42 research outputs found
Sonographically detected costo-chondral dislocation in an abused child - A new sonographic sign to the radiological spectrum of child abuse
A case of an abused child with fractures of the skull, ribs and long bones is presented. Sonographically a costochondral dislocation of the left lower ribs was detected, which has not been reported in the literature
Congenital arterioportal fistula of the liver with reversal of flow in the superior mesenteric vein
We report on a newborn with a large arterioportal fistula of the liver complicated by a sudden reversal of flow in the portal and superior mesenteric vein, leading to congestion and ischemia of the small intestine. Ultrasound, duplex Doppler sonography and angiographic features are presented. Ligation of the hepatic artery led to a complete recovery
Plain film diagnosis in meconium plug syndrome, meconium ileus and neonatal Hirschsprung's disease - A scoring system
Abdominal plain films of 133 neonates, with 82 cases of meconium plug syndrome (MPS), 27 cases of meconium ileus (MI) and 24 cases of neonatal Hirschsprung's disease (HD), were reviewed to assess the value of such radiographs for diagnosis. The radiographs were examined according to a list of 11 parameters. By using multivariate discriminant analysis, it appeared that 4 parameters i.e. dilatation of bowel loops, varying loop calibre, fluid levels and colonic gas were most important in discriminating among the three disorders. For each parameter the weight (in points) was derived. To classify patients, three group-scores had to be calculated: the group-score with the largest value indicated the most likely disorder. So in 99%, 88% and 63% of MPS, HD and MI, respectively, an accurate diagnosis could be predicted. The overall diagnostic accuracy was 89%. Such a diagnosis can be a sound basis for further investigation
Anterior joint capsule of the normal hip and in children with transient synovitis: US study with anatomic and histologic correlation
PURPOSE: To study the anatomic components of the anterior joint capsule of
the normal hip and in children with transient synovitis. MATERIALS AND
METHODS: Six cadaveric specimens were imaged with ultrasonography (US)
with special attention to the anterior joint capsule. Subsequently, two
specimens were analyzed histologically. These anatomic findings were
correlated with the US findings in 58 healthy children and 105 children
with unilateral transient synovitis. RESULTS: The anterior joint capsule
comprises an anterior and posterior layer, mainly composed of fibrous
tissue, lined by only a minute synovial membrane. Both fibrous layers were
identified separately at US in 98 of 116 (84%) hips of healthy subjects
and in all hips with transient synovitis. Overall, the anterior layer was
thicker than the posterior layer. In transient synovitis compared with
normal hips, no significant thickening of both layers was present (P = .24
and .57 for the anterior and posterior layers, respectively). Normal
variants include plicae, local thickening of the capsule, and
pseudodiverticula. CONCLUSION: Increased thickness of the anterior joint
capsule in transient synovitis is caused entirely by effusion. There is no
US evidence for additional capsule swelling or synovial hypertrophy
High resolution MRI for preoperative work-up of neonates with an anorectal malformation: a direct comparison with distal pressure colostography/fistulography
Objective: To compare MRI and colostography/fistulography in neonates with anorectal malformations (ARM), using surgery as reference standard. Methods: Thirty-three neonates (22 boys) with ARM were included. All patients underwent both preoperative high-resolution MRI (without sedation or contrast instillation) and colostography/fistulography. The Krickenbeck classification was used to classify anorectal malformations, and the level of the rectal ending in relation to the levator muscle was evaluated. Results: Subjects included nine patients with a bulbar recto-urethral fistula, six with a prostatic recto-urethral fistula, five with a vestibular fistula, five with a cloacal malformation, four without fistula, one with a H-type fistula, one with anal stenosis, one with a rectoperineal fistula and one with a bladderneck fistula. MRI and colostography/fistulography predicted anatomy in 88Β % (29/33) and 61Β % (20/33) of cases, respectively (p = 0.012). The distal end of the rectal pouch was correctly predicted in 88Β % (29/33) and 67Β % (22/33) of cases, respectively (p = 0.065). The length of the common channel in cloacal malformation was predicted with MRI in all (100Β %, 5/5) and in 80Β % of cases (4/5) with colostography/fistulography. Two bowel perforations occurred during colostography/fistulography. Conclusions: MRI provides the most accurate evaluation of ARM and should be considered a serious alternative to colostography/fistulography during preoperative work-up. Key Points: β’ High-resolution MRI is feasible without the use of sedation or anaesthesia. β’ MRI is more accurate than colostography/fistulography in visualising the type of ARM. β’ MRI is as reliable as colostography/fistulography in predicting the level of the rectal pouch. β’ Colostography/fistulography can be complicated by bowel perforation
High resolution MRI for preoperative work-up of neonates with an anorectal malformation: a direct comparison with distal pressure colostography/fistulography
OBJECTIVE: To compare MRI and colostography/fistulography in neonates with anorectal malformations (ARM), using surgery as reference standard. METHODS: Thirty-three neonates (22 boys) with ARM were included. All patients underwent both preoperative high-resolution MRI (without sedation or contrast instillation) and colostography/fistulography. The Krickenbeck classification was used to classify anorectal malformations, and the level of the rectal ending in relation to the levator muscle was evaluated. RESULTS: Subjects included nine patients with a bulbar recto-urethral fistula, six with a prostatic recto-urethral fistula, five with a vestibular fistula, five with a cloacal malformation, four without fistula, one with a H-type fistula, one with anal stenosis, one with a rectoperineal fistula and one with a bladderneck fistula. MRI and colostography/fistulography predicted anatomy in 88Β % (29/33) and 61Β % (20/33) of cases, respectively (pβ=β0.012). The distal end of the rectal pouch was correctly predicted in 88Β % (29/33) and 67Β % (22/33) of cases, respectively (pβ=β0.065). The length of the common channel in cloacal malformation was predicted with MRI in all (100Β %, 5/5) and in 80Β % of cases (4/5) with colostography/fistulography. Two bowel perforations occurred during colostography/fistulography. CONCLUSIONS: MRI provides the most accurate evaluation of ARM and should be considered a serious alternative to colostography/fistulography during preoperative work-up. KEY POINTS: β’ High-resolution MRI is feasible without the use of sedation or anaesthesia. β’ MRI is more accurate than colostography/fistulography in visualising the type of ARM. β’ MRI is as reliable as colostography/fistulography in predicting the level of the rectal pouch. β’ Colostography/fistulography can be complicated by bowel perforation
Reduced renal length and volume 20Β years after very preterm birth
Intrauterine growth retardation is presumed to be associated with decreased renal size and impaired renal function as a result of stunted kidney development and nephron deficit. To study whether very preterm birth also affects renal size at young adulthood, we sonographically measured bipolar kidney length and volume in 51 very premature individuals (<32Β weeks of gestation), either small (SGA) or appropriate (AGA) for gestational age (22 SGA and 29 AGA), and 30 full-term controls 20 years after birth. Relative kidney length and volume were calculated. Both absolute and relative left kidney length and volume were significantly lower in SGA and AGA individuals, notably in women. Renal size did not differ between SGA and AGA individuals. In 70% of controls, the left kidney was larger than the right one compared with 40.9% in SGA [relative risk (RR) 1.7; 95% confidence interval (CI) 1.0β3.0] and 48.3% in AGA (RR 1.5; 95% CI 0.9β2.3) individuals. Renal structural anomalies were present in eight prematurely born participants only. Our data suggest that kidney growth is stunted after preterm birth, especially on the left side, and in the female gender