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Kwok PL, Lai AYT, Lai BMH, Luk SY, Tang KYK, Wong WWC, Khoo JLS. Magnetic resonance imaging of disorders with white matter changes in children and adolescents: a pictorial essay. Pediatr Radiol 2023; 53:1188-1206. [PMID: 36625927 DOI: 10.1007/s00247-022-05580-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/15/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023]
Abstract
White matter changes are seen in a spectrum of disorders in children and adolescents. Understanding their distribution and appearance helps to reach diagnoses in daily radiologic practice. This pictorial essay will outline the magnetic resonance imaging (MRI) appearances of diseases with white matter changes including demyelinating diseases, dysmyelinating disorders/leukodystrophies, infections, autoimmune diseases, vascular causes, mitochondrial disorders and neurocutaneous syndromes, along with a brief overview of clinical aspects of the diseases such as typical age of presentation, etiology, symptoms and signs and treatment options. This article highlights important features in common white matter diseases in children and adolescents.
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Affiliation(s)
- Po Lam Kwok
- Department of Radiology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong, SAR, China.
| | - Alta Y T Lai
- Department of Radiology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong, SAR, China
| | - Billy M H Lai
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong, SAR, China
| | - Shiobhon Y Luk
- Department of Radiology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong, SAR, China
| | - Kendrick Y K Tang
- Department of Radiology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong, SAR, China
| | - Wendy W C Wong
- Department of Radiology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong, SAR, China
| | - Jennifer L S Khoo
- Department of Radiology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong, SAR, China
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Martin D, Tong E, Kelly B, Yeom K, Yedavalli V. Current Perspectives of Artificial Intelligence in Pediatric Neuroradiology: An Overview. FRONTIERS IN RADIOLOGY 2021; 1:713681. [PMID: 37492174 PMCID: PMC10365125 DOI: 10.3389/fradi.2021.713681] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 07/21/2021] [Indexed: 07/27/2023]
Abstract
Artificial Intelligence, Machine Learning, and myriad related techniques are becoming ever more commonplace throughout industry and society, and radiology is by no means an exception. It is essential for every radiologists of every subspecialty to gain familiarity and confidence with these techniques as they become increasingly incorporated into the routine practice in both academic and private practice settings. In this article, we provide a brief review of several definitions and techniques that are commonly used in AI, and in particular machine vision, and examples of how they are currently being applied to the setting of clinical neuroradiology. We then review the unique challenges that the adoption and application of faces within the subspecialty of pediatric neuroradiology, and how these obstacles may be overcome. We conclude by presenting specific examples of how AI is currently being applied within the field of pediatric neuroradiology and the potential opportunities that are available for future applications.
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Affiliation(s)
- Dann Martin
- Vanderbilt University, Nashville, TN, United States
| | - Elizabeth Tong
- Department of Neuroradiology, Stanford Health Care, Stanford, CA, United States
| | - Brendan Kelly
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Kristen Yeom
- Department of Neuroradiology, Stanford Health Care, Stanford, CA, United States
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Ivanova GE, Bushkova YV, Suvorov AY, Stahovskaya LV, Dzhalagoniya IZ, Varako NA, Kovyazina MS, Bushkov FA. Use of a BCI-Exoskeleton Simulator with Multichannel Biofeedback in a Multidisciplinary Rehabilitation Program in Poststroke Patients. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s11055-018-0673-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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A systematic review investigating the relationship of electroencephalography and magnetoencephalography measurements with sensorimotor upper limb impairments after stroke. J Neurosci Methods 2018; 311:318-330. [PMID: 30118725 DOI: 10.1016/j.jneumeth.2018.08.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 07/17/2018] [Accepted: 08/09/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND Predicting sensorimotor upper limb outcome receives continued attention in stroke. Neurophysiological measures by electroencephalography (EEG) and magnetoencephalography (MEG) could increase the accuracy of predicting sensorimotor upper limb recovery. NEW METHOD The aim of this systematic review was to summarize the current evidence for EEG/MEG-based measures to index neural activity after stroke and the relationship between abnormal neural activity and sensorimotor upper limb impairment. Relevant papers from databases EMBASE, CINHAL, MEDLINE and pubMED were identified. Methodological quality of selected studies was assessed with the Modified Downs and Black form. Data collected was reported descriptively. RESULTS Seventeen papers were included; 13 used EEG and 4 used MEG applications. Findings showed that: (a) the presence of somatosensory evoked potentials in the acute stage are related to better outcome of upper limb motor impairment from 10 weeks to 6 months post-stroke; (b) an interhemispheric imbalance of cortical oscillatory signals associated with upper limb impairment; and (c) predictive models including beta oscillatory cortical signal factors with corticospinal integrity and clinical measures could enhance upper limb motor prognosis. COMPARING WITH EXISTING METHOD The combination of neurological biomarkers with clinical measures results in higher statistical power than using neurological biomarkers alone when predicting motor recovery in stroke. CONCLUSIONS Alterations in neural activity by means of EEG and MEG are demonstrated from the early post-stroke stage onwards, and related to sensorimotor upper limb impairment. Future work exploring cortical oscillatory signals in the acute stage could provide further insight about prediction of upper limb sensorimotor recovery.
