ABSTRACT
AIM: A standard assessment tool for direct evaluation of procedural skills to ensure proficiency of trainees is necessary for cranial ultrasound (US) in clinical practice. This study created and validated an assessment tool for cranial US performance by radiologists. MATERIAL AND METHODS: An initial evaluation tool for cranial US using criteria was developed based on existing literature. The assessment form was modified using a three-round Delphi process by an expert panel, conducted between January 2021 and April 2021. Rubric scales for grading were added once consensus regarding generated items was reached. Experts confirmed the final assessment tool using a rubric scale. Two raters evaluated cranial US performance of 27 residents in video clips using the tool. Reliability and percent agreement were assessed. RESULTS: Seventeen pediatric radiologists working in different settings participated in the expert panel. The content validation of the proposed evaluation tool was enabled by expert pediatric radiologists. Following three rounds of the Delphi process, the initial 14-item assessment form became a final 15-item form. A three-part rubric scale was used in the final form (preparation, US machine operation, and cranial US performance). Interrater reliability was evaluated with Cohen's Kappa. The Kappa value and percent interrater agreement for most items was moderate to almost perfect (0.42-0.93 and 77.8-100%, respectively). The Cronbach's alpha values for both raters were 0.856 and 0.891. CONCLUSIONS: This study produced the first validated cranial US assessment tool using a modified Delphi method. The final assessment form is a simple and reliable tool.
Subject(s)
Echoencephalography , Radiologists , Child , Humans , Reproducibility of Results , Ultrasonography , Clinical CompetenceABSTRACT
BACKGROUND: Giant cavernous malformation (GCM) is rarely found in intraventricular or paraventricular locations. CASE SUMMARY: We present two cases of 6-mo and 21-mo boys with intraventricular and paraventricular GCMs including a literature review focused on location and imaging findings. Characteristic magnetic resonance imaging findings such as multicystic lesions and a hemosiderin ring or bubbles-of-blood appearance can assist in the differential diagnosis of a hemorrhagic intraventricular and/or paraventricular mass. CONCLUSION: Multifocal intraventricular and/or paraventricular GCM in small children is rare. The characteristic magnetic resonance imaging findings can help to differentiate GCMs from other intraventricular tumors.
ABSTRACT
OBJECTIVE: The objective of the study was to determine whether body weight (BW) can be substituted for body diameters to calculate size-specific dose estimate (SSDE) in the children. MATERIALS AND METHODS: A total of 196 torso computed tomography (CT) studies were retrospectively reviewed. Anteroposterior diameter (DAP) and lateral diameter (Dlat) were measured, and DAP+Dlat, effective diameter, SSDE diameter and SSDEBW were calculated. Correlation coefficients among body diameters, all SSDE types and percentage changes between CT dose index volumes and SSDEs were analyzed by BW and age subgroups. RESULTS: Overall BW was more strongly correlated with body diameter (r = 0.919-0.960, P < 0.001) than was overall age (r = 0.852-0.898, P < 0.001). The relationship between CT dose index volume and each of the SSDE types (r = 0.934-0.953, P < 0.001), between SSDEBW and all SSDE diameters (r = 0.934-0.953, P < 0.001), and among SSDE diameters (r = 0.950-0.989, P < 0.001) overall had strong correlations with statistical significance. The lowest magnitude difference was SSDEBW-SSDEeff. CONCLUSION: BW can be used instead of body diameter to calculate all SSDE types, with our suggested best accuracy for SSDEeff and the least variation in age < four years and BW < 20 kg. KEY MESSAGES: Size-specific dose estimate (SSDE) is a new and accurate dose-estimating parameter for the individual patient which is based on the actual size or body diameter of the patient. BW can be an important alternative for all body diameters to estimate size-specific dose or calculate SSDE in children.
