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Imaging of the neonatal genitourinary tract
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Abstracts / Clinical Imaging 31 (2007) 220 – 223
affecting the pathway as demonstrated by magnetic resonance imaging (MRI) and computed tomography (CT). We stress the need to review the lumbosacral plexus in patients with nonspecific symptoms such as back, hip, pelvic pain, and in those who present with sciatica unaccompanied by demonstrable intervertebral disc prolapse. We illustrate that the imaging appearances may be nonspecific and reinforce the importance of the clinical history and the use of tissue sampling to achieve an accurate diagnosis. n 2007 The Royal College of Radiologists. Reprinted by permission.
Magnetic resonance imaging of bone marrow edema associated with focal bone lesions James SLJ, Hughes RJ, Ali KE, Saifuddin A (Department of Radiology, The Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK). Clin Radiol 2006;61:1003–1009. Aim: To quantify the volume of bone marrow edema surrounding focal bone lesions and to identify its relevance relative to diagnosis. Methods: Three hundred and eighty-eight of 1456 patients included in the orthopedic oncology database who underwent magnetic resonance imaging (MRI) demonstrated bone marrow edema and were included in the study. There were 225 males and 163 females, age range 1–87 years (mean, 29 years), MRI images were retrospectively reviewed and assessed for the extent of bone marrow edema. The amount of edema was graded as follows: Grade 1: edema present but smaller than the lesion size; Grade 2: edema equivalent to the lesion size; Grade 3: edema greater than the lesion size. Results: There were 190 Grade 1 lesions: 56% malignant, 33% benign, 11% nonneoplastic; 74 Grade 2 lesions: 19% malignant, 50% benign, 31% nonneoplastic; and 124 Grade 3 lesions: 10% malignant, 46% benign, 44% nonneoplastic. There was a significant relationship between edema grade (i.e., volume of edema) and final diagnosis (Pb.0005). Conclusion: Bone marrow edema may be associated with a wide range of focal bony lesions, including malignant, benign and nonneoplastic causes. As the volume of bone marrow edema increases relative to the size of the underlying lesion, the probability that the underlying lesion is benign is increased. n 2007 The Royal College of Radiologists. Reprinted by permission.
Imaging of the neonatal CNS Simbrunner J, Riccabona M (Department of Radiology, LKH Graz, University Hospital, Auenbruggenplatz 9, A-8036 Graz, Austria). Eur Radiol 2006;60:133–151. Imaging of the central nervous system is one of the major tasks of pediatric radiology, particularly in newborns, who present with a variety of conditions that need more or less urgent imaging. Imaging is usually performed primarily by bedside US, in rare cases supplemented by a skull or spine radiograph. For more detailed information and preoperatively, MRI has become the neuroimaging tool. Thus, CT today is only used for acute trauma assessment, for assessment of potential cerebral calcifications or when MRI is not available. In cases with vascular anomalies or unsuccessful punctures, image-guided interventions (embolisation) or image guidance for access (lumbar puncture, puncture of skull collections, etc.) may become necessary. This article tries to give a brief overview on the common disease entities, their typical imaging features in the major modalities applied and the implications of imaging potential for indication and choice of imaging method. In general, acute assessment may become everywhere and major features of important diseases should be recognised so as not to miss conditions that need urgent treatment or referral to a dedicated paediatric unit. Many other conditions will only be seen at centres with
a dedicated neonatal care unit and dedicated paediatric radiologist who then also will be able to provide proper imaging with adapted protocols and methods for these partially severely sick babies. As these specific features and adapted capabilities as well as dedicated training and clinical experience are necessary for providing best results and proper handling in neonates, many neonatal conditions will not be imaged at a peripheral site, but primarily should be referred to a pediatric (radiology) center.
The neonatal chest Lobo L (Estrada de Telheiras, 79-9B, 1600-768 Lisboa, Portugal). Eur J Radiol 2006;60:152–158. Lung diseases represent one of the most life-threatening conditions in the newborn. Important progresses in modern perinatal care have resulted in a significantly improved survival and decreased morbidity, in both term and preterm infants. Most of these improvements are directly related to the better management of neonatal lung conditions, and infants of very low gestational ages are now surviving. This article reviews the common spectrum of diseases of the neonatal lung, including medical and surgical conditions, with emphasis to the radiological contribution in the evaluation and management of these infants. Imaging evaluation of the neonatal chest, including the assessment of catheters, lines and tubes, is presented.
Imaging the neonatal heart — essentials for the radiologist Schweigmann G, Gassner I, Maurer K (Department of Pediatrics, Section of Pediatric Radiology, Universe Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck, Austria). Eur J Radiol 2006;60:159–270. Modern radiological imaging provides precise diagnosis in congenital heart disease (CHD). The most important and readily available radiological examination is still chest radiography. The diagnostically most important imaging method is echocardiography. Magnetic resonance imaging and computed tomography have gained much ground over the more invasive cardiac catheter angiography, which is still needed in more complex conditions and for interventional procedures, which are performed more frequently. This article is focused on imaging of the neonatal heart. Basically, characteristics of the chest radiograph in CHD are illustrated. To establish an understanding of CHD, haemodynamics are reviewed. It is not the role of the radiologist to make a detailed anatomic or physiologic diagnosis on the basis of a plain film, but the radiologist should be aware of changes in a neonatal chest X-ray that CHD can cause and should point out that the child might have CHD, thus initiating further work-up.
