INTRODUCTION/AIMS:Nerve ultrasound is becoming increasingly important for diagnosing and monitoring peripheral nerve disorders in children. This research seeks to determine reference values for ultrasound cross-sectional area (CSA) and elastography of peripheral nerves in healthy children from northern China. METHODS:A total of 150 healthy children aged 2-16 years were recruited. To make the results more intuitive and applicable, the CSA data were divided into five age groups and the elastography data into two. The CSA measurements included nerves of the cervical region (C5, C6, vagus), upper limb (median, ulnar, radial), and lower limb (sciatic, tibial, common peroneal, sural). Shear wave velocity (SWV) measurements were performed solely on the median nerve in the right forearm. t Tests and analysis of variance (ANOVA) were used to compare the data. RESULTS:The average CSA of all nerves increased with age, particularly in the sciatic, tibial, and common peroneal nerves. No sex-based differences were observed in nerve CSA, which increased with weight and height. Among groups categorized by weight and height, significant differences were noted in the larger nerves, with the exception of the vagus and sural nerves. The mean median nerve SWV in this cohort was 3.48 ± 0.62 m/s, with no significant variations attributable to sex, age, height, weight, or CSA. DISCUSSION:In children, nerve CSA as measured by ultrasound changes with age, height, and weight, while median nerve SWV values remain consistent despite these variations.

Objective: To investigate the sensitivity and safety of contrast-enhanced cystosonography in the diagnosis of primary vesicoureteral reflux (VUR) after urinary tract infection (UTI) in infants. Methodology: This was a retrospective study. Infants diagnosed with VUR after UTI in Baoding Hospital, Beijing Children's Hospital Affiliated to Capital Medical University were selected from July 2019 to May 2024. All the infants were subjected to contrast-enhanced cystosonography and voiding cystourethrography (VCUG). The detection rate of VUR by contrast-enhanced cystosonography and VCUG, as well as the consistency of VUR classification were analyzed. Results: The proportion of VUR diagnosed by contrast-enhanced ultrasonography (CEUS) was 32.00%, which was significantly higher than 18.00% by VCUG(P< 0.05). The incidence of VUR was 38.23% and 43.75% in male and female infants, respectively, without statistically significant differences(P> 0.05). Among the male infants, the proportion of VUR diagnosed by CEUS was 20.58%, while the proportion by VCUG was 17.65% (P> 0.05). In the female infants, the proportion of VUR diagnosed by CEUS was 50.00%, which was significantly higher than 18.75% by VCUG (P< 0.05). VUR was diagnosed in 31.00% (31/100) pyelo-ureter units (PUUs) by CEUS, and in 18.00% (18/100) PUUs by VCUG, with good consistency(Kappa value, 0.547). The consistency of both methods in diagnosing VUR at different degrees was good, with higher diagnostic rates of Grade-II and III VUR. Conclusion: Both contrast-enhanced cystosonography and VCUG have high diagnostic value in the detection of infants with VUR after UTI. The value of contrast-enhanced cystosonography in the diagnosis of infants with UTI and VUR is higher.

ObjectiveTo evaluate the clinical efficacy of ultrasound-guided puncture drainage for pediatric appendiceal abscess and summarize operational experience.MethodsThis study conducted a retrospective analysis of clinical data from pediatric patients who underwent ultrasound-guided percutaneous drainage for appendiceal abscess at Beijing Children's Hospital between January 2022 and June 2025. The safety and efficacy of ultrasound-guided abscess drainage were analyzed, along with key technical points and experiences for different types of appendiceal abscesses. Categorical variables were compared using the χ2 or Fisher's exact test, and continuous variables were analyzed using the t-test or Mann–Whitney U test. A P-value < 0.05 was considered statistically significant.ResultsA total of 90 children underwent ultrasound-guided puncture of the appendiceal abscess and were included in this study, and the control group consisted of 41 children with appendiceal abscess who received conservative treatment during the same period. Children who underwent ultrasound-guided abscess drainage under local anesthesia showed a faster decrease in white blood cell count (7.0 ± 2.0 vs. 11.0 ± 3.0 × 109/L; t = 4.0, P < 0.05) and C-reactive protein levels (7.3 ± 2.1 vs. 11.3 ± 3.1 mg/L; t = −7.6, P < 0.05) after one week of treatment, shorter duration of abdominal pain (4.3 ± 1.5 vs. 5.8 ± 1.3 days; t = −5.7, P < 0.05), and quicker resolution of the abscess compared (11.3 ± 1.2 vs. 15.7 ± 1.1 days; t = −21.1, P < 0.05) to those who received intravenous antibiotics alone. Ultrasound-guided abscess drainage resulted in minimal trauma and lower rates of early and late postoperative complications. A retrospective review of ultrasound data from 90 children who underwent ultrasound-guided abscess drainage demonstrated that our hospital had extensive operational experience in performing drainage for various types of complicated appendiceal abscesses.ConclusionUltrasound-guided percutaneous drainage is a safe and effective minimally invasive treatment for pediatric appendiceal abscess in children who can cooperate with local anesthesia. Physicians must master the indications for drainage and specific puncture techniques for different types of appendiceal abscesses.

