AJAY TARANATH - Academia.edu (original) (raw)

Papers by AJAY TARANATH

Neuroradiology, May 8, 2024

Anz Journal of Surgery, May 9, 2023

BackgroundCurrently, the primary management of ileocolic intussusception in children is usually b... more BackgroundCurrently, the primary management of ileocolic intussusception in children is usually by non‐operative image‐guided enema reduction. In most centres around the world especially in Australasia the predominant technique is the pneumatic reduction under fluoroscopic guidance. At our institution, we have been performing ultrasound‐guided hydrostatic reduction since 2012.This is an audit to determine the efficacy and safety of ultrasound‐guided hydrostatic reduction for intussusception.MethodsFollowing ethics approval, a retrospective review of all patients presenting to our institution with intussusception and subsequently undergoing hydrostatic reduction over a period of 9 years (2012 to–2020) was performed. The parameters studied included (i) successful reduction, (ii) recurrence, (iii) need for surgery and (iv) lead point at surgery.ResultsThe mean age at presentation was 12 months. One hundred and eight children were diagnosed to have ileocolic intussusception. One hundred and six underwent ultrasound‐guided hydrostatic reduction with successful reduction in 96 (90.5%) patients. Reduction was unsuccessful in 10 patients (9.5%). Of these eight were noted to have a pathological lead point (four—Meckel's diverticulum and four—Lymphoma) at the time of the surgery. The intussusception recurred in six patients (6.25%) within 24 h. No reduction related perforation occurred during the study period.ConclusionUltrasound‐guided hydrostatic reduction is a safe and effective technique for managing intussusception as it allows continuous monitoring of the reduction of the intussusception without exposing the children to ionizing radiation.

Poster: "2014 CSM / R-0052 / Hip hip but no hooray: Paediatric ultrasound in hip pain" ... more Poster: "2014 CSM / R-0052 / Hip hip but no hooray: Paediatric ultrasound in hip pain" by: "T. Nguyen, L. Lukic, A. Taranath; ADELAIDE/AU"

Australasian journal of ultrasound in medicine, May 5, 2021

Fibrodysplasia ossificans progressiva (FOP) is an extremely rare connective tissue disease, diagn... more Fibrodysplasia ossificans progressiva (FOP) is an extremely rare connective tissue disease, diagnosed by genetic testing. This is the first report in English literature wherein an ultrasound examination suggested this specific diagnosis. In this case, a two month old girl presented with bi‐parieto‐occipital swellings that were being managed as subgaleal haematoma. The parents were anxious that there was no resolution of the swellings. The suspicion of FOP was raised during the ultrasound examination where a review of the images prompted a questioning of the parents about other lesions in the body. Ultrasound examination of a lump in the thigh revealed calcifications in the vastus lateralis muscle. The appearances on the ultrasound combined with the presence of hallucis valgi suggested a diagnosis of FOP. The diagnosis was subsequently confirmed by genetic studies. This case highlights the need for good communication between the physician, patient and the imaging department.

Pediatric Anesthesia, Oct 27, 2020

We thank Dr Nicole Wylie for her help in editing the paper and all members of the Departments of ... more We thank Dr Nicole Wylie for her help in editing the paper and all members of the Departments of Children's Anaesthesia and Medical Imaging for embracing the technique. Clinical Implications Fast, Feed and Wrap (FFW) technique has been proven effective for the acquisition of brain MRI in neonates and infants. This study shows that FFW can also be used effectively for neonatal and infant PICC insertion to avoid the unnecessary use of general anesthesia.

