Computed Tomography Findings In Children Research Articles

The Child with a Large Head: Cranial Computed Tomography Findings in 123 Nigerian Children with Macrocephaly

Objectives: Differentiation of benign macrocephaly from other etiologies that may require prompt evaluation and intervention is very necessary to prevent long term neurological deficits. Cross-sectional imaging of the brain with Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) is recommended in evaluation of such patients. In resource poor-settings, CT is more readily available, hence the objective in this study is to evaluate the spectrum of CT findings in children with macrocephaly in our locality and document the possible etiologic factors that are amenable to surgical intervention.
 Materials and Methods: This is a retrospective study of pediatric patients with clinical diagnosis of large head/macrocephaly who were evaluated with cranial CT in a tertiary hospital in Abuja from January 2018- June 2022. SAS software (SAS Institute, Cary, North Carolina, USA) version 9.4 was used for database management and analysis with P≤ 0.05 level of significance.
 Results: One hundred and twenty three children were included in the study with ages ranging from 2 days to 4 years. Majority of the children were males, 74 (60.2%). The predominant age group at presentation was between 0 to 6 months,78 (63.4%). Hydrocephalus was the main cause of macrocephaly in 110 patients (89.4%). Congenital hydrocephalus was predominant in 81 children (73.6%). Communicating hydrocephalus was noted in 44 children (40%) while 62 (56.4%) were non-communicating. The commonest level of obstruction was at the aqueduct of Sylvius and exit foramina in 22 (35.5%) patients each. There was no significant statistical difference between the genders(P=0.920).
 Conclusion: CT is a veritable tool in the evaluation of the child with a large head with an appreciable number of surgically amenable pathologies noted. Hydrocephalus is the commonest etiology of macrocephaly in our environment with the majority of the cases due to congenital abnormalities.

Imaging of pulmonary fibrosis in children: A review, with proposed diagnostic criteria.

Computed tomography (CT) imaging findings of pulmonary fibrosis are well established for adults and have been shown to correlate with prognosis and outcome. Recognition of fibrotic CT findings in children is more limited. With approved treatments for adult pulmonary fibrosis, it has become critical to define CT criteria for fibrosis in children, to identify patients in need of treatment and those eligible for clinical trials. Understanding how pediatric fibrosis compares with idiopathic pulmonary fibrosis and other causes of fibrosis in adults is increasingly important as these patients transition to adult care teams. Here, we review what is known regarding the features of pulmonary fibrosis in children compared with adults. Pulmonary fibrosis in children may be associated with genetic surfactant dysfunction disorders, autoimmune systemic disorders, and complications after radiation, chemotherapy, transplantation, and other exposures. Rather than a basal-predominant usual interstitial pneumonia pattern with honeycombing, pediatric fibrosis is primarily characterized by reticulation, traction bronchiectasis, architectural distortion, or cystic lucencies/abnormalities. Ground-glass opacities are more frequent in children with fibrotic interstitial lung disease than adults, and disease distribution appears more diffuse, without clearly defined axial or craniocaudal predominance. Following discussion and consensus amongst a panel of expert radiologists, pathologists and physicians, distinctive disease features were integrated to develop criteria for the first global Phase III trial in children with pulmonary fibrosis.

Overview of chest involvement at computed tomography in children with coronavirus disease 2019 (COVID-19)

BackgroundChest computed tomography (CT) findings in children with coronavirus disease 2019 (COVID-19) have been rarely reported in a comprehensive and systematic manner.ObjectiveWe investigated the chest CT findings in children with COVID-19, and explored the differences in these findings between symptomatic patients and asymptomatic patients.Materials and methodsDemographic findings, clinical characteristics, duration of hospital stay and viral shedding, and chest CT findings in 201 children infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) were retrospectively analyzed from January 15 to March 20, 2020, and divided into two groups: symptomatic group (n=136) and asymptomatic group (n=65). Chi-square test and Student’s t-test were used for statistical analysis.ResultsSymptomatic patients were mainly young children ≤3 years old (54/63, 86%),while asymptomatic patients were mainly children ≥ 6 years old (51/111, 46%). Fever (41%) and cough (41%) were the most common symptoms. Overall, 119/201 (59%) patients had chest CT findings, and symptomatic patients accounted for 82% (98/119). The CT findings presented as bilateral multiple lesions (60/119, 50.4%), ground-glass opacities (83/119, 70%) and/or consolidation (44/119, 37%) with a peripheral and subpleural distribution (62/83, 75%). Fifteen of 87 (7.2%) patients with lung lesions showed complete lesion absorption, and 42/87 (48%) improved within a mean of 9.1 (standard deviation [SD] 3.2) days. The mean duration of viral shedding was 8.7 (SD 4.9) days. Pleural effusion was very rare. No lymphadenopathy was found in either group.ConclusionSymptoms associated with pulmonary involvement were most common in infants and young children. The lung lesions of most patients were absorbed and improved in about 9 days.

A Study of CT Findings in children with neurotuberculosis

Objectives: To study the computed tomography (CT) features of tuberculous meningitis in children. Methods: A total of 45 patients diagnosed with neurotuberculosis were included. Cranial CT scans were done in these patients with and without IV contrast. The CT results were evaluated. Results: CT findings were abnormal in 41 (91.11%) and normal in 4 (8.89%). Basal exudate was the most common finding, seen in 25 (55.55%) cases followed by hydrocephalus in 15 (33.33%) cases. Infarcts were seen in 8 (17.77%), tuberculoma in 6 (13.33%), cerebral oedema in 3 (6.66%) children, cerebral atrophy and cerebral abscess were 1 (2.22%) each. Conclusion: CT is abnormal in the great majority of patients with neurotuberculosis and can aid in the diagnosis. Basal enhancement was the most common finding in our study.