Jerele Cene, Lovrič Dimitrij, Kuhelj Dimitrij
Clinical Institute of Radiology, University Medical Centre Ljubljana, Zaloška Cesta 7, 1000 Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1104 Ljubljana, Slovenia.
Children (Basel). 2023 Apr 12;10(4):715. doi: 10.3390/children10040715.
Pediatric interventional neuroradiology (PINR) is a relatively new field of diagnostic and therapeutic care in the pediatric population that has seen considerable advances in recent decades. However, it is still lagging behind adult interventional neuroradiology due to a variety of reasons, including the lack of evidence validating pediatric-specific procedures, the relative absence of pediatric-specific equipment, and the challenges in establishing and maintaining PINR competencies in a relatively small number of cases. Despite these challenges, the number and variety of PINR procedures are expanding for a variety of indications, including unique pediatric conditions, and are associated with reduced morbidity and psychological stigma. Continued technological advances, such as improved catheter and microwire designs and novel embolic agents, are also contributing to the growth of the field. This review aims to increase awareness of PINR and provide an overview of the current evidence base for minimally invasive neurological interventions in children. Important considerations, such as sedation, contrast agent use, and radiation protection, will also be discussed, taking into account the distinct characteristics of the pediatric population. The review highlights the usefulness and benefits of PINR and emphasizes the need for ongoing research and development to further advance this field.
儿科介入神经放射学(PINR)是儿科诊断和治疗护理领域中一个相对较新的领域,近几十年来取得了显著进展。然而,由于多种原因,它仍落后于成人介入神经放射学,这些原因包括缺乏验证儿科特定程序的证据、相对缺乏儿科专用设备,以及在相对较少的病例中建立和维持PINR能力方面的挑战。尽管存在这些挑战,PINR程序的数量和种类仍在因各种适应症而不断扩大,包括独特的儿科病症,并且与发病率降低和心理污名化相关。持续的技术进步,如改进的导管和微丝设计以及新型栓塞剂,也在推动该领域的发展。本综述旨在提高对PINR的认识,并概述目前儿童微创神经介入的证据基础。还将讨论一些重要的注意事项,如镇静、造影剂使用和辐射防护,同时考虑到儿科人群的独特特征。该综述强调了PINR的实用性和益处,并强调了持续进行研究和开发以进一步推动该领域发展的必要性。