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Alexopoulou E, Prountzos S, Raissaki M, Mazioti A, Caro-Dominguez P, Hirsch FW, Lovrenski J, Ciet P. Imaging of Acute Complications of Community-Acquired Pneumonia in the Paediatric Population-From Chest Radiography to MRI. CHILDREN (BASEL, SWITZERLAND) 2024; 11:122. [PMID: 38255434 PMCID: PMC10814200 DOI: 10.3390/children11010122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024]
Abstract
The most common acute infection and leading cause of death in children worldwide is pneumonia. Clinical and laboratory tests essentially diagnose community-acquired pneumonia (CAP). CAP can be caused by bacteria, viruses, or atypical microorganisms. Imaging is usually reserved for children who do not respond to treatment, need hospitalisation, or have hospital-acquired pneumonia. This review discusses the imaging findings for acute CAP complications and the diagnostic role of each imaging modality. Pleural effusion, empyema, necrotizing pneumonia, abscess, pneumatocele, pleural fistulas, and paediatric acute respiratory distress syndrome (PARDS) are acute CAP complications. When evaluating complicated CAP patients, chest radiography, lung ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) can be used, with each having their own pros and cons. Imaging is usually not needed for CAP diagnosis, but it is essential for complicated cases and follow-ups. Lung ultrasound can supplement chest radiography (CR), which starts the diagnostic algorithm. Contrast-enhanced computed tomography (CECT) is used for complex cases. Advances in MRI protocols make it a viable alternative for diagnosing CAP and its complications.
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Affiliation(s)
- Efthymia Alexopoulou
- 2nd Department of Radiology, University General Hospital “Attikon”, National and Kapodistrian University of Athens, 12462 Athens, Greece; (E.A.); (A.M.)
| | - Spyridon Prountzos
- 2nd Department of Radiology, University General Hospital “Attikon”, National and Kapodistrian University of Athens, 12462 Athens, Greece; (E.A.); (A.M.)
| | - Maria Raissaki
- University Hospital of Heraklion, Medical School, University of Crete, 70013 Heraklion, Greece;
| | - Argyro Mazioti
- 2nd Department of Radiology, University General Hospital “Attikon”, National and Kapodistrian University of Athens, 12462 Athens, Greece; (E.A.); (A.M.)
| | - Pablo Caro-Dominguez
- Pediatric Radiology Unit, Radiology Department, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot s/n, 41013 Seville, Spain;
| | - Franz Wolfgang Hirsch
- Department of Pediatric Radiology, University Hospital, Liebigstraße 20a, 04107 Leipzig, Germany;
| | - Jovan Lovrenski
- Radiology Department, Faculty of Medicine, Institute for Children and Adolescents Health Care of Vojvodina, University of Novi Sad, 21000 Novi Sad, Serbia;
| | - Pierluigi Ciet
- Department of Radiology and Nuclear Medicine, Erasmus MC—Sophia Children’s Hospital, 3015 CN Rotterdam, The Netherlands;
- Department of Radiology, University of Cagliari, 09124 Cagliari, Italy
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Concepcion NDP, Laya BF, Andronikou S, Abdul Manaf Z, Atienza MIM, Sodhi KS. Imaging recommendations and algorithms for pediatric tuberculosis: part 1-thoracic tuberculosis. Pediatr Radiol 2023; 53:1773-1781. [PMID: 37081179 PMCID: PMC10119015 DOI: 10.1007/s00247-023-05654-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 04/22/2023]
Abstract
Tuberculosis (TB) remains a global health problem and is the second leading cause of death from a single infectious agent, behind the novel coronavirus disease of 2019. Children are amongst the most vulnerable groups affected by TB, and imaging manifestations are different in children when compared to adults. TB primarily involves the lungs and mediastinal lymph nodes. Clinical history, physical examination, laboratory examinations and various medical imaging tools are combined to establish the diagnosis. Even though chest radiography is the accepted initial radiological imaging modality for the evaluation of children with TB, this paper, the first of two parts, aims to discuss the advantages and limitations of the various medical imaging modalities and to provide recommendations on which is most appropriate for the initial diagnosis and assessment of possible complications of pulmonary TB in children. Practical, evidence-based imaging algorithms are also presented.
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Affiliation(s)
- Nathan David P. Concepcion
- Section of Pediatric Radiology, Institute of Radiology, St. Luke’s Medical Center – Global City, Rizal Drive cor. 32nd St. and 5th Ave., Taguig, 1634 Philippines
- Section of Pediatric Radiology, Institute of Radiology, St. Luke’s Medical Center – Quezon City, 279 E. Rodriguez Sr. Ave., Quezon City, 1112 Philippines
| | - Bernard F. Laya
- Section of Pediatric Radiology, Institute of Radiology, St. Luke’s Medical Center – Global City, Rizal Drive cor. 32nd St. and 5th Ave., Taguig, 1634 Philippines
- Section of Pediatric Radiology, Institute of Radiology, St. Luke’s Medical Center – Quezon City, 279 E. Rodriguez Sr. Ave., Quezon City, 1112 Philippines
- Department of Radiology, St. Luke’s Medical Center College of Medicine William H Quasha Memorial, Quezon City, Philippines
| | - Savvas Andronikou
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA USA
- Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Zaleha Abdul Manaf
- Al Islam Specialist Hospital, Kuala Lumpur, Malaysia
- Faculty of Medicine, MAHSA University, Bioscience & Nursing, Kuala Lumpur, Malaysia
| | - Maria Isabel M. Atienza
- Institute of Pediatrics and Child Health, St Luke’s Medical Center, Quezon City, Philippines
- Department of Pediatrics, St. Luke’s Medical Center College of Medicine William H. Quasha Memorial, Quezon City, Philippines
| | - Kushaljit Singh Sodhi
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO USA
- Department of Radiodiagnosis, PGIMER, Chandigarh, India
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