We present a case of a 6-month-old boy who was diagnosed with Peutz-Jeghers polyps, intestine fusiform mesenchymal tumor, Wilms tumor, and Ir type pleuropulmonary blastoma (PPB) successively, with mosaic DICER1 RNase IIIb hotspot mutation: c.5113G>A p.E1705K. The patient underwent surgeries to resect the intestine polyps, intestine tumor, Wilms tumor, nephroblastomatosis, and PPB, combined with chemotherapy aimed at Wilms tumor and PPB. Diseases were stable at follow-up 27 months since the initial diagnosis.

OBJECTIVE:To evaluate the safety and efficacy of ultrasound (US)-guided percutaneous needle biopsy combined with FAL tissue adhesive needle tract sealing in pediatric hypervascular malignant solid tumors. METHODS:A retrospective analysis was conducted on 149 pediatric patients with Adler grade ≥2 malignant solid tumors who underwent US-guided percutaneous needle biopsy between January 2021 and October 2025. Based on the application of FAL sealing, patients were divided into the FAL group (n = 57) and control group (n = 92). Using 1:1 propensity score matching (PSM) for baseline covariates (e.g., age, tumor size, Adler grade, biopsy needle size, and hematological metrics), we generated 39 matched pairs. The number of needle passes, postoperative changes in laboratory values, complication rates, and follow-up outcomes were compared between the two cohorts. RESULTS:Before matching, the FAL group presented with larger tumors, lower preoperative hemoglobin levels, a different pathological distribution, and imbalance in biopsy needle size than the control group. After PSM, baseline characteristics were balanced between the two groups. Patients in the FAL group more frequently underwent ≥4 needle passes than those in the control group [84.6% (33/39) vs. 60.5% (23/38), P = 0.034]. Furthermore, there were no significant differences in postoperative laboratory changes, complication rates, or diagnostic accuracy among surgically validated cases between the two groups. No FAL-related adverse events or needle tract seeding were observed during a median follow-up of 140 days in the matched FAL group. CONCLUSION:In pediatric hypervascular malignant solid tumors, US-guided PNB combined with FAL tract sealing was associated with a higher number of biopsy passes without an observed increase in procedure-related complications, while diagnostic accuracy remained comparable. Further prospective multicenter and large-sample studies are needed for validation. LEVEL OF EVIDENCE:Level III (Retrospective comparative study).

As described in isolated case reports, axial torsion is an extremely rare complication of Meckel’s diverticulum (MD). Diagnosis based on preoperative imaging alone is challenging for clinicians. The aim of this study was to investigate the clinical and sonographic characteristics of axial torsion of MD in Chinese pediatric patients treated at a single center and to review the published literature on this condition. We conducted a retrospective analysis of pediatric patients (< 18 years) who underwent surgical treatment for MD torsion between November 2008 and January 2023 at our institution, focusing on clinical presentation and ultrasound findings. In addition, a systematic review of English-language articles in PubMed (1989–2023) was performed to summarize reported cases of MD torsion in pediatric populations. Twelve patients (10 males, 2 females; male-to-female ratio 5:1; median age 4 years, range 2–15) were included. The predominant symptoms were abdominal pain (91.7