American Journal of Perinatology Reports, Apr 1, 2017

A male infant was born at term to a 31-year-old, gravid 3 para 2 mother by precipitous spontaneou... more A male infant was born at term to a 31-year-old, gravid 3 para 2 mother by precipitous spontaneous vaginal birth. Pregnancy and third trimester fetal ultrasound scan were unremarkable. Apgar scores were 7 (1 minute) and 9 (5 minutes). Birth weight was 3,815 g (75th percentile). Facial suffusion was noted immediately after birth and intramuscular vitamin K was administered shortly after birth. At 16 hours of age, proptosis of the right eye was noted with associated subconjunctival hemorrhage, right-sided hypotropia, and impaired right lateral gaze (►Fig. 1a). The cornea appeared clear bilaterally, pupils responded to light symmetrically, both fundi and the baby's physical examination were unremarkable. A full blood count and coagulation profile were unremarkable (results not shown). Imaging and Clinical Course Orbital ultrasound demonstrated a well-defined hypoechoic, nonvascular 13 Â 9 mm mass in the superior aspect of right orbit, exerting mass effect and scalloping the retroorbital fat and superior rectus muscle (►Fig. 1b, calipers, contralateral eye not shown). A cranial magnetic resonance imaging (MRI) study on day 12 of life demonstrated an ellipsoid lesion measuring 19.8 Â 22.8 Â 11 mm with elevation of the roof of the right orbit. The lesion was hyperintense on T1 and showed mixed intensity on T2 sequences (►Fig. 1c). There Keywords ► newborn ► orbital ► subperiosteal ► hematoma ► proptosis ► ultrasound

American Journal of Roentgenology, Sep 1, 2020

N e u r o r a d io l og y/ H e a d a n d N e c k I m ag i ng • R ev i ew

Journal of Pediatric Surgery, Dec 1, 2021

BACKGROUND Upper gastrointestinal contrast study is considered the gold standard investigation to... more BACKGROUND Upper gastrointestinal contrast study is considered the gold standard investigation to diagnose intestinal malrotation and midgut volvulus which is potentially devastating condition. Ultrasound imaging is an alternative but has been considered unreliable due to significant false negative results. At our institution we have been using ultrasound imaging as the first line investigation to diagnose malrotation since 2008 with a preliminary study of 139 patients published in 2014. This is an ongoing audit of a further much larger cohort of patients to determine the efficacy and safety of ultrasound imaging in the diagnosis of intestinal malrotation. MATERIALS AND METHODS Following ethics approval, a retrospective analysis of a prospectively collected patient database undergoing ultrasound scans to exclude malrotation at our centre was performed from 2012 to 2019. RESULTS 539 patients underwent ultrasound to assess for malrotation. The mean age of presentation was 365 days (median 30 days, mode 1 day). Malrotation was diagnosed in 17 with 5 having volvulus, with findings confirmed at surgery. 12 had equivocal findings and subsequent contrast studies ruled out malrotation. The remaining 510 patients with no evidence of malrotation were managed conservatively. CONCLUSION We have shown ultrasound to be a safe and effective tool to assess intestinal malrotation without exposure to ionizing radiation. LEVEL OF EVIDENCE Level IV.

Journal of medical imaging and radiation oncology, Oct 1, 2005

Desmoplastic infantile ganglioglioma is a rare intracranial tumour of childhood that involves the... more Desmoplastic infantile ganglioglioma is a rare intracranial tumour of childhood that involves the cerebral cortex and the leptomeninges. We report two patients with desmoplastic infantile gangliogliomas and multiple cerebrospinal metastases. To our knowledge, only two similar cases have been reported in the published literature. Pathologically, this rare intracranial tumour shows glial and ganglionic differentiation, accompanied by an extreme desmoplastic reaction. These are low-grade neoplasms that are questionably benign.

