Yue Liu

Neurological disorders often result in significant morbidity and mortality, highlighting the need for timely and accurate diagnosis. Magnetic Resonance Ima

We evaluated the feasibility of reducing contrast agent and radiation dose in pediatric computed tomography pulmonary angiography (CTPA) while ensuring image quality. In this prospective study, two readers assessed the computed tomography (CT) image quality (using a 5-point scale (1: undiagnosable and 5: excellent) and objective evaluation criteria (measuring CT and noise values of the left atrium and pulmonary trunk) of 116 patients who underwent pulmonary artery computed tomography angiography (CTA) from January 2023 to April 2024. independent sample t-test and Chi-square test were used to analyze and evaluate group differences. Fifty-eight participants were enrolled in the study group (mean age, 6.86 years ± 2.74, 30 males) and fifty-eight participants were enrolled in the control group (mean age, 6.71 years ± 2.59, 22 males). The radiation dose was significantly decreased in the study group (study group, 3.01 ± 0.24 mGy, control group 3.77 ± 1.06 mGy, p < 0.001). Overall quality was higher in control group, but displaying ability of pulmonary artery trunk and branch was higher in study group (p < 0.001). This study proved that a low-dose, low-contrast CTPA strategy could reduce radiation dosage by 50% and contrast agent by 20% while maintaining a satisfying image quality.

To assess the disruptions of brain white matter (WM) structural network in children with obstructive sleep apnea (OSA) using diffusion kurtosis imaging (DKI). We use DKI tractography to construct individual whole-brain, region-level WM networks in 40 OSA and 28 healthy children. Then, we apply graph theory approaches to analyze whether OSA children would show altered global and regional network topological properties and whether these alterations would significantly correlate with the clinical characteristics of OSA. We found that both OSA and healthy children showed an efficient small-world organization and highly similar hub distributions in WM networks. However, characterized by kurtosis fractional anisotropy (KFA) weighted networks, OSA children exhibited decreased global and local efficiency, increased shortest path length compared with healthy children. For regional topology, OSA children exhibited significant decreased nodal betweenness centrality (BC) in the bilateral medial orbital superior frontal gyrus (ORBsupmed), right orbital part superior frontal gyrus (ORBsup), insula, postcentral gyrus, left middle temporal gyrus (MTG), and increased nodal BC in the superior parietal gyrus, pallidum. Intriguingly, the altered nodal BC of multiple regions (right ORBsupmed, ORBsup and left MTG) within default mode network showed significant correlations with sleep parameters for OSA patients. Our results suggest that children with OSA showed decreased global integration and local specialization in WM networks, typically characterized by DKI tractography and KFA metric. This study may advance our current understanding of the pathophysiological mechanisms of impaired cognition underlying OSA.

Yue Liu, Hongwei Wen, Yun Peng; Cortical thinning and hippocampal hypertrophy: Two risk factors for adolescents and children with OSA, Sleep, , zsad002, https:/

Childhood obstructive sleep apnea (OSA) is a common chronic sleep-related breathing disorder in children, which leads to growth retardation, neurocognitive impairments, and serious complications. Considering the previous studies about brain structural abnormalities in OSA, in the present study, we aimed to explore the altered spontaneous brain activity among OSA patients, using amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo) methods based on resting-state functional magnetic resonance imaging (MRI). Thirty-one untreated OSA children and 33 age-and gender-matched healthy children (HC) were included in this study. Compared with controls, the OSA group showed significant lower ALFF in the right lingual gyrus, decreased fALFF in the left middle frontal gyrus (MFG), but increased fALFF in the left precuneus. Decreased ReHo was found in the left inferior frontal gyrus (orbital part) and left middle frontal gyrus. Notably, the mean fALFF value of left MFG was not only significantly related to multiple sleep parameters but also demonstrated the best performance in ROC curve analysis. These findings revealed OSA children were associated with dysfunctions in the default mode network, the frontal lobe, and the lingual gyrus, which may implicate the underlying neurophysiological mechanisms of intrinsic brain activity. The correlation between the altered spontaneous neuronal activity and the clinical index provides early useful diagnostic biomarkers for OSA children as well.

Background: To explore the correlation between magnetic resonance imaging (MRI) findings and clinical prognosis in children with purulent meningitis. Methods : Forty-nine cases of children with purulent meningitiswere collected from January 2016 to December 2018 in Beijing Children's Hospital. According to the Glasgow Outcome Scale（GOS), there were 35 patients with good prognosis and 14 patients with poor prognosis. All patients were scanned by MRI. We used Chi-square test and Logistic regression to analyse the correlation between MRI features and clinical prognosis in children with purulent meningitis. Results : Among the two groups, the poor prognosis group had the worst imaging performance, while the good prognosis group had the lighter imaging performance. Chi-square test showed that the imaging signs of cerebral edema, cerebral hemorrhage, subdural effusion, hydrocephalus, venous sinus thrombosis, cerebral hernia had statistical significance between the two groups (P < 0.05). Multivariate logistic regression analysis showed that the signs of cerebral edema, subdural effusion were risk factor for poor prognosis (P < 0.001). Conclusion : There are many complications and sequelae in children with purulent meningitis. The MRI findings of cerebral edema, cerebral hemorrhage, subdural effusion, hydrocephalus, venous sinus thrombosis, cerebral hernia suggest poor prognosis. It is instructive to clinical treatment and prognosis.

Cryptococcosis is a rare pediatric disease. The aim of the study is to describe clinical characteristics and prognosis of pediatric cryptococcosis from 2002 to 2014 in Beijing Children’s Hospital. A total of 53 cases of cryptococcosis were identified, 69.8% of which were males. The mean age was 7 years. Forty-one (77.4%) patients had no underlying conditions. Fever, headache, and vomiting were the most common symptoms. The most common sites were the central nervous system (CNS), followed by the lungs. Most patients received a combination of amphotericin B and fluconazole with or without flucytosine as their initial regimen. Twenty-seven patients received a follow-up and six patients (22.2%) had died. The factors associated with neurological complications or death were headache (P = 0.008), seizures (P = 0.006), visual impairment (P = 0.011), neck stiffness (P = 0.008), low erythrocyte sedimentation rate (ESR) (P = 0.024), and a cerebral spinal fluid (CSF) cryptococcal antigen titer ≥ 1:1024 (P = 0.038). Conclusions: The majority of cryptococcosis cases in China occurred in children without underlying conditions, causing multiple organ damage. The CNS was the most common site. Patients who had headaches, seizures, or high CSF antigen titers experienced neurological complications or died. What is known: • Cryptococcosis is a rare cause of infection in children. What is new: • This review gives a brief overview over pediatric cryptococcosis in China.