PURPOSE:This study aimed to develop a predictive model based on ultrasonographic characteristics to improve the diagnostic accuracy in differentiating cystic neuroblastoma from hematoma. METHODS:This retrospective study included newborns who had undergone their first ultrasonography from 2013 to 2023. In total, 39 267 newborns, including those with hematoma and suspected cystic neuroblastoma, were included. Ultrasonographic characteristics of newborns with hematoma and suspected cystic neuroblastoma were compared, and data analysis was performed using a binary logistic regression model. RESULTS:Anterior-posterior size, vertical size, presence of calcification, and cystic fluid echogenicity were identified as significant predictive factors for distinguishing between cystic neuroblastoma and hematoma. The area under the curve of the model was 0.962, indicating a high diagnostic efficacy. CONCLUSION:The predictive model constructed based on ultrasonographic characteristics effectively differentiated between cystic neuroblastoma and hematoma, providing a highly efficient diagnostic tool for clinical use. To further validate and optimize this predictive model, future research should expand the sample size and include multicenter data.

OBJECTIVE:This study aimed to analyze the ultrasound findings of bile duct involvement in pediatric Langerhans cell histiocytosis (LCH). METHODS:We retrospectively analyzed 42 patients diagnosed with pediatric LCH by pathology at our hospital from December 2016 to December 2023. All patients had comprehensive clinical data and ultrasound findings indicating biliary abnormalities. This study analyzed intrahepatic and extrahepatic bile duct dilation, the extent of bile duct wall thickening, and surrounding abnormal echoes. RESULTS:Among the 42 children, ultrasonography showed intrahepatic and extrahepatic bile duct dilation in 27 cases (64%), bile duct wall thickening in 21 cases (50%), hypoechoic areas along the intrahepatic bile ducts in 16 cases (38%), and thickening of the Glisson's capsule with decreased echogenicity around the bile ducts in 8 cases (19%). CONCLUSION:Ultrasonography revealing varying degrees of bile duct dilatation or stenosis, thickened bile duct walls, and abnormal echo patterns along the bile duct in the liver in pediatric patients with cholangitis should raise suspicion for LCH.

To develop a systematic and efficient decision tree analysis (DTA) model to improve the diagnostic accuracy of transient small-bowel intussusception (TSBI) and persistent small-bowel intussusception (PSBI) in children. From February 2019 to June 2022, ultrasound (US) features and clinical findings of pediatric patients with small-bowel intussusception (SBI)—including SBI diameter, outer bowel wall thickness, thickness of the head and body of the intussusceptum, length of the intussusceptum, and presence of pathological lead points (PLPs)—were recorded and analyzed. A classification and regression tree algorithm was then used to develop a DTA model, which was trained and validated by randomly categorizing the patients into training (60

This study aims to review and summarize the ultrasound characteristics of alveolar soft part sarcoma (ASPS) in children. We retrospectively analyzed 20 pediatric ASPS cases confirmed by surgery or biopsy at our hospital between January 2014 and January 2024. Clinical data, including age, sex, symptoms, and tumor location, were collected. Ultrasound reports and images were reviewed to extract data on tumor size, boundaries, echogenicity, and vascularity. The study included 20 children with ASPS. The tumors were located in the trunk and limbs (50

