Papers by Kirsten Ecklund
AJR. American journal of roentgenology, 2002
The purpose of this study was to use MR imaging, especially fat-suppressed three-dimensional (3D)... more The purpose of this study was to use MR imaging, especially fat-suppressed three-dimensional (3D) spoiled gradient-recalled echo sequences, to identify patterns of growth arrest after physeal insult in children. We evaluated 111 children with physeal bone bridges (median age, 11.4 years) using MR imaging to analyze bridge size, location in physis, signal intensity, growth recovery lines, avascular necrosis, and metaphyseal cartilage tongues. Fifty-eight patients underwent fat-suppressed 3D spoiled gradient-recalled echo imaging with physeal mapping. The cause, bone involved, radiographic appearance, and surgical interventions (60/111) were also correlated. Data were analyzed with the two-tailed Fisher's exact test. Posttraumatic bridges, accounting for 70% (78/111) of patients, were most often distal, especially of the tibia (n = 43) and femur (n = 14), whereas those due to the other miscellaneous causes were more frequently proximal (p < 0.0001). The position of the bridge i...
Background: The development of clinical practice guidelines is a central precept of the evidence-... more Background: The development of clinical practice guidelines is a central precept of the evidence-based-medicine movement. The purposes of this study were to develop a guideline for the treatment of septic arthritis in children and to evaluate its efficacy with regard to improving the process of care and its effect on the outcome of septic arthritis of the hip in children.
Radiologic Clinics of North America, 2001
Disturbance of skeletal growth occurs often in children and results in considerable lifelong disa... more Disturbance of skeletal growth occurs often in children and results in considerable lifelong disability. When acquired, it is most frequently post-traumatic but may also be caused by other insults, such as infection, ischemia, tumoral lesions, and radiation. 15 The complications ...
Pediatric Radiology, 1996
The appearance of pulmonary nodules in a child with a solid malignancy undergoing chemotherapy is... more The appearance of pulmonary nodules in a child with a solid malignancy undergoing chemotherapy is a clinically worrisome event. The diagnosis in such cases is not always metastatic disease, and the differential diagnosis should include granulomatous disease, atelectasis, pneumonia, inflammatory pseudotumor, hamartoma, radiation pneumonitis, and bronchiolitis obliterans with organizing pneumonia. There is no consistent radiologic feature to help distinguish benign from malignant causes of these new lesions. However, repeat chest CT 4-6 weeks after the lesions are first noted can be used to track lesion progression and may obviate the need for biopsy.
Pediatric Radiology, 2007
Background-Neurosonography can assist clinicians and can provide researchers with documentation o... more Background-Neurosonography can assist clinicians and can provide researchers with documentation of brain lesions. Unfortunately, we know little about the reliability of sonographically derived diagnoses.
Journal of Magnetic Resonance Imaging, 2010
Purpose: To demonstrate water-and fat-suppressed proton projection MRI (WASPI) in a clinical scan... more Purpose: To demonstrate water-and fat-suppressed proton projection MRI (WASPI) in a clinical scanner to visualize the solid bone matrix in animal and human subjects.
Journal of Clinical Ultrasound, 2010
The purpose of this article is to investigate the hyperechoic lesion seen adjacent to a lateral v... more The purpose of this article is to investigate the hyperechoic lesion seen adjacent to a lateral ventricle that contains blood but is not distended. The literature on ependymal barrier dysfunction was reviewed in search of mechanisms of injury to the white matter adjacent to an intraventricular hemorrhage. The clinical literature on the clinical diagnosis of periventricular hemorrhagic infarction was also reviewed to find out how frequently this diagnosis was made. Support was found for the possibility that the ventricular wall does not always function as an efficient barrier, allowing ventricular contents to gain access to the white matter where they cause damage. Hemorrhagic infarction may not be the only or the most frequent mechanism of white matter damage adjacent to a large intraventricular hemorrhage.
