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Comparison of sonographic findings between pediatric patients with mediastinitis and without mediastinitis after cardiovascular surgery

  • Original Article–Pediatrics
  • Published:
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Abstract

Purpose

To compare the sonographic findings between pediatric patients with/without mediastinitis after cardiovascular surgery.

Methods

We included 18 pediatric patients with suspected mediastinitis after cardiovascular surgery who underwent ultrasound. They were divided into two groups according to the presence of mediastinitis, confirmed by positive bacterial culture from the mediastinum (number with/without mediastinitis = 5/13). The following sonographic findings were compared between the groups: (1) increased parasternal fat echogenicity and (2) retrosternal mediastinal fluid collection. Additionally, sex, age, and the interval between surgery and ultrasound examination were also compared. Fisher’s exact and Mann–Whitney U tests were used for statistical comparisons.

Results

A significant difference was observed between patients with and without mediastinitis in the presence of increased fat echogenicity around the sternum (present/absent with mediastinitis vs. present/absent without mediastinitis: 5/0 vs. 3/10, respectively; P = 0.007) and retrosternal mediastinal fluid collection (5/0 vs. 2/11, respectively; P = 0.002). There was no significant difference in sex (male/female; 3/2 vs. 6/7; P > 0.999); age (months; 12.6 ± 9.4 (range, 1–22) vs. 6.9 ± 5.4 (range, 1–21); P = 0.336); and interval between surgery and ultrasound examination (days; 12.8 ± 7.2 (range, 6–20) vs. 19.1 ± 14.9 (range, 1–45); P = 0.443).

Conclusion

Although our cohort was small, none of the patients without increased parasternal fat echogenicity or mediastinal fluid collection was diagnosed with mediastinitis. These sonographic findings may help identify the possible presence of mediastinitis. Ultrasound may be the modality of first choice to evaluate pediatric patients for mediastinitis after cardiovascular surgery.

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Authors and Affiliations

  1. Department of Radiology, Saitama Children’s Medical Center, 1-2 Shintoshin Chuo-ku, Saitama, Saitama, 330-8777, Japan

    Takahiro Hosokawa, Yutaka Tanami, Yumiko Sato & Eiji Oguma

  2. Department of Cardiovascular Surgery, Saitama Children’s Medical Center, 1-2 Shintoshin Chuo-ku, Saitama, Saitama, 330-8777, Japan

    Yoshihiro Ko & Koji Nomura

Authors
  1. Takahiro Hosokawa
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  2. Yutaka Tanami
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  3. Yumiko Sato
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  4. Yoshihiro Ko
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  5. Koji Nomura
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  6. Eiji Oguma
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Corresponding author

Correspondence to Takahiro Hosokawa.

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Conflict of interest

TH, YT, YS, YK, KN, and EO declare that they have no financial or personal relationships that could lead to a conflict of interest.

Research involving human subjects

This research was performed in accordance with the tenets of the Declaration of Helsinki.

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This retrospective study was approved by the ethics committee of our institution, and informed consent was waived.

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Hosokawa, T., Tanami, Y., Sato, Y. et al. Comparison of sonographic findings between pediatric patients with mediastinitis and without mediastinitis after cardiovascular surgery. J Med Ultrasonics 47, 625–633 (2020). https://doi.org/10.1007/s10396-020-01029-3

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  • DOI: https://doi.org/10.1007/s10396-020-01029-3

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