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1.
Eur Radiol ; 24(1): 19-25, 2014 Jan.
Article in English | MEDLINE | ID: mdl-23884301

ABSTRACT

OBJECTIVES: To evaluate the performance of diffusion-weighted imaging (DWI) against the reference standard of gadolinium-enhanced T1-weighted imaging (Gd-T1-WI) in children. METHODS: Thirty-nine consecutive patients (mean age 5.7 years) with suspected acute pyelonephritis underwent magnetic resonance imaging (MRI) including DWI and (the reference standard) Gd-T1-WI. Each study was read in double-blinded fashion by two radiologists. Each kidney was graded as normal or abnormal. Sensitivity and specificity of DWI were computed. Agreement between sequences and interobserver reproducibility were calculated (Cohen κ statistic and the McNemar tests). RESULTS: Thirty-two kidneys (41 %) had hypo-enhancing areas on Gd-T1-W images. The sensitivity and specificity of DWI were 100 % (32/32) and 93.5 % (43/46). DWI demonstrated excellent agreement (κ = 0.92,) with Gd-T1-W, with no significant difference (P = 0.25) in detection of abnormal lesions. Interobserver reproducibility was excellent with DWI (κ = 0.79). CONCLUSION: DWI enabled similar detection of abnormal areas to Gd-T1-WI and may provide an injection-free means of evaluation of acute pyelonephritis. KEY POINTS: • Diffusion weighted magnetic resonance imaging (DWI) can confirm acute pyelonepritis. • DWI provided comparable results to gadolinium enhanced T1-W MRI in acute pyelonepritis. • Contrast medium injection could be avoided for diagnosing acute pyelonephritis by MRI. • MRI with T2-WI and DWI provide a fast and comprehensive diagnostic tool.


Subject(s)
Contrast Media , Diffusion Magnetic Resonance Imaging/methods , Gadolinium DTPA , Kidney/pathology , Pyelonephritis/diagnosis , Acute Disease , Adolescent , Child , Child, Preschool , Diagnosis, Differential , Female , Humans , Infant , Magnetic Resonance Imaging/methods , Male , ROC Curve , Reproducibility of Results
2.
Eur J Pediatr Surg ; 23(4): 285-8, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23487306

ABSTRACT

INTRODUCTION: The aim of this study was to evaluate the medium-term results and complications of open inguinal varicocelectomy, including vein ligation, intraoperative venography, and antegrade sclerotherapy. MATERIALS AND METHODS: Sixty-four children were treated between 2000 and 2009 for idiopathic varicocele. Fifty children were examined 6 months after surgery. In 2010, 22 patients were recalled for testicular ultrasound scans (US) to evaluate the medium-term results of the technique. RESULTS: The mean age of the children was 12.8 years at first consultation. Of the 50 cases, 35 children were asymptomatic, 13 experienced pain, 3 suffered from discomfort, and 1 had testicular asymmetry. Thirteen children had delayed left testicular growth compared with the right testis. The mean age at surgery was 13.3 years, and follow-up duration was 8.3 months ± 13.9. Thirty-eight patients achieved good results postsurgery; there was varicocele recurrence in 3, testicular hypotrophy in 7, and complete testicular atrophy in 2 patients. CONCLUSION: Naked eye inguinal surgical ligation does not appear to be safe enough to treat young adolescents, with the theoretical risk of a decrease in fertility in the future. In teams which are untrained in microsurgical or laparoscopic varicocelectomy, we suggest referring adolescent patients to a radiologist for embolization.


Subject(s)
Inguinal Canal , Sclerotherapy/methods , Testis/pathology , Varicocele/surgery , Adolescent , Follow-Up Studies , Groin/surgery , Humans , Ligation , Male , Retrospective Studies , Risk Assessment , Risk Factors , Sclerotherapy/adverse effects , Treatment Outcome , Ultrasonography , Urologic Surgical Procedures, Male/methods , Varicocele/diagnostic imaging , Varicocele/therapy
3.
Pediatr Radiol ; 42(6): 764-7, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22138865

ABSTRACT

An 11-year-old Caucasian girl was investigated for a clitoromegaly that had increased in size over 5 weeks. Clitoromegaly is a rare condition in childhood. Among nonhormonal causes are tumours, both benign and malignant. Evaluation of the adrenal glands and ovaries was performed by US. An epidermoid cyst was suggested by MRI including diffusion-weighted imaging, and this was confirmed histopathologically.


Subject(s)
Clitoris/diagnostic imaging , Clitoris/pathology , Epidermal Cyst/diagnosis , Vulvar Diseases/diagnosis , Child , Diagnosis, Differential , Female , Humans , Ultrasonography
4.
Pediatr Radiol ; 41(9): 1205-7, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21706209

ABSTRACT

We report a case of Herlyn-Werner-Wunderlich syndrome diagnosed in the neonatal period. US revealed the classic association of a uterus didelphys with blind hemivagina and no ipsilateral kidney. The diagnosis was established by postnatal US and confirmed by MRI. Differential diagnoses are discussed. A trans-hymeneal resection of the vaginal septum was performed at 1 month of age. Intra operative endoscopy revealed no left hemitrigone but showed an atretic orifice in the ipsilateral blind hemivagina, probably corresponding to the insertion of an ectopic ureter. Follow-up was unremarkable.


Subject(s)
Abnormalities, Multiple/diagnosis , Kidney/abnormalities , Urogenital Abnormalities/diagnosis , Uterine Diseases/diagnosis , Uterus/abnormalities , Vagina/abnormalities , Abnormalities, Multiple/diagnostic imaging , Female , Humans , Infant, Newborn , Magnetic Resonance Imaging , Ultrasonography , Urogenital Abnormalities/diagnostic imaging , Uterine Diseases/diagnostic imaging
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