Developmental Cell, Oct 1, 2022

Topics in Magnetic Resonance Imaging, Dec 1, 2018

Abstract Medulloblastoma is the most common malignant solid tumor in childhood and the most commo... more Abstract Medulloblastoma is the most common malignant solid tumor in childhood and the most common embryonal neuroepithelial tumor of the central nervous system. Several morphological variants are recognized: classic medulloblastoma, large cell/anaplastic medulloblastoma, desmoplastic/nodular medulloblastoma, and medulloblastoma with extensive nodularity. Recent advances in transcriptome and methylome profiling of these tumors led to a molecular classification that includes 4 major genetically defined groups. Accordingly, the 2016 revision of the World Health Organization's Classification of Tumors of the Central Nervous System recognizes the following medulloblastoma entities: Wingless (WNT)-activated, Sonic hedgehog (SHH)-activated, Group 3, and Group 4. This transcriptionally driven classification constitutes the basis of new risk stratification schemes applied to current therapeutic clinical trials. Because additional layers of molecular tumor heterogeneities are being progressively unveiled, several clinically relevant subgroups within the 4 major groups have already been identified. The purpose of this article is to review the recent basic science and clinical advances in the understanding of “medulloblastomas,” and their diagnostic imaging correlates and the implications of those on current neuroimaging practice.

Acta Radiologica, Feb 1, 2006

The vitelline or omphalomesenteric duct malformations constitute a rare group and are seen in onl... more The vitelline or omphalomesenteric duct malformations constitute a rare group and are seen in only 2% of people. The malformations can take the form of a patent duct, a cyst, a fistula, or a sinus. They may or may not be symptomatic depending on the type of malformation. We present ultrasonographic features of a patent omphalomesenteric duct remnant in a 3-week-old boy who presented to our hospital with a non-healing umbilical lesion. Ultrasound can prove beneficial in the work-up of such cases.

Journal of Thoracic Imaging, Aug 1, 2008

Mycotic pulmonary artery aneurysms are rare but potentially fatal complications of infective endo... more Mycotic pulmonary artery aneurysms are rare but potentially fatal complications of infective endocarditis. Three mycotic aneurysms developed in a 22-year-old female patient who had a history of intravenous drug use. She suffered from Staphylococcus aureus pneumonia and infective endocarditis. The patient was managed conservatively with antibiotics. She did not have hemoptysis during a prolonged hospital stay. Several multislice computed tomography examinations were performed to follow these aneurysms over a period of 19 months. The 2 smaller aneurysms had resolved by 9 weeks postdevelopment. The largest aneurysm was stable at 9 weeks and was smaller at 19 months, but it had not yet completely resolved. The literature on this rare condition was reviewed and its prognosis and management were discussed.

Neuroradiology, Mar 3, 2020

Pediatric Radiology, Sep 13, 2022

Background Perinatal and childhood postmortem imaging has been accepted as a noninvasive alternat... more Background Perinatal and childhood postmortem imaging has been accepted as a noninvasive alternative or adjunct to autopsy. However, the variation in funding models from institution to institution is a major factor prohibiting uniform provision of this service. Objective To describe current funding models employed in European and non-European institutions offering paediatric postmortem imaging services and to discuss the perceived barriers to future postmortem imaging service provision. Materials and methods A web-based 16-question survey was distributed to members of the European Society of Paediatric Radiology (ESPR) and ESPR postmortem imaging task force over a 6-month period (March-August 2021). Survey questions related to the radiologic and autopsy services being offered and how each was funded within the respondent's institute. Results Eighteen individual responses were received (13/18, 72.2% from Europe). Only one-third of the institutions (6/18, 33.3%) have fully funded postmortem imaging services, with the remainder receiving partial (6/18, 33.3%) or no funding (5/18, 27.8%). Funding (full or partial) was more commonly available for forensic work (13/18, 72%), particularly where this was nationally provided. Where funding was not provided, the imaging and reporting costs were absorbed by the institute. Conclusion Increased access is required for the expansion of postmortem imaging into routine clinical use. This can only be achieved with formal funding on a national level, potentially through health care commissioning and acknowledgement by health care policy makers and pathology services of the value the service provides following the death of a fetus or child. Funding should include the costs involved in training, equipment, reporting and image acquisition.