Background:Parameningeal rhabdomyosarcoma (PM-RMS) accounts for about 20% of all rhabdomyosarcoma (RMS) cases. At present, most research on PM-RMS has been conducted in Europe and the United States of America, and research in China has been very limited. This study sought to analyze the clinical outcomes and prognostic factors of PM-RMS in children and adolescents from two consecutive protocols at Beijing Children's Hospital (BCH). Methods:A total of 80 patients aged up to 18 years with previously untreated PM-RMS who had received treatment under two consecutive protocols [i.e., either the BCH-RMS-2006 protocol or the Chinese Children Cancer Group (CCCG)-RMS-2016 protocol] were included in the statistical analysis. The Kaplan-Meier method was used for the survival analysis, and Cox regression was used for the univariate and multivariate analyses. Results:Of the 80 patients enrolled in the study, 69 (86.2%) had meningeal invasion (MI). Of these 69 MI patients, 18 (22.5%) had cranial nerve palsy (CNP), 64 (80.0%) had cranial base bone erosion (CBBE), 25 (31.3%) had intracranial extension (ICE), and 2 (2.5%) had positive cerebrospinal fluid (CSF) tumor cells. The median follow-up time was 20.5 months (range, 5-100 months). The 5-year overall survival (OS) and progression-free survival (PFS) rates for the entire cohort were 51.7% and 45.6%, respectively. The 5-year OS rates of the patients who received the BCH-RMS-2006 protocol (18/80, 22.5%) and the CCCG-RMS-2016 protocol (62/80, 77.5%) were 33.3% and 57.0%, respectively (P<0.05), while the PFS rates of these patients were 22.2% and 53.6%, respectively (P<0.05). In relation to the PM-RMS patients with MI, the 5-year OS rates were 21.4% and 52.7%, and the 5-year PFS rates were 14.3% and 51.1% for the patients who received the old and new regimens, respectively (P<0.05). The extent of surgical resection had no significant effect on survival. The multivariate analysis showed that the coexistence of CBBE and ICE, no radiotherapy, a poor response to induction chemotherapy, and the BCH-RMS-2006 protocol were risk factors affecting PFS and OS. Conclusions:Of the patients examined in this study, those with PM-RMS with CBBE accompanied by ICE had the worst prognosis. The patients with MI benefited from intensive chemotherapy combined with radiation therapy, but the effect of surgery was very limited.

Neonatal appendicitis is a rare but critical condition that presents diagnostic challenges due to its nonspecific symptoms and clinical manifestations. Early and accurate diagnosis is crucial for reducing the high mortality rates associated with this condition. Abdominal ultrasonography plays a pivotal role in identifying characteristic signs of appendicitis in neonates. This study aimed to investigate whether neonatal appendicitis can be diagnosed with abdominal ultrasonography by identifying its specific signs. This study reviewed 20 consecutive cases of neonatal appendicitis confirmed through surgery at a National Medical Center. Preoperative abdominal ultrasonography was analyzed for direct and indirect signs of appendicitis. Our study included neonates with a mean age of 13.0 ± 7.1 days. The appendix was identifiable in 13 out of 20 cases (65

Langerhans cell histiocytosis (LCH) is the most common histiocytic disorder in children, and liver involvement in LCH is rare. This retrospective study reported the clinical features and prognosis of patients with hepatic LCH. Liver involvement was defined by histopathological findings, liver dysfunction or abnormalities, or ultrasound imaging. A total of 130 patients (14.5%) with hepatic LCH out of 899 in the LCH population were enrolled. Patients with liver involvement had greater frequencies of skin, lung, hearing system, and haematologic system involvement, and hemophagocytic lymphohistiocytosis (P<0.001, 0.001, 0.002, 0.009, and <0.001, respectively). Overall survival and progression-free survival were lower in LCH patients with liver involvement than in those without liver involvement (P<0.001 and <0.001). In patients with liver involvement, the overall survival (OS) and progression-free survival (PFS) rates were lower in patients with cholangitis than in those without cholangitis (P<0.020 and 0.030). For the treatment response, the response rate of hepatic LCH patients to initial first-line therapy (n=89) was 22.5%. However, there was no significant difference in the response rate or recurrence rate between patients who shifted from first-line treatment to second-line treatment (n=29) or to targeted therapy (n=13) (P=0.453 and 1.000). The response rate of hepatic LCH patients who received initial second-line therapy (n=13) was 38.5%. Two of these patients subsequently experienced bone recurrence. The response rate of hepatic LCH patients who received initial targeted therapy (n=16) was 75.0%. Three patients subsequently experienced recurrence, including 2 in the bone and 1 in the liver and skin. A total of 39.3% of patients who received second-line treatment had severe myelosuppression (grade III-IV), and 50.8% had varying degrees of gastrointestinal events, whereas there was no severe toxicity in patients who received first-line treatment and targeted therapy. Four patients underwent liver transplantation because of liver cirrhosis. The patients' liver disease improved within a follow-up period of 18-79 months. This study demonstrated that LCH with liver involvement, especially cholangitis, indicates a poor prognosis. Targeted therapy provides a good treatment response and less toxicity. However, it may relapse after withdrawal. Liver transplantation is still a reliable salvage option for patients with end-stage liver disease.

