3(3.4%)cases with tracheal bronchus; 2 of which with the right upper lobe bronchus arising from the tracheal 1case with the apical and posterior segment of the right upper lobe bronchus arising from the tracheal;7(8.0%) cases with tracheal- bronchus Stenosis:1 case with the cross diameter of the tracheal narrow 4 cases with the left bronchus narrow 2 cases with tracheal narrow compressed by esophagitis foreign body;2(2.3%) cases with trachea stenosis associated with tracheal bronchus: 1 case with the cross diameter of the tracheal narrow and the tracheal diverticulum above the carina the other one with the right tracheal-bronchus,then tracheal stenosis above the carina;4(4.6%) cases with bronchitis;2(2.3%) cases with bronchus granuloma.1(1.2%)cases bronchus TB. Conclusion:Axial and Direct coronal CT scanning can demonstrate the cause of some lung and airway diseases,provide evidence for the differential diagnosis in children and be helpful in planning virtual flexible bronchoscopy.
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With the progress of the medical imaging technology,imaging medicine plays an essential role in medical treatment practice,primarily including the imaging equipment and personnel cultivation。This paper presents some opinions on how to combine imaging technology with personnel and bring modern imaging medicine into full play. Imaging medicine progress is also changing our thought on the diagnosis and treatment,and we should accept new technology and adopt new idea,so as to bring many patients new hope.
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Objective The localization of AQP4 was studied in the brain,especially,in the periventricular organs,such as ependyma,choroid plexues,area postrema(AP) and neurohypophysis,and telencephalon as well as two kinds of endocrine gland:pineal gland and adenohypophysis,so as to provide morphological basis for water transport and balance,the secretion and regulation mechanisms of endocrine gland in the brain. Methods Immunohistochemical staining techniques(LAB-SA,BCIP/NBT) were used. Results AQP4 was most abundantly expressed in the tissues directly contacting with CSF,including the cerebral pia mater,ependyma lining of ventricules and the aqueductal system and choroid plexues.Heavy express of AQP4 was also found in the perivascular glial processes of the brain tissue.In addition,AQP4 was also distributed to the pyramidal cell layer of hippocampus,granular cell layer and polymorphic cell layer of dentate gyrus,adenohypophysis(intermedius included) and pineal gland cells as well as the periventricular organs such as area postrema(AP) and neurohypophysis.Conclusion The localization of AQP4 indicates that AQP4 is involved in not only the transport and balance of water,electrolyte metabolism and the regulation of secretion of the endocrine gland,but also in the neuroendocrine activity of the hypothalamus.