Austin Journal of Anatomy, Oct 30, 2021

Background: Congenital Lamina Papyracea Dehiscence (LPD) is a described anatomical variant, knowl... more Background: Congenital Lamina Papyracea Dehiscence (LPD) is a described anatomical variant, knowledge of which is important to avoid misdiagnosis of orbital fractures, to indentify this variant prior to sinonasal instrumentation including Functional Endoscopic Sinus Surgery (FESS) and to improve interpretation when evaluating orbital and sinus pathologies such as infection and tumour infiltration. We aim to quantify the prevalence of LPD in children presenting for Computerized Tomography Scan (CT) of the paranasal sinuses. Methods: The database in the Radiology and Imaging System (RIS) for all CT scans of paranasal sinuses performed between 1/1/2019 and 31/1/2021 at the Women’s and Children’s Hospital (WCH), Adelaide, South Australia, were accessed for this study. Patients aged above 18 years were excluded. Subjects with repeat studies were only included once. Standardized CT imaging was performed on a GE machine. Images obtained were 0.6 mm thick and were subjected to reformatting during observer interpretations. Imaging review was performed by two readers who agreed on the findings. Prevalence was calculated by dividing the number of subjects with LPD by the total number of subjects included. Results: Using the above criteria 90 subjects were included in the study, and among these, one patient was noted to have congenital LPD. Conclusion: Congenital LPD is an uncommon anatomical variant and was found in 1.1% of children presenting for CT evaluation of the nasal sinuses in this study of a South Australian paediatric population.

Childs Nervous System, Jul 10, 2021

Craniosynostosis is a condition of premature fusion of the cranial sutures. Multi-suture craniosy... more Craniosynostosis is a condition of premature fusion of the cranial sutures. Multi-suture craniosynostosis has been found to be associated with a number of syndromes and underlying gene mutations. Tumour necrosis factor receptor-associated factors (TRAFs) are a family of adaptor proteins interacting with cell surface receptors or other signalling molecules. TRAF7 is one of the factors involved in multiple biologic processes, including ubiquitination, myogenesis and toll-like receptor signalling. Here, we report a child who presented with multi-suture craniosynostosis and had the uncommon c.1570C>T (p.Arg524Trp) variant of TRAF7.

Sonography, Sep 7, 2017

Retinopathy of prematurity (ROP) is a potentially blinding vasoproliferative retinal disorder tha... more Retinopathy of prematurity (ROP) is a potentially blinding vasoproliferative retinal disorder that occurs in premature infants born with immature retinal vasculature. Babies born at term, unlike premature neonates, have a fully vascularised retina and are not at risk of developing retinopathy of prematurity. The most rapidly progressing, virulent form of retinopathy is described as ‘aggressive posterior retinopathy of prematurity’ (AP-ROP). Ultrasound can evaluate the posterior segment in cases which are complicated by vitreous haemorrhage and aid when surgery is planned. This report discusses the clinical, sonographic and pathological features of this disease, which, to our knowledge, has not been published previously.

The Internet Journal of Radiology, 2005

Juvenile dermatomyositis is a rare disorder with very few reports of multi-system involvement. We... more Juvenile dermatomyositis is a rare disorder with very few reports of multi-system involvement. We report a 10-year-old child known to have dermatomyositis who developed a combination of pneumothorax, pneumomediastinum, subcutaneous emphysema and intracerebral haemorrhage. Vasculopathy as a part of the Juvenile dermatomyositis spectrum has been implicated as a cause of many of these complications but reports have also suggested long term cortico-steroid treatment as a possible causative agent.

Topics in Magnetic Resonance Imaging, Aug 1, 2018

Lysosomal storage disorders are a heterogeneous group of genetic diseases characterized by defect... more Lysosomal storage disorders are a heterogeneous group of genetic diseases characterized by defective function in one of the lysosomal enzymes. In this review paper, we describe neuroradiological findings and clinical characteristics of neuronopathic lysosomal disorders with a focus on differential diagnosis. New insights regarding pathogenesis and therapeutic perspectives are also briefly discussed.