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Hatem SM, Saussez G, Della Faille M, Prist V, Zhang X, Dispa D, Bleyenheuft Y. Rehabilitation of Motor Function after Stroke: A Multiple Systematic Review Focused on Techniques to Stimulate Upper Extremity Recovery. Front Hum Neurosci 2016; 10:442. [PMID: 27679565 PMCID: PMC5020059 DOI: 10.3389/fnhum.2016.00442] [Citation(s) in RCA: 406] [Impact Index Per Article: 50.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 08/18/2016] [Indexed: 12/27/2022] Open
Abstract
Stroke is one of the leading causes for disability worldwide. Motor function deficits due to stroke affect the patients' mobility, their limitation in daily life activities, their participation in society and their odds of returning to professional activities. All of these factors contribute to a low overall quality of life. Rehabilitation training is the most effective way to reduce motor impairments in stroke patients. This multiple systematic review focuses both on standard treatment methods and on innovating rehabilitation techniques used to promote upper extremity motor function in stroke patients. A total number of 5712 publications on stroke rehabilitation was systematically reviewed for relevance and quality with regards to upper extremity motor outcome. This procedure yielded 270 publications corresponding to the inclusion criteria of the systematic review. Recent technology-based interventions in stroke rehabilitation including non-invasive brain stimulation, robot-assisted training, and virtual reality immersion are addressed. Finally, a decisional tree based on evidence from the literature and characteristics of stroke patients is proposed. At present, the stroke rehabilitation field faces the challenge to tailor evidence-based treatment strategies to the needs of the individual stroke patient. Interventions can be combined in order to achieve the maximal motor function recovery for each patient. Though the efficacy of some interventions may be under debate, motor skill learning, and some new technological approaches give promising outcome prognosis in stroke motor rehabilitation.
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Affiliation(s)
- Samar M Hatem
- Physical and Rehabilitation Medicine, Brugmann University HospitalBrussels, Belgium; Systems and Cognitive Neuroscience, Institute of Neuroscience, Université Catholique de LouvainBrussels, Belgium; Faculty of Medicine and Pharmacy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit BrusselBrussels, Belgium
| | - Geoffroy Saussez
- Systems and Cognitive Neuroscience, Institute of Neuroscience, Université Catholique de Louvain Brussels, Belgium
| | - Margaux Della Faille
- Systems and Cognitive Neuroscience, Institute of Neuroscience, Université Catholique de Louvain Brussels, Belgium
| | - Vincent Prist
- Physical and Rehabilitation Medicine, Centre Hospitalier de l'Ardenne Libramont, Belgium
| | - Xue Zhang
- Movement Control and Neuroplasticity Research Group, Motor Control Laboratory, Department of Kinesiology, Katholieke Universiteit Leuven Leuven, Belgium
| | - Delphine Dispa
- Systems and Cognitive Neuroscience, Institute of Neuroscience, Université Catholique de LouvainBrussels, Belgium; Physical Medicine and Rehabilitation, Cliniques Universitaires Saint-Luc, Université Catholique de LouvainBrussels, Belgium
| | - Yannick Bleyenheuft
- Systems and Cognitive Neuroscience, Institute of Neuroscience, Université Catholique de Louvain Brussels, Belgium
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Abstract
Despite being as common as brain tumors in children, lack of awareness of pediatric stroke presents unique challenges, both in terms of diagnosis and management. Due to diverse and overlapping risk factors, as well as variable clinical presentations, the diagnosis can be either missed or frequently delayed. Early recognition and treatment of pediatric stroke is however critical in optimizing long-term functional outcomes, reducing morbidity and mortality, and preventing recurrent stroke. Neuroimaging plays a vital role in achieving this goal. The advancements in imaging over the last two decades have allowed for multiple modality options for suspected stroke with more accurate diagnosis, as well as quicker turnaround time in imaging diagnosis, especially at primary stroke centers. However, with the multiple imaging possibilities, referring physicians can be overwhelmed with the best option for each clinical situation and what the literature recommends. Here the authors review the etiology of pediatric stroke in the settings of arterial ischemia, hemorrhage, and cerebral sinovenous thrombosis (CSVT), with emphasis on the best diagnostic tools available, including advanced imaging techniques.
