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Kinderradiologie (Subject) / Alles (Lesson)

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• Common complications of esophageal atresia repair Anastomotic strictures (40%). Anastomotic leakage (14% to 21%). Recurrent fistula (3% to 14%). Esophageal dysmotility. GER.
• Complete transposition of the great vessels (D-transposition) Most common form of cyanotic congenital heart disease with increased pulmonary blood flow. Positions of aorta and PA are reversed. Aorta arises anteriorly from RV. PA arises posteriorly from LV. VSD, ASD, or PDA allow for survival.
• Congenital Hutch diverticulum Adjacent to ureterovesical junction. Increased incidence of VUR.
• Congenital pulmonary hypoplasia Hypoplasia or absence of ipsilateral pulmonary artery. Sometimes associated with tetralogy of Fallot or persistent truncus arteriosus.
• Cor triatriatum Rare cause of obstruction of venous emptying into LA. Pulmonary veins empty into a common vein incorporated into the LA. Partial membrane creates an extra chamber along the posterosuperior LA.
• Corrected transposition of the great vessels (L-transposition) Ventricular inversion with functional correction of transposition. Blood circulates through RA to LV to PA to lungs to LA to RV to aorta to body. Anatomic RV functions as LV and vice versa. Aorta lies anteriorly and to the left hence L-transposition.
• CSF Pseudocyst VP shunt tip fluid collection causing shunt malfunction.
• CT findings of acute appendicitis Distended appendix greater than 6mm. Fatty infiltration (stranding). Appendicolith (20-40%). Complications of perforation: fluid collections and free air.
• Cystic adenomatoid malformation Congenitallung lesion containing dysplastic adenomatous tissue with communicating cysts of variable sizes. Vary from solid lesion to multiple tiny cysts to large, thin-walled cysts. May mimic congenital lobar emphysema. Cysts can enlarge leading to respiratory distress. Usually are unilateral and can affect any portion of the lung.
• Dermoid versus teratoma Dermoids contain only ectodermal elements. Teratomas contain elements from all dermal layers.
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• Describe course of umbilical artery catheter? Enters umbilical artery, Proceeds caudad in iliac vessels, Ascends left of midling in abdominal aorta.
• Describe course of umbilical vein catheter? Pass into left portal vein through ductus venosus and into inferior vena cava.
• Dextrocardia Cardiac apex lies to the right of the spine. Levocardia is the normal position of the cardiac apex.
• Dextroversion Right-sided rotation of heart. RA and RV become more posterior. LA and LV lie anterior. Chamber inversion does not occur.
• DiGeorge syndrome Thymic aplasia. Absence of parathyroid glands. Cardiovascular anomalies. Faulty development of third and fourth pharyngeal pouches.
• Distinguishers of neuroblastoma from Wilms tumor? More common in neuroblastoma: Calcification. Spinal involvement. Nodal encasement.
• Distinguishes GI duplication cyst from Mesenteric and omental cysts at ultrasound Cyst wall has a single layer rather than a double layer (gut signature) seen with GI duplication cysts.
• Distinguishing ileal atresia from meconium ileus Air-fluid levels in the dilated small bowel are more commonly seen with ileal atresia. Ileal atresia is corrected surgically whereas meconium ileus is often treated with water-soluble contrast enema.
• Drash syndrome Male pseudohermaphroditism. Glomerular disease. Wilms tumor.
• Ebstein anomaly Malformed, enlarged tricuspid valve that is displaced downward. Atrialization of RV. Severe TR. Atrial right-to-left shunting results in cyanosis in the more severely affected patients.
• Echogenicity of neonatal renal cortex Approximates or exceeds liver echogenicity
• Favorable neuroblastoma features Intrathoracic. Less than 12 months old.
• Foregut. midgut. and hindgut boundaries? Midgut extends from ampulla of Vater (2nd portion duodenum) to midtransverse colon. Foregut, bowel proximal to ampulla of Vater. Hindgut, bowel distal to midtransverse colon.
• Functional megacolon Common condition in childhood. Spasm of puborectalis muscle. Prominence of puborectalis sling. Patients can hold large volumes of stool in colon.
• GI cystic masses Duplication cyst. Mesenteric cyst. Meconium pseudocyst. Lymphangioma. Appendiceal abscess.