Imaging of the neonatal genitourinary tract Riccabona M (Department of Radiology, Division of Pediatric Radiology, LKH Graz, University Hospital, Auenbruggenplatz, A-8036 Graz, Austria). Eur J Radiol 2006;60:187–198. Objective: To describe imaging of typical conditions and diseases in the neonatal genitourinary (GU) tract. Method: The use, applications, and typical findings of standard imaging techniques [e.g., ultrasound, US, voiding cystourethrography (VCUG)] are described, with emphasis on technical aspects, indications and restrictions in neonatal queries. Only basic applications as used in routine clinical work are included, other more sophisticated and
Abstracts / Clinical Imaging 31 (2007) 220 – 223 advanced imaging techniques such as scintigraphy, MR urography, genitography or image-guided interventional procedures will only be briefly mentioned. Summary and conclusion: Conventional imaging methods are valuable and — particularly in the neonatal GU tract — sometimes irreplaceable. Skillfully used basic imaging techniques, particularly of US (including modern methods such as Doppler sonography, harmonic imaging or contrast enhanced US), supplemented by fluoroscopy for VCUG, can answer most accurately treatment-relevant queries. Rarely early scintigraphic studies, genitography or MRI may become indicated, usually not for establishing the diagnosis, but to collect additional (functional or anatomical) information necessary for deciding on further treatment, or even image-guided interventional procedures may become necessary.
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Acute osteomyelitis, septic arthritis and discitis: differences between neonates and older children. Review Offiah AC (Department of Radiology, Great Ormond Street Hospital for Children, London WCIN 3JH, UK). Eur J Radiol 2006;60:221–232. There are aetiological, clinical, radiological and therapeutic differences between musculoskeletal infection in the neonate (and infant) and in older children and adults. Due to the anatomy and blood supply in neonates, osteomyelitis often coexists with septic arthritis. Discitis is more common in infants, whereas vertebral body infection is more common in adults. This review article discusses the important clinical and radiological differences that in the past have led many authors to consider neonatal osteomyelitis as a separate entity from osteomyelitis in the older child.
Abstracts / Clinical Imaging 31 (2007) 220 – 223
affecting the pathway as demonstrated by magnetic resonance imaging (MRI) and computed tomography (CT). We stress the need to review the lumbosacral plexus in patients with nonspecific symptoms such as back, hip, pelvic pain, and in those who present with sciatica unaccompanied by demonstrable intervertebral disc prolapse. We illustrate that the imaging appearances may be nonspecific and reinforce the importance of the clinical history and the use of tissue sampling to achieve an accurate diagnosis. n 2007 The Royal College of Radiologists. Reprinted by permission.
Magnetic resonance imaging of bone marrow edema associated with focal bone lesions James SLJ, Hughes RJ, Ali KE, Saifuddin A (Department of Radiology, The Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK). Clin Radiol 2006;61:1003–1009. Aim: To quantify the volume of bone marrow edema surrounding focal bone lesions and to identify its relevance relative to diagnosis. Methods: Three hundred and eighty-eight of 1456 patients included in the orthopedic oncology database who underwent magnetic resonance imaging (MRI) demonstrated bone marrow edema and were included in the study. There were 225 males and 163 females, age range 1–87 years (mean, 29 years), MRI images were retrospectively reviewed and assessed for the extent of bone marrow edema. The amount of edema was graded as follows: Grade 1: edema present but smaller than the lesion size; Grade 2: edema equivalent to the lesion size; Grade 3: edema greater than the lesion size. Results: There were 190 Grade 1 lesions: 56% malignant, 33% benign, 11% nonneoplastic; 74 Grade 2 lesions: 19% malignant, 50% benign, 31% nonneoplastic; and 124 Grade 3 lesions: 10% malignant, 46% benign, 44% nonneoplastic. There was a significant relationship between edema grade (i.e., volume of edema) and final diagnosis (Pb.0005). Conclusion: Bone marrow edema may be associated with a wide range of focal bony lesions, including malignant, benign and nonneoplastic causes. As the volume of bone marrow edema increases relative to the size of the underlying lesion, the probability that the underlying lesion is benign is increased. n 2007 The Royal College of Radiologists. Reprinted by permission.