Journal of Bone and Mineral Research, 2010
Early osteoporosis is common among adolescent girls with anorexia nervosa (AN) and may result fro... more Early osteoporosis is common among adolescent girls with anorexia nervosa (AN) and may result from premature conversion of red (RM) to yellow bone marrow. We performed right knee magnetic resonance imaging (MRI) on a 1.0 T extremity scanner in 20 patients and 20 healthy controls, aged 16.2 AE 1.6 years (mean AE SD). Coronal T 1 -weighted (T 1 W) images and T 1 maps were generated from T 1 relaxometry images. Blinded radiologists visually assessed RM in the distal femoral and proximal tibial metaphyses in T 1 W images using a scale of signal intensity from 0 (homogeneous hyperintensity, no RM) to 4 (all dark, complete RM). Subjects with AN exhibited nearly twofold lower metaphyseal RM scores in both the femur (0.64 versus 1.22, p ¼ .03) and tibia (0.54 versus 0.96, p ¼ .08). In relaxometric measurements of four selected regions (femur and tibia amd epiphysis and metaphysis), subjects with AN showed higher mean epiphyseal but lower metaphyseal T 1 . The net AN-control difference between epiphysis and metaphysis was 70 ms in the femur (þ31 versus À35 ms, p ¼ .02) and of smaller magnitude in the tibia. In relaxometry data from the full width of the femur adjacent to the growth plate, AN subjects showed mean T 1 consistently lower than in controls by 30 to 50 ms in virtually every part of the sampling region. These findings suggest that adolescents with AN exhibit premature conversion of hematopoietic to fat cells in the marrow of the peripheral skeleton potentially owing to adipocyte over osteoblast differentiation in the mesenchymal stem cell pool. ß
Bone, 2008
Plasma with Optical Emission Spectroscopy demonstrated that the labeled cells had an average tota... more Plasma with Optical Emission Spectroscopy demonstrated that the labeled cells had an average total intracellular iron load of 107 pg[Fe]/ cell on day 0 and 15.96 pg[Fe]/cell on day 33 for Fe 3 O 4 -SiO 2 -NH 2 , and 29 pg[Fe]/cell on day 0 and 5.8 pg[Fe]/cell on day 33 for Fe 3 O 4 -SiO 2 .
American Journal of Roentgenology, 2005
Oligoarthritis is the most common manifestation of late Lyme disease in children. Considerable ov... more Oligoarthritis is the most common manifestation of late Lyme disease in children. Considerable overlap can occur in the clinical presentation of Lyme arthritis and acute septic arthritis. Early differentiation is critical, given the disparate therapeutic implications; Lyme arthritis is treated with outpatient oral antibiotics, while septic arthritis requires hospitalization, IV antibiotics, and, often, surgical drainage. We wanted to identify MRI features that may distinguish Lyme arthritis from septic arthritis in children. Knee MR images in 11 children with Lyme arthritis and 7 with septic arthritis, with a mean age 10.6 years old and 11.7 years old, respectively, were reviewed by a radiologist blinded to the final diagnosis. Joint effusion size, synovial thickness, adenopathy, subcutaneous, marrow, and muscle edema on MRI; and clinical parameters including age, sex, fever, WBC, erythrocyte sedimentation rate, C-reactive protein, and joint fluid WBC in the two patient groups were compared using univariate and multivariate analyses. Subcutaneous edema was seen in all septic arthritis patients but in only one of 11 patients with Lyme arthritis (p &amp;amp;amp;amp;amp;amp;lt; 0.01). Myositis and adenopathy were present in all Lyme arthritis patients and two of seven patients with septic arthritis (both p &amp;amp;amp;amp;amp;amp;lt; 0.01). No significant difference was present in synovial thickness, marrow edema, or joint fluid size. There were no statistically significant differences in the clinical parameters assessed. Our results identified three MRI features, specifically, myositis, adenopathy, and lack of subcutaneous edema, that strongly suggest the diagnosis of Lyme arthritis rather than septic arthritis in children with acute inflammation of the knee. Awareness of these characteristic MRI features may avoid unnecessary invasive procedures and cost.
Journal of Clinical Ultrasound, 2010
Purpose-To evaluate reader variability of white matter lesions seen on cranial sonographic scans ... more Purpose-To evaluate reader variability of white matter lesions seen on cranial sonographic scans of extreme low gestational age neonates (ELGANs).
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Papers by Kirsten Ecklund