Abstract:
BACKGROUND:The classic metaphyseal lesion (CML) is highly specific for non-accidental trauma in infants. While the radiographic findings are well documented, there is little literature on the ultrasound (US) appearance. OBJECTIVE:To evaluate US findings in CMLs identified on radiographs. MATERIAL AND METHODS:This institutional review board-approved, retrospective evaluation of targeted US of CMLs was performed in selected groups of children from 2014 to 2017. Only CMLs confidently identified on radiography by a consensus of two radiologists were included. US images were obtained with a linear transducer, including longitudinal images at lateral, anterior, medial and posterior aspects. Two pediatric radiologists evaluated the US appearance, specifically the metaphyseal bone collar for thickness, deformity and fracture, as well as the sonographic zone of provisional calcification for irregularity and appearance of multiple lines. Radiography was the reference standard. RESULTS:Twenty-two patients (13 female; mean age: 4.2 months) were identified, with 39 CMLs in the tibia (n=22), femur (n=11), humerus (n=3), radius (n=2) and fibula (n=1). Thirty-three of the 39 CMLs (85%) were identified on US, while 6 (15%) were not seen (false negatives). Thirty of the 39 (77%) had metaphyseal bone collar thickening, 29 (74%) had collar deformity and 12 (31%) had visible fracture of the collar. At the sonographic zone of provisional calcification, 16/39 (41%) had irregularity and 5 (13%) had multiple lines visible. CONCLUSION:Identifying metaphyseal bone collar and zone of provisional calcification abnormalities is key to recognizing CMLs on US. While additional studies are necessary to evaluate the accuracy of US in the diagnosis of CMLs, our findings suggest US may have a potential role in either confirming or evaluating radiographically equivocal/occult CMLs.
journal_name
Pediatr Radioljournal_title
Pediatric radiologyauthors
Marine MB,Hibbard RA,Jennings SG,Karmazyn Bdoi
10.1007/s00247-019-04373-wsubject
Has Abstractpub_date
2019-06-01 00:00:00pages
913-921issue
7eissn
0301-0449issn
1432-1998pii
10.1007/s00247-019-04373-wjournal_volume
49pub_type
杂志文章abstract:BACKGROUND:Knowledge of ovarian volume is important for diagnostic evaluations; however, normal ovarian volume studies on children and adolescents are lacking. OBJECTIVE:This study aimed to analyze age-specific ovarian volume and identify the diverse factors that contribute to ovarian diagnoses. MATERIALS AND METHODS...
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更新日期:2015-02-01 00:00:00
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