目的 探讨超声对先天性胆总管囊肿术后腹内疝的诊断价值.方法 连续选取行胆总管囊肿术后,因突然出现腹痛、呕吐、发热等梗阻相似症状而疑诊腹内疝的病例作为研究对象.根据最终诊断将所有病例分为腹内疝组与非腹内疝组,对比两组间一般特征、临床表现、声像图特点是否存在可供鉴别的差异性,并对其实际诊断效能做出评价与比较.结果 共 43 例患儿满足条件构成样本队列:腹内疝组 8 例,内含既往采用经结肠前重构胆道者 6 例(占比 75%);非腹内疝组 35 例.两组在一般特征(发病年龄、性别构成比、胆总管囊肿术后时间)、临床表现(发热、呕吐、腹痛)的差异不具有统计学意义(P>0.05);声像图特点中除"胆道是否扩张"(P=0.356)差异无统计学意义外,其余指标("胆枝肠襻梗阻""十字交叉征""漩涡征")差异则均具有统计学意义(P<0.001,P=0.036、0.036),其中以 AUC 表示的"胆枝肠襻梗阻"具体诊断效能为 0.938,优于"十字交叉征"与"漩涡征"(P=0.018、0.001),对应灵敏度为 87.5%,特异度为 100%.结论 "胆枝肠襻梗阻"作为特异度超声表现,可有效诊断先天性胆总管囊肿术后腹内疝.

目的 评价超声小肠分区检查法诊断儿童梅克尔憩室出血的价值.方法 收集疑诊梅克尔憩室出血患儿 233 例.7 位培训合格的进修医师采用超声小肠分区检查法进行检查.可靠性评价组30 例以Kappa值对随机选取的 2 位医师进行小肠完整显示及肠管准确辨识一致性评价;真实性评价组 203 例以手术病理及临床诊断为金标准,以曲线下面积(AUC)评价该方法诊断梅克尔憩室出血的效能.结果 可靠性评价组小肠完整显示及肠管辨识一致性Kappa值分别为 0.760 及 0.880,提示该检查法具有良好的可重复性;超声小肠分区检查法诊断梅克尔憩室出血的 AUC为 0.970,灵敏度为 97.6%,特异度为 95.8%.结论 超声小肠分区检查法通过规范培训即可获得稳定、满意的梅克尔憩室出血诊断效能,具备推广价值.

BackgroundThe incidence of magnet ingestion by children has recently increased in China. Magnet ingestion is associated with an extremely high risk of gastrointestinal damage because loops of bowel can become trapped and squeezed between multiple magnets in different locations. However, the lack of imaging sensitivity makes clinical decision-making difficult. ObjectiveThis study was conducted to investigate the performance of ultrasound in diagnosing gastrointestinal magnet ingestion in children. MethodsFrom April 2017 to February 2021, all children with a history of magnet ingestion or a diagnosis of gastrointestinal magnet as shown by x-ray or ultrasound in our hospital were included as study candidates. Patients who were lost to follow-up or had known malformations of the gastrointestinal tract were excluded. Eligible patients were those with surgical or endoscopic confirmation of gastrointestinal magnet, those who passed the magnet out of the alimentary tract without assistance, and those with confirmed absence of the magnet on abdominal x-ray examination after 1 month of conservative treatment. All eligible patients' ultrasound and x-ray examination data were evaluated. The sensitivity, specificity, and area under the curve (AUC) of ultrasound was calculated for diagnosing magnet ingestion, locating the magnet (stomach, small intestine, or colon), and confirming the phenomenon of wall entrapment. ResultsOf 112 patients, 107 had a magnetic foreign body and 5 did not. Magnets were correctly detected by ultrasound in 97 patients, with an observed sensitivity of 90.65% and specificity of 100%. Satisfactory sensitivity was obtained for ultrasound localization of gastric magnets (96.30%) and small intestinal magnets (100.00%), but sensitivity for ultrasound localization of colonic magnets was relatively poor (73.33%). The discrimination of wall entrapment by ultrasound was good (AUC = 0.93), with an observed sensitivity and specificity of 92.00% and 93.62%, respectively. ConclusionsUltrasound can be used to locate gastrointestinal magnets (in the stomach, small intestine, or colon) with good clinical efficacy in identifying wall entrapment.

