Mccallummcbride5116
To evaluate the subtype imaging features of basal ganglia germ cell tumors (GCTs).
Clinical and imaging data of 33 basal ganglia GCTs were retrospectively analyzed, including 17 germinomas and 16 mixed germ cell tumors (MGCTs).
The cyst/mass ratio of germinomas (0.53 ± 0.32) was higher than that of MGCTs (0.28 ± 0.19,
= 0.030). CT density of the solid part of germinomas (41.47 ± 5.22 Hu) was significantly higher than that of MGCTs (33.64 ± 3.75 Hu,
< 0.001), while apparent diffusion coefficients (ADC, ×
mm
/s) value of the solid part was significantly lower in geminomas (0.86 ± 0.27 ×
mm
/s) than in MGCTs (1.42 ± 0.39 ×
mm
/s,
< 0.001). MGCTs were more common with intratumoral hemorrhage (68.75%
11.76%,
= 0.01), T1 hyperintense foci (68.75%
5.88%,
< 0.001) and calcification (64.29%
20.00%,
= 0.025) than germinomas. There was no significant difference in internal capsule involvement between the two subtypes (
= 0.303), but Wallerian degeneration was more common in germinomas than in MGCTs (70.59%
25.00%,
= 0.015).
The subtypes of GCT have different imaging features. Tumoral cystic-solidity, heterogeneity, ADC value, CT density, and Wallerian degeneration are helpful to differentiate germinomas and MGCTs in basal ganglia.
The subtypes of GCT have different histological characteristics, leading to various imaging findings. The imaging features of GCT subtypes in basal ganglia may aid clinical diagnosis and treatment.
The subtypes of GCT have different histological characteristics, leading to various imaging findings. The imaging features of GCT subtypes in basal ganglia may aid clinical diagnosis and treatment.
To evaluate the visualization of incidentally imaged normal pituitary gland on three-dimensional (3D) pseudo continuous arterial spin labeling (PCASL) perfusion imaging of the brain.
Ninety-three patients with a normal pituitary gland who underwent 3D PCASL for suspected brain diseases were retrospectively included. Visualization of the pituitary gland on PCASL cerebral blood flow (CBF) maps was assessed independently by two observers using a three-point grading system Grade 1, pituitary CBF ≤ CBF of the cerebral white matter (WM); Grade 2, CBF of WM < pituitary CBF ≤ CBF of the cortical gray matter (GM); and Grade 3, CBF of GM < pituitary CBF. The interobserver agreement of visual grading was determined using weighted κ statistic. The associations of visual grades with age, sex, and pituitary volume were assessed using multivariate logistic regression. Pituitary glands were divided equally into three groups (small, medium, and large) according to their volume for categorization.
The interobserver agreement for visual rating was excellent (weighted κ = 0.823). Of the 93 cases, Grades 1, 2, and 3 included 17 (18.3%), 41 (44.1%), and 35 cases (37.6%), respectively. selleck compound Medium and large pituitary volume were significantly associated with Grade 3 visualization (
= 0.0153, OR = 4.8323; 95% CI 1.3525, 17.2649 and
= 0.0009; OR = 9.0299; 95% CI 2.4663, 33.0614, respectively), whereas there was no significant association for age or sex.
The normal pituitary gland is often visualized with higher CBF than cortical GM on 3D PCASL, especially in individuals with larger pituitary volume.
Appearance of the normal pituitary gland on 3D PCASL has been documented for the first time.
Appearance of the normal pituitary gland on 3D PCASL has been documented for the first time.
Although the hospital remains the dominant site for delivering most pediatric cancer care, home-based care is increasingly provided. To effectively deliver comprehensive, relevant, and acceptable care in children's homes, the voices of these key informants must be considered. We examined the views of children with cancer, their family caregivers, and clinicians on home-based cancer care to identify necessary strategies to improve the delivery of care.
Children with cancer, their family caregivers, and multiprofessional clinicians who provide care at a tertiary pediatric care center or in the community participated in audio-recorded, semistructured interviews in French and English. Interviews were conducted until data saturation in each participant group was achieved. Interviews were transcribed, coded, and analyzed using thematic analysis.
Thirteen children, 20 family caregivers, and 22 clinicians participated. Home-based care was endorsed as a means to improve child health-, family social- and financial-, and system-level outcomes. The success of a home-based model is built on care that addresses child and family informational, treatment and care, material, and psychosocial needs. Mechanisms to improve care include enhanced homecare agency-hospital-family communication, training for homecare nurses in pediatric cancer care, virtual solutions, and an expanded breadth of services provided in-home. Child-, family-, and system-related factors affect the delivery of optimal home-based care.
Children, families, and clinicians value a model of pediatric cancer care that incorporates home-based services. The insights of these key informants should be reflected in the principles that become the basis of home-based cancer care best practices.
Children, families, and clinicians value a model of pediatric cancer care that incorporates home-based services. The insights of these key informants should be reflected in the principles that become the basis of home-based cancer care best practices.Achondroplasia is the commonest hereditary skeletal dysplasia exhibiting dwarfism with characteristic rhizomelic (proximal) shortening of the limbs. It is predominantly linked with an autosomal dominant inheritance, but sporadic mutations can occur which are associated with advanced maternal age. Approximately 1 in every 25 000-30 000 live births are affected, and the overall life expectancy is marginally reduced by ~10 years. Mutations in the fibroblast growth factor receptor causes a decrease in endochondral ossification, which results in stunted growth of cartilaginous bones. A resultant narrowed foramen magnum and a short clivus are seen which predisposes to craniocervical spinal canal stenosis. Apnoeic events arising from the compression of the vertebral arteries at the level of the craniocervical junction lead to fatality in the young, with a death rate as high as 7.5%. Decrease in the caudal inter-pedicular distance is characteristic and a contributory factor for cervical, thoracic and lumbar spinal canal stenosis, most pronounced in the lumbar spine with patients often requiring surgical intervention to ease symptoms.
