- Differentiation of Speech Delay and Global Developmental Delay in Children Using DTI Tractography-Based Connectome
This study investigated whether diffusion tensor imaging tractography-based connectome can differentiate global developmental delay from speech delay in young children. Twelve children with pure speech delay, 14 children with global developmental delay, and 10 children with typical development underwent 3T DTI. Whole-brain connectome analysis was performed by using 116 cortical ROIs. Network metrics were measured at individual regions: strength, efficiency, cluster coefficient, and betweeness. Compared with typical development, global and local efficiency were significantly reduced in both global developmental delay and speech delay. Nodal strength of the cognitive network was reduced in global developmental delay, whereas the nodal strength of the language network was reduced in speech delay. This finding resulted in a high accuracy of >83% to discriminate global developmental delay from speech delay.
- How to Reduce Head CT Orders in Children with Hydrocephalus Using the Lean Six Sigma Methodology: Experience at a Major Quaternary Care Academic Children's Center
The authors describe a Lean Six Sigma project with the goal of reducing the relative use of pediatric head CTs in their population of patients with hydrocephalus by 50% within 6 months. The existing baseline imaging practice for hydrocephalus was outlined in a Kaizen session, and potential interventions were discussed. An improved radiation-free workflow with ultrafast MR imaging was created. Baseline data were collected for 3 months by using the departmental radiology information system and data collection continued postintervention and during the control phase. The improved workflow resulted in a 75% relative reduction in the percentage of hydrocephalus imaging performed by CT between the pre- and postintervention/control phases. The authors conclude that the lean interventions in the pediatric hydrocephalus care pathway resulted in a significant reduction in head CT orders.
- Brain Structural and Vascular Anatomy Is Altered in Offspring of Pre-Eclamptic Pregnancies: A Pilot Study
The authors assessed the brain structural and vascular anatomy in 7- to 10-year-old offspring of pre-eclamptic pregnancies compared with matched controls (n=10 per group). TOF-MRA and a high-resolution anatomic T1-weighted MPRAGE sequence were acquired for each participant. Offspring of pre-eclamptic pregnancies exhibited enlarged brain regional volumes of the cerebellum, temporal lobe, brain stem, and right and left amygdalae. These offspring displayed reduced cerebral vessel radii in the occipital and parietal lobes. The authors conclude that these structural and vascular anomalies may underlie the cognitive deficits reported in the pre-eclamptic offspring population.
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