Computed tomographic lung density in children.

The effects of patient age, anatomic level, anteroposterior location, and phase of respiration on pulmonary density were analyzed retrospectively in 33 children and prospectively in 13 children. Density standards were positioned on the chest wall for correction of scanner performance changes. The subgroup of 32 children over 7 years of age, ie, with respiratory cooperation, was analyzed separately using moderate inspiration; its mean lung density (MLD) of three levels was -792 HU (95% range, -702-882 HU). Although MLD decreased with increasing age, a significant linear regression was found only in the prospective subgroup. Densities of the apical, subcarinal, and basal levels of the lung were not different. From maximal expiration to maximal inspiration, MLD decreased by 158 HU in the subgroup studied prospectively. Anteroposterior density gradients averaged 56 HU at the subcarinal level and increased with maximal expiration.

Clinical proton MR spectroscopy of neurodegenerative disease in childhood.

PURPOSE: To determine the contribution of MR spectroscopy in the assessment of childhood neurodegenerative disease. METHODS: Fifty-one subjects (7 weeks to 17 years of age), 22 with either hereditary (n = 16) or acquired (n = 6) neurodegenerative disorders and 29 age-matched control subjects, were studied with combined proton MR spectroscopy and MR imaging. Single-voxel (2.0-8.0 cc) MR spectra were acquired at 1.5 T, with either short-echo-stimulated echoes and/or long-echo spin echoes. RESULTS: MR spectra exhibited signals from n-acetyl-, creatine-, and choline-containing compounds, neurotransmitters (glutamate), intracellular mediators (inositols), and glycolytic products (lactate). Abnormal MR spectra in neurodegenerative disorders reflected: demyelination, neuronal loss, and gliosis (increased mobile lipid presence and reduction of n-acetylaspartate to choline); metabolic acidosis (lactate accumulation); and neurotransmitter neurotoxicity (increased glutamate, glutamine, and inositols). CONCLUSION: Proton MR spectroscopy may complement MR imaging in diagnostic assessment and therapeutic monitoring of neurodegenerative disorders.

Chest computed tomography in children.

This article describes the use of computed tomography for the evaluation of pediatric patients with a variety of chest diseases. Indications for chest CT, constraints of technical factors on the study, and analysis of the benefits of CT examination versus risks will also be discussed.

Diagnostic imaging of pediatric abdominal masses.

This overview delineates the clinical and pathological features of various abdominal mass lesions found in neonates and in older infants and children. The application and limitations of imaging procedures currently available are reviewed with emphasis on the principles and advantages of advanced imaging techniques. Selected pediatric abdominal masses are discussed and their radiologic features illustrated. Integrated imaging strategies for abdominal masses in the newborn and in the older infant and child are proposed.

Malrotation - the ubiquitous anomaly.

Although anomalies of rotation and fixation of the gastrointestinal tract are recognized to be associated frequently with anomalies of the abdominal wall and diaphragmatic hernia, the frequency with which these common anomalies are associated with other congenital and acquired lesions of the gastrointestinal tract has not been sufficiently emphasized. Sixty-two percent of our series of 34 patients were associated with such lesions as upper gastrointestinal atresias and stenoses, intussusception, and Hirschsprung's disease. The embryologic and anatomic features of rotational anomalies, their clinical presentation, and radiologic features are presented with the suggestion that knowledge of this information, along with the appreciation of the frequent association of malrotation with other common congenital and acquired abnormalities, will help to prevent the devastating morbidity and mortality of undiagnosed midgut volvulus.

The diagnosis of primary and recurrent tracheoesophageal fistulas: value of selective catheterization.

To avoid an unnecessary second thoracotomy, unequivocal demonstration of a recurrent tracheoesophageal fistula after repair of esophageal atresia with tracheoesophageal fistula is mandatory. Transesophageal selective catheterization of the fistula during cineesophagography may resolve the ambiguities of routine cineesophagography and rod lens telescopic bronchoscopy.

Emergency radiology of the pediatric chest.

This monograph will present an overview of pediatric emergency room chest radiology. Technique, interpretative approach, normal radiologic appearances, common normal variants, and unique features of the pediatric lung are discussed. The radiologic features of common pediatric chest emergencies (infection, airway foreign body, asthma, hydrocarbon aspiration, near-drowning pneumothorax, trauma, hemosiderosis and upper airway obstruction) are described and illustrated.

Radiological evaluation of visceral injuries in the battered child syndrome.

Diagnostic imaging plays an important role in the recognition, evaluation, and follow-up of visceral injuries in the battered child syndrome. Conventional radiography is important for the diagnosis of associated skeletal fractures, pulmonary parenchymal injury, gastric dilatation, and pneumoperitoneum. An upper gastrointestinal series is the examination of choice in suspected intramural duodenal hematoma. Ultrasonography is helpful in the diagnosis of retroperitoneal hematoma, acute traumatic pancreatitis, and pancreatic pseudocyst. Nuclear scintigraphy is valuable if injury is limited to the liver or spleen. CT is the imaging modality of choice for assessing generalized blunt abdominal trauma as well as evaluating the extent of injuries to the liver, spleen, pancreas, kidneys, and mesentery.