Cranial Ultrasonographic Screen in Healthy Neonates

Abstracts unlikely event of occurrence, should be kept in minds in pediatric cases with vascular ovarian masses PPT18-002 Cranial Ultrasonographic Screen in Healthy Neonates Yi-Jie Lin, Nan-Chang Chiu, Che-Sheng Ho Division of Pediatric Neurology, MacKay Children’s Hospital, Taiwan Objectives: Cranial ultrasonography is a non-invasive screening technique for early detection of abnormalities. Methods: We retrospectively reviewed the results of cranial ultrasonographic screen in healthy neonates between October 2011 and August 2014, with gestational age between 35-42 weeks. Results: There were a total of 6405 neonates received cranial ultrasonographic screen during the period, and most of them (5335 cases, 83.3%) were assigned to the normal group. Among the 1070 neonates with abnormal findings, 166 of them (2.6%) had more than two abnormal findings. The most common minor findings were cysts, including 511 (7.97%) subependymal cysts, 118 (1.84%) frontal horn cysts, 148 (2.31%) choroid plexus cysts, and 15 (0.23%) pineal region cysts. Subependymal cysts and frontal horn cysts mostly resolved at the age between 2 and 3 months old (46.1% and 42.8%, respectively). Other detected minor anomalies were lenticulostriate vasculopathy (201, 3.13%), mild ventricular dilatation (92, 1.43%), increased periventricular echogenicity (62, 0.96%), enlarged cisterna magna (47, 0.73%), asymmetric ventricles (7, 0.10%), and mild brain edema (5, 0.07%).There were 10 (0.15%) major anomalies confirmed by MRI, including cerebral hemorrhage, cerebral infarction, periventricular heterotopia, lipoma in perisplenimu of corpus callosum, vascular malformation, arachnoid cyst, dysgenesis of corpus callosum and agenesis of corpus callosum. Conclusions: In our study, the incidence of intracranial anomalies found by cranial ultrasonographic screen in healthy neonates is 16.7%. Major anomalies were found in 0.12% neonates. Cranial ultrasonography can be an easily used technique for early screening and serial follow-up. Still, continuous clinical assessment is important in neonates even without abnormal newborn screen. PPT18-003 Decision Making of Clinical Management by Sonography in a Very Low Birth Weight Infant with Hydrocephalus Nan-Chang Chiu Department of Pediatrics, MacKay Children’s Hospital, Taiwan Objectives: Intracranial hemorrhage (ICH) can cause hydrocephalus and is not so rare in very low birth weight (VLBW) infant. Progressive hydrocephalus may need surgical approach. However, it is rather difficult to perform in VLBW infants. Here present a case of facing such situation and demonstrate the decisive role of cranial sonography for choosing the proper clinical management. Methods: Case report. Results: The patient was born with 24+1 weeks’ gestational age and a birth weight of 609 gm. Grade II ICH was found on the second day after birth. A hematoma posterior to 3rd ventricle with dilated lateral and 3rd ventricles was found on the 10th day. Progressive dilatation of the ventricles was detected by the following sonographies. The resistant index (RI) of anterior cerebral artery (ACA) increased gradually. Transient diastolic reversal flow was found on the 19th day. Fortunately, it disappeared after compressing the anterior fontanelle so ventricular tapping was avoided. The RI of ACA decreased and the hematoma and the dilated ventricles shrinked finally. He had no abnormal neurological finding at corrected age of 4 months.

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Conclusions: Hydrocephalus is usually a critical condition but the tolerance of the brain decides the necessity of surgical approach. We constantly monitored the cerebral blood flow condition by cranial sonography and held invasive procedure in this case. Serial sonography is helpful for managing ICH in infants. PPT18-004 Evaluation of Right Atrial Size in Children Andrey Tsokolov, Viktor Krilov Department of Diagnostic, Federal State Agency «1409 Clinical Hospital Of The Baltic Sea Fleet», Russia Objectives: A need to get scientific and clinically reasonable data on standard values of the right atrial (RA) size has appeared with the exclusion of unsubstantiated diagnostic approach. Methods: A total of 1008 people were examined, boys and girls of all age groups (from 3 weeks up to 15 years), and body weight 3.1-40.9 kg. Evaluation of the RA size was carried out from the apical 4-chamber position from the level of the plane of the tricuspid valve ring to the base of the RA. Results: The mean values of the RA size for the different weight groups of patients from the examination, as well as the value of the 2 standard deviations (62d) are given below. Moreover, all the RA values obtained in the study are within the specified interval of 2 standard deviations. Weight 3.1-4.9 kg – size RA 17.266.5 mm; 5.0-6.9 - 19.963.4; 7.0-8.9 - 21.564.3; 9.0-10.9 - 23.963.6; 11.0-12.9 - 24.764.0; 13.0-14.9 - 26.563.1; 15.0-16.9 - 27.465.7; 17.0-18.9 - 27.964.6; 19.0-20.9 - 28.763.8; 21.0-22.9 - 29.164.1; 23.0-24.9 - 31.265.7; 25.0-26.9 - 31.764.3; 27.0-30.9 - 32.664.4; 31.0-35.9 - 33.465.2; 36.0-40.9 - 34.865.9, respectively. Conclusions: A close correlation (r50.87) between the size of the RA and the body weight of the examined children and adolescents, as well as the links between body weight and dimensional parameters of the heart chambers, supposes a comprehensive assessment of the last, with the purpose of the correct interpretation of the data and verification of the diagnosis. PPT18-005 Imaging Findings of Rapunzel Syndrome Including Sonography _ D€undar,3 Alpaslan Yavuz,1 Mehmet Melek,2 Ilyas 1 S€umeyra Demirkol Alag€oz, Fatma Durmaz1 1 Department of Radiology, Yuzuncu Yil University, Turkey, 2Department of Pediatric Surgery, Yuzuncu Yil University, 3Department of Urology, Yuzuncu Yil University Objectives: Rapunzel syndrome caused by thichobezoar is an extremely rare intestinal condition in humans resulting from ingesting hair (trichophagia). Trichobezoars (hair ball) are usually located in the stomach, but may extend through the pylorus into the duodenum and small bowel (Rapunzel syndrome). They are almost always associated with trichotillomania and trichophagia or other psychiatric disorders. When not recognized, the trichobezoar continues to grow in size and weight due to the continued ingestion of hair. This increases the risk of severe complications, such as gastric mucosal erosion, ulceration and even perforation of the stomach or the small intestine. In this presentation, it was aimed to make a well-groomed demonstration of the radiologic findings of a giant gastric bezoar that was determined in a young female. Methods: Case report and literature review. Results: 15-years-old woman was referred with complaints of anorexia, weight loss and left upper quadrant mass. Physical examination specified a left hypochondriac solid mass bloating the skin upwards. BMode Ultrasound imaging of upper abdomen revealed an echogenic mass with acoustic shadow behind at gastric site. CT examination following intravenous contrast administration revealed a heterogeneous