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Kinderradiologie (Fach) / Alles (Lektion)

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• In the newborn, prolonged jaundice (over 2 weeks) is most commonly due Neonatal hepatitis. Biliary atresia.
• Infants with increased lung volumes and fine lace-like strands or cysts. Pulmonary interstitial emphysema. Bronchopulmonary dysplasia.
• Neonate with increased lung volumes and localized lung opacity. Pneumonia
• Neonate with increased lung volumes with multiple coarse areas (strand-like densities following bronchovascular patterns). Meconium aspiration. Retained fetal fluid (TTN).
• Infant GER is best imaged with Nuclear scintigraphy. Tc-99m sulfur colloid formula (best sensitivity)
• Intussusception Generally occur after 6 months of age. Most are ileocolic and the cause is idiopathic. Treatment is water-soluble or air enema reduction. Contraindicationsto enema reduction: Free air, Signs of peritonitis. Recurrent intussusception occurs in 5% to 10% of cases.
• Unilateral hyperexpansion of one or two lobes in children, common causes Aspirated foreign body. Hilar nodes compressing bronchus.
• Hyperinflated lung findings Flattening or inversion of diaphragm. Widening of rib interspaces. Larger retrosternal and retrocardiac clear spaces.
• Lung disease correlate with gestational age: Near term (34-37 weeks) and term (38-42 weeks) Retained fetal fluid. Aspiration syndromes, including meconium aspiration. Persistent pulmonary hypertension.
• Lung disease correlate with gestational age: Premature (24-34 weeks) Immature lung. Hyaline membrane disease. Persistent pulmonary hypertension.
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• Malignant Wilms tumor spread Local: Renal vein. Inferior vena cava. Perirenal lymph nodes. Contiguous invasion of liver. Remote: Lungs. Liver. Bone.
• Malrotation Duodenal-jejunal junction is not properly fixed by ligament of Treitz. Results in duodenal obstruction by peritoneal bands or twisting of duodenum (midgut volvulus).
• Meconium Aspiration Intrauterine fetal distress can lead to passage of meconium. Aspirated meconium particles cause obstruction of small peripheral bronchioles. Results in areas of subsegmental atelectasis and areas of overdistension. Coarse reticulonodular or nodular appearance of lungs.
• Meconium aspiration radiographic findings. Increased lung volumes. Patchy perihilar opacities.
• Meconium ileus features Earliest manifestation of cystic fibrosis. Thick meconium plugs cant pass through ileocecal valve. Multiple dilated loops of small intestine. Bubbly intestinal contents represent retained meconium. Often treated with water-soluble contrast enema.
• Meconium peritonitis Intrauterine intestinal perforation from bowel obstruction or ischemia. Extruded meconium mayh calcify. Scattered amorphous or curvilinear calcifications throughout peritoneum. Snowstorm ultrasound appearance.
• Meconium plug syndrome also known as small left colon syndrome Transient functional immaturity and abnormal peristalsis of distal colon. Normal to dilated proximal colon filled with meconium. Empty distal descending colon. More common in normal large infants and infants of diabetic mothers. Often treated with rectal stimulation or saline enemas.
• Megacystis-microcolon-hypoperistalsis (MMH) syndrome Disorder of smooth muscle in urinary and GI tract. Almost exclusively in girls. Insufficient abdominal muscles. Very large dysfunctional bladder. Bladder exstrophy may occur: Widened pubic symphysis. Splaying of pelvic bones. Decreased peristalsis leads to poor evacuation of colon.
• Mesenteric adenitis Self-limiting, usually viral inflammatory condition of mesenteric lymph nodes Normal appendix. Cluster of large right lower quadrant lymph nodes.
• Microgastria occurs with GI atresias. VACTERL syndrome. Polysplenia/asplenia syndromes.
