The importance of FDG PET/CT in the diagnostic process of the middle aortic syndrome in a 15-year-old boy patient with suspected systemic vasculitis and final diagnosis of Williams-Beuren syndrome.

The differential diagnosis in children with the systemic vasculopathy is still a challenge for clinicians. The progress in vascular imaging and the latest recommendations improve the diagnostic process, but only single reports describe the use of new imaging tests in children. The publication aims to demonstrate the important role of 18F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography combined with anatomical computed tomography angiography (PET/CTA) imaging in the case of a 15-year-old boy with chest pain, intermittent claudication, hypertension and features of middle aortic syndrome in computed tomography angiography (CTA). The patient was suspected to have Takayasu arteritis, but was finally diagnosed with Williams-Beuren syndrome. The case indicates that the FDG PET/CT imaging might be essential in the diagnostic process of middle aortic syndrome in children. We suggest that this imaging technique should be considered in the diagnostic process of systemic vasculopathy particularly in children.

Usefulness of 3D sonography of the central nervous system in neonates and infants in the assessment of intracranial bleeding and its consequences when examined through the anterior fontanelle.

Due to the possibility to examine at the patient bedside or incubator, ultrasound imaging of the central nervous system, particularly through the anterior fontanelle, is the most common diagnostic examination performed in neonates and infants with neurological problems. Despite its common application, this method has certain limitations. These limitations are associated with cross-sections of the cerebral structures that can be obtained when examining through the anterior fontanelle. The aim of the paper was to assess the usefulness of three dimensional sonography of the central nervous system in neonates and infants in the assessment of intracranial bleeding and its consequences when examined through the anterior fontanelle. The study enrolled 283 patients treated at the Pediatric Teaching Hospital at the Medical University of Lublin in whom a transfontanelle cerebral examination was indicated. The two- and three-dimensional ultrasound examinations of the central nervous system were conducted in 283 patients aged from 1 day to 18 months (mean age: 2 months). 254 three-dimensional examinations were of diagnostic value. The number of detected pathological lesions was higher in a statistically significant way (p = 0.007) in the three-dimensional ultrasound examination. In the authors' own studies, the highest sensitivity and statistically significant superiority of the three-dimensional method over the two-dimensional one referred to detecting intraventricular or intracerebral hemorrhages. Novel techniques of ultrasound imaging, including the three-dimensional one, have undoubtedly increased the diagnostic possibilities of sonography and, at the same time, retained all its advantages.