Imaging of the neonatal CNS Simbrunner J, Riccabona M (Department of Radiology, LKH Graz, University Hospital, Auenbruggenplatz 9, A-8036 Graz, Austria). Eur Radiol 2006;60:133–151. Imaging of the central nervous system is one of the major tasks of pediatric radiology, particularly in newborns, who present with a variety of conditions that need more or less urgent imaging. Imaging is usually performed primarily by bedside US, in rare cases supplemented by a skull or spine radiograph. For more detailed information and preoperatively, MRI has become the neuroimaging tool. Thus, CT today is only used for acute trauma assessment, for assessment of potential cerebral calcifications or when MRI is not available. In cases with vascular anomalies or unsuccessful punctures, image-guided interventions (embolisation) or image guidance for access (lumbar puncture, puncture of skull collections, etc.) may become necessary. This article tries to give a brief overview on the common disease entities, their typical imaging features in the major modalities applied and the implications of imaging potential for indication and choice of imaging method. In general, acute assessment may become everywhere and major features of important diseases should be recognised so as not to miss conditions that need urgent treatment or referral to a dedicated paediatric unit. Many other conditions will only be seen at centres with
a dedicated neonatal care unit and dedicated paediatric radiologist who then also will be able to provide proper imaging with adapted protocols and methods for these partially severely sick babies. As these specific features and adapted capabilities as well as dedicated training and clinical experience are necessary for providing best results and proper handling in neonates, many neonatal conditions will not be imaged at a peripheral site, but primarily should be referred to a pediatric (radiology) center.
The neonatal chest Lobo L (Estrada de Telheiras, 79-9B, 1600-768 Lisboa, Portugal). Eur J Radiol 2006;60:152–158. Lung diseases represent one of the most life-threatening conditions in the newborn. Important progresses in modern perinatal care have resulted in a significantly improved survival and decreased morbidity, in both term and preterm infants. Most of these improvements are directly related to the better management of neonatal lung conditions, and infants of very low gestational ages are now surviving. This article reviews the common spectrum of diseases of the neonatal lung, including medical and surgical conditions, with emphasis to the radiological contribution in the evaluation and management of these infants. Imaging evaluation of the neonatal chest, including the assessment of catheters, lines and tubes, is presented.
Imaging the neonatal heart — essentials for the radiologist Schweigmann G, Gassner I, Maurer K (Department of Pediatrics, Section of Pediatric Radiology, Universe Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck, Austria). Eur J Radiol 2006;60:159–270. Modern radiological imaging provides precise diagnosis in congenital heart disease (CHD). The most important and readily available radiological examination is still chest radiography. The diagnostically most important imaging method is echocardiography. Magnetic resonance imaging and computed tomography have gained much ground over the more invasive cardiac catheter angiography, which is still needed in more complex conditions and for interventional procedures, which are performed more frequently. This article is focused on imaging of the neonatal heart. Basically, characteristics of the chest radiograph in CHD are illustrated. To establish an understanding of CHD, haemodynamics are reviewed. It is not the role of the radiologist to make a detailed anatomic or physiologic diagnosis on the basis of a plain film, but the radiologist should be aware of changes in a neonatal chest X-ray that CHD can cause and should point out that the child might have CHD, thus initiating further work-up.
Imaging of the neonatal genitourinary tract Riccabona M (Department of Radiology, Division of Pediatric Radiology, LKH Graz, University Hospital, Auenbruggenplatz, A-8036 Graz, Austria). Eur J Radiol 2006;60:187–198. Objective: To describe imaging of typical conditions and diseases in the neonatal genitourinary (GU) tract. Method: The use, applications, and typical findings of standard imaging techniques [e.g., ultrasound, US, voiding cystourethrography (VCUG)] are described, with emphasis on technical aspects, indications and restrictions in neonatal queries. Only basic applications as used in routine clinical work are included, other more sophisticated and
Abstracts / Clinical Imaging 31 (2007) 220 – 223 advanced imaging techniques such as scintigraphy, MR urography, genitography or image-guided interventional procedures will only be briefly mentioned. Summary and conclusion: Conventional imaging methods are valuable and — particularly in the neonatal GU tract — sometimes irreplaceable. Skillfully used basic imaging techniques, particularly of US (including modern methods such as Doppler sonography, harmonic imaging or contrast enhanced US), supplemented by fluoroscopy for VCUG, can answer most accurately treatment-relevant queries. Rarely early scintigraphic studies, genitography or MRI may become indicated, usually not for establishing the diagnosis, but to collect additional (functional or anatomical) information necessary for deciding on further treatment, or even image-guided interventional procedures may become necessary.
223
Acute osteomyelitis, septic arthritis and discitis: differences between neonates and older children. Review Offiah AC (Department of Radiology, Great Ormond Street Hospital for Children, London WCIN 3JH, UK). Eur J Radiol 2006;60:221–232. There are aetiological, clinical, radiological and therapeutic differences between musculoskeletal infection in the neonate (and infant) and in older children and adults. Due to the anatomy and blood supply in neonates, osteomyelitis often coexists with septic arthritis. Discitis is more common in infants, whereas vertebral body infection is more common in adults. This review article discusses the important clinical and radiological differences that in the past have led many authors to consider neonatal osteomyelitis as a separate entity from osteomyelitis in the older child.