[Diffuse brain involvement in paediatrics: magnetic resonance findings]. / Afectación difusa del cerebelo en la edad pediátrica: hallazgos en resonancia magnética.

Posterior fossa involvement, which may be focal or diffuse, is an uncommon finding in paediatric patients. Acute cerebellitis is the first condition to be suspected among the diffuse forms, and ataxia is the most characteristic symptom. This condition is occasionally difficult to diagnose clinically, thus imaging tests play an important role in this. However, there are other rare conditions which may be clinically and radiologically similar to acute cerebellitis and which should be taken into account when making a differential diagnosis. The aim of this article is to present five diseases with diffuse brain involvement in paediatric patients and describe how they show up in MR imaging.

[MR-arthrography of the shoulder. Description and evaluation of the technique using a US-guided pediatric spinal needle]. / RM-artrografía de hombro. Descripción y valoración de la técnica guiada con ecografía y utilizando una aguja espinal infantil.

OBJECTIVE: To describe the technique of US-guided shoulder arthrography using a pediatric needle (modified Valls- Melloni technique) and to assess its efficacy. MATERIAL AND METHODS: Descriptive study of articular puncture for 48 magnetic resonance imaging arthrographs of the shoulder in 48 consecutive patients. The puncture was performed by a radiologist without prior experience in the technique. We used an anterior approach to the shoulder, guiding the puncture using US according to the Valls-Melloni technique; however, we used a pediatric spinal needle (Yale spinal; 22G: 0.7 x 40 mm). The efficacy of the technique was evaluated using the following variables: time employed, number of attempts, extravasation of contrast outside the joint, pain reported by the patient (on a scale from 0 to 10), and immediate or late complications of the technique. RESULTS: The time required for the procedure was 15.2+/-2.6 min (mean+/-standard deviation). A single puncture sufficed in 45 patients (94%); two attempts were necessary in two patients (4%) and three in one patient (2%). Contrast extravasation outside the joint occurred only in two patients (4%). The mean pain reported was 3.6 points (confidence interval: 3.1-4). Three patients (6%) had a vasovagal reaction. No late complications were observed. CONCLUSION: US-guided shoulder arthrography using a pediatric spinal needle is fast, simple, and safe; it can be performed by any radiologist, even without prior experience in the technique.

RM-artrografía de hombro. Descripción y valoración de la técnica guiada con ecografía y utilizando una aguja espinal infantil / MR-arthrography of the shoulder. Description and evaluation of the technique using a US-guided pediatric

Objetivo. Describir la técnica de artrografía de hombro guiada con ecografía utilizando una aguja espinal infantil (técnica modificada de Valls y Melloni) y verificar su eficacia. Material y métodos. Estudio descriptivo de la técnica de punción articular en 48 artrografías de hombro mediante resonancia magnética, realizadas en 48 pacientes consecutivos. La punción la realizó un radiólogo sin experiencia previa en esta técnica. Se empleó un abordaje anterior del hombro guiando la punción mediante ecografía según la técnica de Valls y Melloni, pero utilizando una aguja espinal infantil (Yale spinal; 22G: 0,7 × 40 mm). La eficacia de la prueba se valoró mediante las variables: tiempo empleado, número de intentos, extravasación del contraste fuera de la articulación, dolor referido por el paciente (escala de 0 a 10) y complicaciones inmediatas o tardías de la técnica. Resultados. El tiempo del procedimiento fue de 15,2 ± 2,6 min (media ± desviación estándar). Se precisó una sola punción en 45 pacientes (94%); dos intentos en dos pacientes (4%) y tres en un paciente (2%). Solamente en dos pacientes existió extravasación del contraste fuera de la articulación (4%). La media del dolor referido fue de 3,6 puntos (intervalo de confianza: 3,1-4). Tres pacientes (6%) sufrieron una reacción vaso-vagal. No hubo complicaciones tardías. Conclusión. La artrografía de hombro guiada por ecografía y usando una aguja espinal infantil es una técnica rápida, sencilla y segura, que puede ser realizada por cualquier radiólogo, incluso sin experiencia previa en la técnica

Objective. To describe the technique of US-guided shoulder arthrography using a pediatric needle (modified Valls- Melloni technique) and to assess its efficacy. Material and methods. Descriptive study of articular puncture for 48 magnetic resonance imaging arthrographs of the shoulder in 48 consecutive patients. The puncture was performed by a radiologist without prior experience in the technique. We used an anterior approach to the shoulder, guiding the puncture using US according to the Valls-Melloni technique; however, we used a pediatric spinal needle (Yale spinal; 22G: 0.7 × 40 mm). The efficacy of the technique was evaluated using the following variables: time employed, number of attempts, extravasation of contrast outside the joint, pain reported by the patient (on a scale from 0 to 10), and immediate or late complications of the technique. Results. The time required for the procedure was 15.2 ± 2.6 min (mean ± standard deviation). A single puncture sufficed in 45 patients (94%); two attempts were necessary in two patients (4%) and three in one patient (2%). Contrast extravasation outside the joint occurred only in two patients (4%). The mean pain reported was 3.6 points (confidence interval: 3.1-4). Three patients (6%) had a vasovagal reaction. No late complications were observed. Conclusion. US-guided shoulder arthrography using a pediatric spinal needle is fast, simple, and safe; it can be performed by any radiologist, even without prior experience in the technique