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Imaging Studies for Cardiovascular System III: X-Ray01:20

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The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
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Radiographic Characterization of Rib Structural Deformity Following Surgical Patent Ductus Arteriosus Clipping in

Naoto Nishizaki1, Michimasa Suzuki2, Nao Kikuchi2

  • 1Pediatrics, Juntendo University Urayasu Hospital, Chiba, JPN.

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Summary

Patent ductus arteriosus (PDA) ligation in preterm infants can cause rib deformities, especially in those not given NSAIDs pre-surgery. Retinopathy of prematurity also correlates with these structural changes.

Keywords:
bone deformitychest radiographyheart surgerypatent ductus arteriosuspreterm infantspreterm neonatesrib deformitysurgical clippingsurgical ligation

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Area of Science:

  • Neonatal surgery
  • Pediatric radiology
  • Thoracic surgery

Background:

  • Patent ductus arteriosus (PDA) ligation is a common procedure in preterm infants.
  • The impact of PDA ligation on rib structural integrity remains unclear.
  • This study investigates rib deformities post-PDA ligation in preterm neonates.

Purpose of the Study:

  • To analyze radiographically evident rib deformity in preterm infants following PDA ligation.
  • To identify factors associated with rib structural modifications after PDA ligation.

Main Methods:

  • Retrospective observational study of preterm infants (<37 weeks gestation) undergoing PDA ligation.
  • Left posterolateral thoracotomy approach used for PDA ligation.
  • Two blinded radiologists evaluated serial chest radiographs before and after surgery.

Main Results:

  • Six of 28 eligible preterm infants showed post-ligation rib deformity, affecting ribs 3-6.
  • Rib deformity cohort had lower preoperative NSAID use (P=0.04) and higher incidence of retinopathy of prematurity requiring intervention (P<0.01).
  • Younger corrected gestational age at surgery trended with rib deformities (P=0.05).

Conclusions:

  • Rib structural deformity is common in preterm infants not receiving NSAIDs before PDA ligation.
  • Retinopathy of prematurity is associated with increased risk of rib deformity post-PDA ligation.
  • Younger corrected gestational age at surgery is a potential risk factor for rib deformities.