BackgroundChest tube drainage with fibrinolytics is a cost-effective treatment option for parapneumonic effusion and empyema in children. Although the additional use of ultrasound (US) guidance is recommended, this is rarely performed in real time to direct drain insertion.ObjectiveTo evaluate the effectiveness and safety of real-time US-guided, radiologically placed chest drains at a tertiary university hospital.Materials and methodsThis was a retrospective review over a 16-year period of all children with parapneumonic effusion or empyema undergoing percutaneous US-guided drainage at our centre.ResultsThree hundred and three drains were placed in 285 patients. Treatment was successful in 93% of patients after a single drain (98.2% success with 2 or 3 drains). Five children had peri-insertion complications, but none was significant. The success rate improved with experience. Although five patients required surgical intervention, all children treated since 2012 were successfully treated with single-tube drainage only and none has required surgery.ConclusionOur technique for inserting small-bore (≤8.5 F) catheter drains under US guidance is effective and appears to be a safe procedure for first-line management of complicated parapneumonic effusion and empyema.

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The advances in deep learning algorithms, exponential computing power, and availability of digital patient data like never before have led to the wave of interest and investment in artificial intelligence in health care. No radiology conference is complete without a substantial dedication to AI. Many radiology departments are keen to get involved but are unsure of where and how to begin. This short article provides a simple road map to aid departments to get involved with the technology, demystify key concepts, and pique an interest in the field. We have broken down the journey into seven steps; problem, team, data, kit, neural network, validation, and governance.

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