1.Application of cardiac MRI in myocarditis
Chinese Pediatric Emergency Medicine 2015;22(8):539-542
Myocarditis refers to inflammatory disease of the myocardium caused by variety patho-gens,90%of patients are asymptomatic.A new and effective screening method is badly needed.Lake Louise standard cardiac MRI has become the non-invasive alternative diagnostic methods for myocarditis(instead of myocardial biopsy),as it can not only to show myocardial injury site,but can also reveal the extent of myo-cardial edema,fibrosis repair in late phase.
2.Ontology-based key techniques for structured model of post-EMR
Chinese Journal of Medical Library and Information Science 2017;26(8):13-16
A database model of ontology was established by mining the EMR-covered data according to the con-cept of fuzzy vector space model with Kawasaki disease as an example. The evidence and model for the diagnosis and treatment of Kawasaki disease were detected fromthe EMR of Kawasaki disease in the database model of ontolo-gy in order to help the clinicians to make its differential diagnosis and improve its treatment plan, thus achieving the effective EMR data mining and promoting the computer-aided clinical decision-making.
3.The clinical and high-resolution CT characteristics of invasive pulmonary fungal infections in children
Wenxian HUANG ; Weibin ZENG ; Yuejie ZHENG ; Ranran CHEN ; Hongwu ZENG
Chinese Pediatric Emergency Medicine 2016;23(5):321-324
Objective To investigate and summarize the clinical and high-resolution computed tomography(HRCT) characteristics of invasive pulmonary fungal infections(IPFIs)in children.Methods Clinical and HRCT data of 35 cases with IPFIs admitted in our hospital between March 2007 and July 2015 were retrospectively analyzed.The clinical and HRCT characteristics were summarized.Results Thirty-five patients consisted of 23 boys and 12 girls with mean age of(3.2±1.9) years.Host factors included acute leukemia (n=12),primary immunodeficiency disease (n=4),congenital heart disease (n=2),cerebral palsy (n=2),severe influenza A infection (H1N1) (n=2),ichthyosis (n=1),acquired immunodeficiency syndrome(n=1),systemic lupus erythematous (n=1),tubercular meningitis(n=1),mechanical ventilation(n=2).All patients were treated with broad-spectrum antibiotic,ranking by descending order:third-generation cephalosporins (28 cases),carbapenems(19 cases)and vancomycin (18 cases).Seventeen cases were treated with corticosteroids systemically and 12 cases with acute leukemia took antineoplastic medicine.The symptoms of IPFIs were intermittent or persistent fever,cough and rales.HRCT results:nodules (n=25,71.4%),subpleural patchy opacities (n=24,68.6%),mass (>3cm) (n=4,11.4%),halo sign (n=27,77.1%),cavities (n=8,22.9%),air crescent sign (n=4,11.4%),miliary nodules (n=2,5.7%),pleural effusion (n=14,40%).Conclusion There are certain specific characteristics of IPFIs in children in clinical and HRCT aspects.The possible diagnosis of IPFIs can be made based on clinical and HRCT features.
4.Time-dependent changes of facet joint asymmetry in patients with lumbar disc herniation
Hongwu FAN ; Jianyong ZENG ; Xianfa ZHAN ; Zhengfeng ZHANG
Chinese Journal of Trauma 2010;26(9):826-828
Objective To discuss the time-dependent changes of facet joint asymmetry in patients with lumbar disc herniation (LDH). Methods A total of 54 patients with LDH were prospectively analyzed. CT was used to judge whether there existed small joint facet asymmetry and to measure the facet joints. The present results were compared with the results that would be investigated two years later. Results The sagittal process of small facet plane accounted the majority in patients with LDH after two years, with no statistical difference compared with the results before two years (P > 0.05). During 2-year period, the facet joint asymmetry disappeared in seven patients, while the facet joint asymmetry occurred in other seven patients, with no statistical difference (P > 0.05). Conclusions Facet plane and the asymmetry will change with time. Observation of the relationship between facet joint asymmetry and LDH should be carried out in a period of time rather than at a time point.
