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Aim: A standard assessment tool for direct evaluation of procedural skills to ensure proficiency of trainees is necessary for cranial ultrasound (US) in clinical practice. This study created and validated an assessment tool for cranial US performance by radiologists. Material and methods: An initial evaluation tool for cranial US using criteria was developed based on existing literature. The assessment form was modified using a three-round Delphi process by an expert panel, conducted between January 2021 and April 2021. Rubric scales for grading were added once consensus regarding generated items was reached. Experts confirmed the final assessment tool using a rubric scale. Two raters evaluated cranial US performance of 27 residents in video clips using the tool. Reliability and percent agreement were assessed. Results: Seventeen pediatric radiologists working in different settings participated in the expert panel. The content validation of the proposed evaluation tool was enabled by expert pediatric radiologists. Following three rounds of the Delphi process, the initial 14-item assessment form became a final 15-item form. A three-part rubric scale was used in the final form (preparation, US machine operation, and cranial US performance). Interrater reliability was evaluated with Cohen's Kappa. The Kappa value and percent interrater agreement for most items was moderate to almost perfect (0.42-0.93 and 77.8-100%, respectively). The Cronbach's alpha values for both raters were 0.856 and 0.891. Conclusions: This study produced the first validated cranial US assessment tool using a modified Delphi method. The final assessment form is a simple and reliable tool. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the most reliable measurement method of the head circumference (HC) in brain magnetic resonance imaging (MRI). Material and Methods: The MR images of 84 pediatric brain protocols with both axial T2-weighted image (T2-WI) and sagittal T1-weighted image (T1-WI) were retrospectively reviewed. The HC was independently measured in axial T2-WI and sagittal T1-WI by two radiologists before the data analyses. The reference method was obtained by semi-automatic software from the reconstructive images. Results: Eighty-four patients were included. Both measurement methods had a strong positive correlation (r=0.981, 0.984) with the reference method. The mean difference between all methods was lower than the accepted value of error (2 cm). The second method, called 2D-axial with sagittal measurement, was more accurate than the first method, called 2D-axial measurement, compared with the reference method with a mean difference of 1.52 in radiologist 1 and 1.24 in radiologist 2. The interobserver agreement was good for all measurement methods with ICC of first and second methods being 0.98 and 0.99, respectively. Conclusion: The second method, called 2D-axial with sagittal measurement, is more reliable than the first method, named 2D-axial measurement, to determine the head size in MR images using a simple application formula. Moreover, both methods are reliable to determine the head size in MR images with no limitation of the software. [ABSTRACT FROM AUTHOR]

Although a paraduodenal hernia is the most common intraabdominal herniation causing intestinal obstruction, the condition comprises less than 2% of intestinal obstructions in the pediatric age group. Accurate diagnosis of this condition may help in preparing for surgery and selection of the right surgical choice. Herein, we report a pediatric case of left paraduodenal hernia who presented with intractable vomiting and dehydration without abdominal distension. An upper gastrointestinal study demonstrated a narrow segment of the proximal jejunum with severely delayed passage of contrast media. Surgical exploration found a left paraduodenal hernia and subsequent narrowing of the herniated segment, which was managed by a segmental resection. The patient had an uneventful post-operative course and could regained healthy status within a month of treatment. [ABSTRACT FROM AUTHOR]

The prenatal diagnosis of epignathus presents a unique challenge for physicians. Differential diagnosis is usually based on the anatomic location of the tumor. Typical prenatal ultrasound characteristics of epignathus include a mixed solid and cystic lesion with vascularity in the solid component, originating from the hard or soft palate, and it is often associated with other anomalies such as craniofacial clefts or trans‐sphenoidal intracranial extension. Herein, we present a case of prenatal diagnosis of epignathus with rare ultrasonographic findings, prenatal management requiring collaborative efforts of a multidisciplinary team, and a well‐planned innovative ex utero intrapartum treatment procedure. In addition, this report highlights the evolving postnatal diagnosis of the rare developmental anomaly, duplication of the pituitary gland‐plus syndrome, which includes various midline craniofacial, central nervous system, spinal, and endocrine abnormalities. [ABSTRACT FROM AUTHOR]