Detection of Intestinal Pneumatosis Location by Following Hyperechoic Foci in the Portal Vein Along Its Branches With Real‐time Ultrasound

J of Clinical Ultrasound

Tanami

Sato

et al. 2023

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Objectives To demonstrate the association between the dynamic movements of hyperechoic foci in portal venous gas (PVG) and patients'/sonographic outcomes after congenital heart disease or cardiac events. Methods Thirty‐one pediatric patients requiring management of congenital heart diseases or cardiac events who had PVG on ultrasound were included in this retrospective study. The patient outcome was prognosis: dead or alive. The sonographic outcome was recovery from PVG, measured as days from PVG detection to when it diminished on ultrasound. The following sonographic findings of hyperechoic foci in PVG were compared between patients: detection within the mesenteric vein, having to‐and‐fro movements within the intrahepatic portal vein, distribution (left segment or both left and right segments) and shape (line or punctate) in the liver, and detection within the portal and hepatic veins. Comparisons were made using Fisher's exact/Mann–Whitney U test. Results Four patients died without having recovered from PVG. A significant difference was observed in terms of the to‐and‐fro movement (with/without to‐and‐fro movement in dead vs. alive patients: 3/1 vs. 1/26, respectively; P = 0.003). Furthermore, a significant difference in sonographic outcomes was observed regarding patients with/without hyperechoic foci within the mesenteric vein (days with vs. without this finding: 2.0 ± 1.24(1–5) vs.1 ± 0(1), respectively; P = 0.011). Conclusions In our small limited cohort, when PVG was visualized on ultrasound, close evaluation of the dynamic movement of hyperechoic foci, especially their to‐and‐fro movement within the intrahepatic portal vein and detection of hyperechoic foci within the mesenteric vein, were useful in predicting patients' outcomes and the time to PVG diminishment.

Section: Methodsmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Association between the dynamic movement of hyperechoic foci and patients'/sonographic outcomes among pediatric patients with portal venous gas following a cardiac event

J of Clinical Ultrasound

Tanami

Sato

et al. 2023

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“…Presence or absence of intra-abdominal free air and echogenic ascites are important findings to recommend surgical intervention. [79][80][81][82][83] There are some reports that the cases with pneumatosis intestinalis confined to the colon had better prognosis than that extended to the small intestine, therefore evaluation for location of pneumatosis intestinalis could be useful. 79,84 Portal venous gas, when detected, can be traced to its origin by following the hyperechoic foci in the portal vein along its branches with real-time ultrasound (►Fig.…”

Section: Sonographic Evaluationmentioning

confidence: 99%

“…69 Although radiography is a useful modality to evaluate these findings, ultrasound can more easily detect the portal venous gas and other findings such as the need for an urgent surgical intervention. [79][80][81]…”

Section: Timing Of Occurrence and Strategy For Diagnosismentioning

confidence: 99%

Extracardiac Complications in Intensive Care Units after Surgical Repair for Congenital Heart Disease: Imaging Review with a Focus on Ultrasound and Radiography

J Pediatr Intensive Care

Shibuki

Tanami

et al. 2020

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Pediatric patients show various extracardiac complications after cardiovascular surgery, and radiography and ultrasound are routinely performed in the intensive care unit to detect and evaluate these complications. This review presents images of these complications, sonographic approach, and timing of occurrence that are categorized based on their extracardiac locations and include complications pertaining to the central nervous system, mediastinum, thorax and lung parenchyma, diaphragm, liver and biliary system, and kidney along with pleural effusion and iatrogenic complications. This pictorial review will make it easier for medical doctors in intensive care units to identify and manage various extracardiac complications in pediatric patients after cardiovascular surgery.

“…[3][4][5][6][7] Although various modalities are reported to be used to diagnose dermal sinuses, in children, ultrasound (US) was reported to be the first-line modality because it enables a real-time examination at the bedside, without requiring radiation exposure or sedation. [8][9][10] In contrast, computed tomography (CT) and fistulography involve radiation exposure, and magnetic resonance imaging (MRI) may need sedation of pediatric patients and is more expensive than US. In addition, color Doppler US without contrast enhancement is useful to differentiate a fistula from a vascular lumen.…”

mentioning

confidence: 99%

Ultrasound Evaluation of Dermal Sinuses/Fistulas in Pediatric Patients

J of Ultrasound Medicine

Takahashi

Miyasaka

et al. 2019

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A dermal sinus/fistula is a common condition; the relevant department should be consulted for appropriate treatment. It is important for radiologists to have adequate knowledge of these conditions to provide the correct diagnosis and recommend subsequent management. This review describes the following lesions: preauricular sinus, midline sinus of the upper lip, nasal dermoid sinus cyst, cheek fistula, first branchial cleft anomaly/sublingual branchial cleft anomaly, thyroglossal duct cyst/fistula, lateral cervical sinus/fistula, congenital dermal sinus/fistula of the anterior chest region, congenital skin sinus/fistula with a sternal cleft, and congenital prepubic sinus. On the basis of the skin orifice location and ultrasound images, radiologists can provide useful information to physicians.