5.MRI features of Langerhans cell histiocytosis in central nervous system in children
Hongwu ZENG ; Yungen GAN ; Wenxian HUANG ; Ling HE ; Hongsheng LIU
Chinese Journal of Radiology 2016;50(4):252-255
Objective To explore the MRI features of Langerhans cell histiocytosis (LCH) in central nervous system (CNS) in children. Methods Clinical and MRI data of 25 cases with LCH in CNS from three children's hospitals between January 2009 and December 2014 were retrospectively studied. All cases were confirmed by surgery or biopsy. All cases underwent non?contrast and contrast pituitary and/or cranial MRI examinations. The location, morphology, MRI signal and enhanced patterns of LCH lesions were observed and analyzed. Result A total of 17 cases had hypothalamic-pituitary LCH, with 2 of them complicated with pineal cyst, 2 complicated with brain parenchymal lesions, and one complicated with both pineal cyst and brain parenchymal lesions. MR images showed that neurohypophysis lost its original hyper?intensity on T1WI, and nodular or homogeneous thickening was seen in the pituitary stalks. Dura matter was involved in 3 cases, 2 of them had single lesion, and the other one got multiple lesions. Neoplasm in choroid plexus was seen in trigone of left lateral ventricles in one case. Three cases with pineal gland involved demonstrated cystic change. Four cases had gray matter involved, with cerebellar dentate nuclei involvement in 2 cases, and both thalamus and basal ganglia involvement in the other two cases. Three cases showed white matter involvement without obvious Virchow-Robin space enlargement and brain atrophy. Conclusions MR imaging of LCH in CNS shows certain specific characteristics. The diagnosis can be made comprehensively based on both clinic features and other imaging findings.
6.Objective factors affecting the image quality of low-dose cranial CT of infant
Na XIE ; Yungen GAN ; Hongwei WANG ; Hongwu ZENG ; Weiguo CAO ; Longwei SUN
Chinese Journal of Radiological Medicine and Protection 2010;30(4):472-474
Objective To investigate the objective factors that affect the image quality of infant cranial CT using different mAs. Materials and Methods Ninety infants were divided into three groups randomly. The maximum anteroposterior diameter (MAPD) of skull of each infant was measured. Three reference levels, cerebellar, basal ganglia and centrum semiovale levels were selected respectively. Only one level was studied in each group and scanned with 150, 100 and 80 mAs. The subjective quality grade and the objective noise of all images were recorded and analysed statistically. Result The average MAPD of ninety patients was (148.0 ± 17.4)mm. On the cerebellar level, the subjective quality grade was lower than the other two levels, which were 6.3% , 9.4% and 22.9% respectively when mAs were 150, 100 and 80 mAs. Both quality grade of image and objective noise were significantly correlated with MAPD.Conclusion The inherent high noise of cerebellar level and MAPD were the objective factors that affect the image quality of low-dose cranial CT of infant.
7.2021 Radiological Society of North America annual meeting: molecular nuclear medicine
Weisheng SUN ; Shumin XU ; Nihui PEI ; Peijun WANG ; Hongwu ZENG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2022;42(3):177-180
Molecular nuclear medicine is a new subject that uses nuclear medicine technology to study the changes of molecular level in organisms in order to understand their functional changes. 2021 Radiological Society of North America annual meeting has more than 40 academic reports on molecular nuclear medicine. The main content includes new tracers and new imaging methods in tumors (prostate cancer, breast cancer, rectal cancer, etc.) and other diseases (Coronavirus Disease 2019 (COVID-19), Alzheimer′s disease, Parkinson′s disease, etc.). This article reviews the relevant research progress.
8.Analysis of imaging features of bronchopulmonary dysplasia
Yaowen LI ; Shumin XU ; Hongwu ZENG
Chinese Pediatric Emergency Medicine 2022;29(6):412-417
Bronchopulmonary dysplasia(BPD)is a chronic respiratory disease characterized by alveolar and pulmonary microvascular dysplasia.It happens in premature infants, which is a major cause of death and long-term complications in premature infants.Chest radiology examination is essential for BPD, which not only reveals main radiological features such as pulmonary hyperinflation, pulmonary fibrosis and atelectasis, but also evaluates the severity and progression.These provide significant information for clinical treatment and follow-up study of children with BPD.
9.Recent advance in hypothalamic neuronal hamartoma
Chinese Journal of Neuromedicine 2018;17(7):750-754
Hypothalamic neuronal hamartomas are rarely congenital developmental neuronal masses.They often attach to the third ventricle floor,mammillary bodies and tuber cinereum,and they are composed ofheterotopic gray matter,neurons,glia and myelinated fibers.This article summarizes the etiologies,pathologies,clinical manifestations and classifications,imaging features and therapy methods ofhypothalamic neuronal hamartomas.