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Affiliation(s)
- Aashim Bhatia
- Department of Diagnostic Radiology, Monroe Carell, Jr. Children's Hospital at Vanderbilt, Nashville, TN, 37232, USA
| | - Sumit Pruthi
- Department of Diagnostic Radiology, Monroe Carell, Jr. Children's Hospital at Vanderbilt, Nashville, TN, 37232, USA.
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Chang PT, Yang E, Swenson DW, Lee EY. Pediatric Emergency Magnetic Resonance Imaging: Current Indications, Techniques, and Clinical Applications. Magn Reson Imaging Clin N Am 2016; 24:449-80. [PMID: 27150329 DOI: 10.1016/j.mric.2015.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
MR imaging plays an important role in the detection and characterization of several pediatric disease entities that can occur in the emergent setting because of its cross-sectional imaging capability, lack of ionizing radiation exposure, and superior soft tissue contrast. In the age of as low as reasonably achievable, these advantages have made MR imaging an increasingly preferred modality for diagnostic evaluations even in time-sensitive settings. In this article, the authors discuss the current indications, techniques, and clinical applications of MR imaging in the evaluation of pediatric emergencies.
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Affiliation(s)
- Patricia T Chang
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Edward Yang
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
| | - David W Swenson
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Edward Y Lee
- Division of Thoracic Imaging, Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
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Abstract
Stroke is a major cause of morbidity and mortality in children and long-term neurological deficits. Although cerebrovascular disorders occur less often in children than in adults, recognition of stroke in children has probably increased because of the widespread application of noninvasive diagnostic studies such as magnetic resonance imaging and computed tomography.Computed tomography (CT) should be the first imaging choice in the emergency setting when stroke is suspected. It will show the presence of hemorrhage (eg, bleeding from arteriovenous malformation). It is often normal within the first hours in arterial ischemic stroke. As in adults, magnetic resonance imaging is the neuroimaging modality to confirm the clinical diagnosis of ischemic stroke. In children, however, magnetic resonance imaging requires sedation and may not be as readily available as CT. Perfusion imaging demonstrates flow within the brain and can detect areas that are at risk of ischemia; however, further studies in the pediatric population need to be validated for this technique in children. Angiography detects arterial disease (eg, aneurysm); however, its use has been largely superseded by better magnetic resonance angiography, which is sensitive enough to visualize lesions in the proximal anterior cerebral artery, middle cerebral artery, and distal internal carotid artery (ICA). Magnetic resonance imaging using diffusion- weighted imaging is the most versatile and sensitive imaging technique for identifying ischemic lesions. In the future, we need to identify the pediatric patient presenting to the emergency department with an acute stroke and develop a pathway for the use of particular imaging techniques (eg, CT vs magnetic resonance imaging).
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Beitzke D, Simbrunner J, Riccabona M. MRI in paediatric hypoxic-ischemic disease, metabolic disorders and malformations-a review. Eur J Radiol 2008; 68:199-213. [PMID: 18799278 DOI: 10.1016/j.ejrad.2008.07.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2008] [Accepted: 07/02/2008] [Indexed: 12/20/2022]
Abstract
MRI has become the most important modality in paediatric neuroimaging. It provides an excellent anatomical overview with good spatial and temporal resolution, allows investigations of the blood vessels, and - using technologies such as diffusion-weighted imaging and magnetic resonance spectroscopy - it allows quick and exact differentiation of ischemic, hypoxic, inflammatory, oncologic, traumatic and metabolic diseases. This review presents an overview of brain MRI in infants and children with suspected hypoxic-ischemic disease, metabolic disorders or (vascular) malformations, illustrating these issues by some MRI findings in selected important conditions and discussing some major clinical and pathophysiological aspects important for imaging.
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Affiliation(s)
- Dietrich Beitzke
- Department of Radiology, Division of Neuroradiology, Medical University, Graz, Austria.
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Parikh S, Narayanan V. Misplaced peripherally inserted central catheter: an unusual cause of stroke. Pediatr Neurol 2004; 30:210-2. [PMID: 15033205 DOI: 10.1016/j.pediatrneurol.2003.09.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2003] [Accepted: 09/11/2003] [Indexed: 11/17/2022]
Abstract
Stroke in pediatric patients occurs with a frequency of 3 to 8 per 100,000. The postevent evaluation attempts to identify the etiology of ischemia whether anatomic, hematologic, or embolic, with the intention of preventing future events. We present the case of a previously healthy male who developed unilateral facial and extremity weakness 2 weeks after receiving an appendectomy. Once the usual etiologies of stroke in pediatric patients were excluded, an evaluation of the peripheral venous catheter (placed for postoperative antibiotic delivery) demonstrated arterial misplacement. This article presents the first reported case of such an occurrence in the literature and exhibits the need to pursue all avenues of evaluation if the etiology of a pediatric stroke is not initially identified.
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Affiliation(s)
- Sumit Parikh
- Department of Child Neurology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
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