• Helps distinguish obstructive emphysema from compensatory hyperinflation? Obstructive emphysema generally results in diminished size of pulmonary vessels due to compression and hypoxia-induced reflex arterial spasm. In compensatory hyperinflation pulmonary vessels are normal or even increased in size.
• Hemangioendothelioma possible complications High-output cardiac failure. Hemorrhage. Jaundice. Hemolytic anemia. Thrombocytopenia (Kasabach-Merritt syndrome) sequestration of platelets. DIC.
• Hepatic adenomas are rare in childhood but have been reported in association with Fanconi anemia. Glycogen-storage disease type 1. Hurler disease. Severe combined immunodeficiency.
• Hepatic hemangioendothelioma features? Benign. Most diagnosed within first 6 months of life. Hepatomegaly and high-output congestive heart failure are common. May present with platelet sequestration (Kasabach-Merritt syndrome) or DIC.
• Hepatobiliary cystic masses Gallbladder hydrops. Choledochal cyst. Mesenchymal hamartoma. Abscess/parasitic cyst.
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• Hepatoblastoma features Occurs in children under the age of 5 years. May extend into portal veins, hepatic veins, and inferior vena cava. Prematurity is a risk factor. Usually well-circumscribed, solitary mass. May be multifocal.
• Hepatoblastoma routes of spread Local: Portal vein. Hepatic vein. IVC. Lymph nodes. Diaphragm. Peritoneum. Remote: Lungs.
• Hepatoblastoma occurs at what age and with what syndromes? Early childhood, presenting before 3 years of age. Beckwith-Wiedemann syndrome. Familial adenomatous polyposis.
• Epidermolysis bullosa effect on esophagus Hereditary condition. Inflammatory skin and mucosal lesions that can heal with fibrosis. May result esophageal stricture.
• Hirschsprung disease features Contracted aganglionic distal colon. Abnormal peristalsis and inability to effectively evacuate colon. Rectum is always involved. Extent of proximal involvement varies. Colon caliber transition more common in older infants. Tortuosity or corrugation of narrowed aganglionic segment of the colon is commonly seen. Diagnosis made with rectal biopsy. Necrotizing enterocolitis is an uncommon but serious complication.
• How long does it take for gas to reach the rectum in a normal newborn? May take up to 24 hrs. Occurs by 12 h in most healthy infants.
• Hydrometrocolpos versus hematometrocolpos Both are congenital vaginal obstructions. Hydrometrocolpos anechoic fluid in the newborn. Hematometrocolpos echogenic blood in the adolescent.
• Hypertrophic pyloric stenosis features: Common between 2 and 10 weeks of age. Hypertrophy of pyloric muscle. 4 mm or more in thickness. Pyloric channel elongated beyond 15 mm.
• Hypoplastic right heart Tricuspid atresia. Usually with pulmonary atresia or stenosis. Underdeveloped RV. Common features are small RV with right-to-left shunting through an ASD causing cyanosis.
• Imaging sequence of at risk infants (neonate to 3 years) for suspected pyelonephritis? Nuclear scan with 99mTc -DMSA or 99mTc-GH. If positive, ultrasound and or voiding cystourethrogram.
• Imperforate or ectopic anus Range from simple membranous anal atresia to arrest of colon as it descends through puborectalis sling. Fistula formation may occur to genital or urinary tract.
• Contrast enema with cecum not in the right lower quadrant, suspect Malrotation or malfixation of midgut.
• In a neonate a right-sided aortic arch may be inferred if Carina is midline or to the left.
• In a neonate buckling of the trachea is Normal. Occurs during expiration.
• In a neonate decreased pulmonary vascularity, though difficult to detect may be seen in severe pulmonic stenosis or atresia.
• In a neonate the ideal position of the endotracheal tube is at the level of Inferior margins of the clavicles.
• Neonate with low lung volumes and fine lung opacities with air bronchograms Hyaline membrane disease. Group B b-hemolytic streptococcal pneumonia.
• In children, infarction of the spleen may occur in Sickle cell anemia. Leukemia. Gaucher disease. Cardiac valvular disease.
• In neonates, pulmonary vessels can be seen peripherally only as far as Medial third of lungs.
• Common causes of GI bleeding in neonates Necrotizing enterocolitis. Milk allergy. Enterocolitis that sometimes accompanies Hirschsprung disease.

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