Objective The purpose of this study was to analyze the outcomes of the combination of ultrasound (US)-guided percutaneous external drainage and subsequent definitive operation to manage complicated choledochal cyst in children. Methods This retrospective study included 6 children with choledochal cyst who underwent initial US-guided percutaneous external drainage and subsequent cyst excision with Roux-en-Y hepaticojejunostomy between January 2021 and September 2022. Patient characteristics, laboratory findings, imaging data, treatment details, and postoperative outcomes were evaluated. Results Mean age at presentation was 2.7 ± 2.2 (0.5–6.2) years, and 2 patients (2/6) were boys. Four patients (4/6) had a giant choledochal cyst with the widest diameter of ≥ 10 cm and underwent US-guided percutaneous biliary drainage on admission or after conservative treatments. The other 2 patients (2/6) underwent US-guided percutaneous transhepatic cholangio-drainage and percutaneous transhepatic gallbladder drainage due to coagulopathy, respectively. Five patients (5/6) recovered well after US-guided percutaneous external drainage and underwent the definitive operation, whereas 1 patient (1/6) had liver fibrosis confirmed by Fibroscan and ultimately underwent liver transplantation 2 months after external drainage. The mean time from US-guided percutaneous external drainage to the definitive operation was 12 ± 9 (3–21) days. The average length of hospital stay was 24 ± 9 (16–31) days. No related complications of US-guided percutaneous external drainage occurred during hospitalization. At 10.2 ± 6.8 (1.0–18.0) months follow-up, all patients had a normal liver function and US examination. Conclusions Our detailed analysis of this small cohort suggests that US-guided percutaneous external drainage is technically feasible for choledochal cyst with giant cysts or coagulopathy in children, which may provide suitable conditions for subsequent definitive operation with a good prognosis. Trial registration Retrospectively registered.

目的 探讨膀胱腔增强超声造影对小儿膀胱输尿管反流(VUR)严重程度的判定价值及对手术指导意义.方法 选取保定市儿童医院2018年1月至2021年4月小儿尿路感染病儿82例作为研究对象,均行膀胱腔增强超声造影检查,以排泄性膀胱尿路造影(VCUG)为金标准,分析膀胱腔增强超声造影对小儿VUR及其严重程度的诊断价值,并分析膀胱腔增强超声造影与VCUG检查对手术效果的评价一致性.结果 82例尿路感染病儿,共151个肾输尿管单位(PUUs),VCUG确诊59个PUUs为VUR;膀胱腔增强超声造影检出57个PUUs阳性;ROC曲线分析,膀胱腔增强超声造影诊断VUR的AUC为0.98;经一致性分析,膀胱腔增强超声造影与VCUG检查诊断小儿VUR严重程度一致性极高;42个PUUs的VUR严重程度达Ⅲ度及以上,术后6个月VCUG评估缓解率为95.24%;膀胱腔增强超声造影评估缓解率为95.24%,一致性分析,膀胱腔增强超声造影与VCUG检查对手术效果的评价一致性极高.结论 膀胱腔增强超声造影在小儿VUR及其严重程度中具有较高诊断价值,还能较为可靠地评价手术效果,可作为疾病诊断、病情判定、术前指导及术后疗效评估的重要手段.

A novel 55-kDa hydroxylase was isolated from cultured cells of Catharanthus roseus by a three-step procedure: anion exchange chromatography, affinity chromatography and hydroxylapatite adsorption chromatography. The enzyme specifically catalyzed the hydroxylation of 2-hydroxy-benzoic acid to give 2,5-dihydroxybenzoic acid. The enzyme activity was optimal at pH 7.8 and was completely inhibited by divalent cations, such as Cu2+ and Hg2+. The enzyme showed sequence similarity to certain plant flavonoid 3'-hydroxylases.