10.Clinical and imaging analysis of neurological complications in critically ill children infected with SARS-CoV-2 Omicron.
Xiaoyu WANG ; Xinxin QI ; Yilin ZHAO ; Feng WEI ; Weiguo YANG ; Hongwu ZENG
Chinese Critical Care Medicine 2023;35(11):1157-1163
OBJECTIVE:
To summarize clinical predictors and imaging characteristics of critically ill children infected with SARS-CoV-2 Omicron with neurological complications in Shenzhen during the peak of the first round of infections.
METHODS:
The clinical data of 11 critically ill children with neurological complications infected with SARS-CoV-2 Omicron in Shenzhen Children's Hospital from December 12 to 31, 2022, were retrospectively collected and analyzed. Laboratory test results related to liver parenchymal injury, histiocytic injury, inflammation, and coagulation function were collected, and imaging characteristics including CT and/or magnetic resonance imaging (MRI) were analyzed. The differences in CT/MRI score, acute necrotizing encephalopathy severity scale (ANE-SS) score and total score (CT/MRI score + ANE-SS score) were compared between the two groups with different prognosis during hospitation.
RESULTS:
Among 11 children, 7 were male and 4 were female. The age ranged from 10 months to 16 years. There were 5 cases of acute necrotizing encephalopathy (ANE) and 6 cases of acute fulminant cerebral edema (AFCE). During hospitalization, 3 patients survived and 8 patients died of multiple organ dysfunction syndrome (MODS), including 2 cases of ANE and 6 cases of AFCE. All cases had fever (> 38.5 centigrade), and 3 cases had ultra-high fever (> 41 centigrade). Within 48 hours of onset, all cases had disorders of consciousness and 9 cases had seizures. The 8 dead children had complications with multisystem involvement, including shock, respiratory failure, disseminated intravascular coagulation (DIC), liver failure, renal failure or myocardial damage, and the laboratory predictors related to hepatocellular injury [alanine aminotransferase (ALT), aspartate aminotransferase (AST)], histocyte injury [creatine kinase (CK), lactate dehydrogenase (LDH)], inflammation [procalcitonin (PCT), interleukin-6 (IL-6), serum ferritin (SF)], coagulation function (D-dimer) and blood glucose (Glu) increased in different quantities, of which PCT was specifically increased in 6 cases with AFCE, PLT was specifically decreased in 3 cases with AFCE, and ALT and LDH were significantly increased in 2 cases with ANE. Imaging analysis showed subarachnoid hemorrhage, basal ganglia and thalamus lesions in all 6 cases with AFCE, while thalamus lesions in all 5 cases with ANE. The ANE-SS score of 8 deceased children ranged from 2 to 7 (of which 6 cases were ≥ 5), and the ANE-SS score of 3 surviving children ranged from 0 to 2. Eight dead children had a CT/MRI score of 1-4 (of which 6 cases were 4), and 3 surviving children had a CT/MRI score of 1-2 (of which 2 cases were 1). The total score of 8 deceased children was 6-10 (of which 6 cases ≥ 8), and 3 surviving children was 1-4.
CONCLUSIONS
The neurological complications of critically ill children infected with SARS-CoV-2 Omicron in Shenzhen progressed rapidly to ANE and AFCE, with high mortality. High fever (> 40 centigrade), convulsion/disturbance of consciousness, and multiple organ failure were the most common symptoms in ANE and AFCE cases. PCT increased and PLT decreased specifically in AFCE cases. Poor prognosis (death) was more common in age < 4 years old, predictors of ALT, AST, CK, LDH, PCT, D-dimer, Glu, IL-6 increased significantly, PLT decreased significantly. The common imaging feature of ANE and AFCE is the involvement of dorsal thalamus, a new imaging sign of AFCE (subarachnoid hemorrhage) was found. The higher the ANE-SS score, CT/MRI score and total score, the greater the risk of death.
Humans
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Male
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Child
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Female
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Infant
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Child, Preschool
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SARS-CoV-2
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Interleukin-6
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Retrospective Studies
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Critical Illness
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COVID-19/complications*
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Procalcitonin
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Inflammation
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Brain Diseases/diagnostic imaging*