• Middle mediastinum mass (an abnormality for each organ) Esophagus: Duplication cyst. Great vessels: Aneurysm. Hila: Large lymph nodes (Leukemia, Lymphoma, Tuberculosis). Trachea: Bronchogenic cysts. Pericardium: Cyst
• Midgut volvulus vascular compromise Superior mesenteric vessels: vein before artery.
• Most Common Causes of GI Tract Obstruction by Age. 0-1 month: Congenital anomalies: Atresia/stenosis, Malrotation/volvulus, Hirschsprung disease. Meconium plug/small left colon syndrome. Meconium ileus.
• Most Common Causes of GI Tract Obstruction by Age. 1-5 months: Hernias
• Most Common Causes of GI Tract Obstruction by Age. 3 years and older Perforated appendicitis. Adhesions. Regional enteritis.
• Most Common Causes of GI Tract Obstruction by Age. 5 months - 3 years Intussusception.
• Most common childhood tumors to metastasize to liver (descending order) Neuroblastoma. lymphoma. leukemia. and Wilms tumor.
• Most GI duplication cysts are asymptomatic except for those that Contain ectopic gastric or pancreatic tissue. May ulcerate or hemorrhage.
• Most of the time the right lung hilum is lower than the left. but it is never Higher
• Syndrome with multiple nonossifying fibromas along with cafe-au-lait spots Jaffe-Campanacci syndrome
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• Necrotizing enterocolitis (NEC) Occurs in premature and newborn infants. Thought to be infection and or ischemia of the gut. Findings: Dilated bowel loops. Pneumatosis intestinalis (air in wall of the bowel). Portal venous gas. Free air. Later may develop strictures, commonly in the colon. Treatment: Withholding feedings. Administering antibiotics. Blood transfusions.
• Neonatal hepatitis HIDA scan results? Poor liver uptake.
• Neonate to 2 months with bilious vomiting Midgut volvulus. Small bowel obstruction. Bowel atresia in newborn. Hirschsprung disease
• Neonate to 2 months with nonbilious vomiting Overfeeding Chalasia (gastroesophageal reflux). Pyloric stenosis.
• Neonates at risk for TTN or retained fetal fluid Neonates with tracheobronchial obstruction. Cesarean section delivered neonates.
• Nephroblastomatosis. Primitive metanephric blastema thought to be precursor of Wilms tumor. Commonly seen in neonate kidneys. Normally regress by 4 months of age. Bilateral lobulated and enlarged kidneys. Marked compression and stretching of pelvicaliceal structures. Large echogenic and lobular kidneys. May demonstrate diffuse hypoechoic cortical thickening. Nephrogenic rests are generally cortical, hypoechoic, low attenuationand T1 hypointense.
• Neuroblastoma features Arise along axis of sympathetic nerves (paraspinal). 66% are abdominal. Intraspinal involvement is common. Majority occur between 6 months and 5 years. Present with weight loss. irritability. fever. and/or anemia. Frequently show stippled calcification. Poor prognosis with abdominal involvment in patients over 1 year of age. MIBG avid.
• Nonbilious vomiting in infants aged 2 months to 2 years the possibilities include: Often just GER. Infections: Meningitis. Urinary tract infection.
• Nonvisualized kidney causes Congenital absence. Surgically removed. Ectopic kidney. Multicystic dysplastic kidney. Renal artery thrombosis. Renal vein thrombosis. Tumor.
• Normal or decreased lung volumes and fine granular opacities (ground glass) with air bronchograms. Hyaline membrane disease (RDS and HMD). Group B b-hemolytic streptococcal pneumonia
• Of the talar and calcaneal joint coalitions which is rarest Calcaneocuboid
• Older children develop adrenal hemorrhage as a result of Accidental and nonaccidental trauma. Meningococcemia. Anticoagulant therapy.
• Olliers disease Multiple enchondromas generally presenting in childhood. Generaly asymptomatic. Risk of malignant transformation.
• Ostium secundum versus ostium primum atrial septal defects? Ostium secundum: Most common type of ASD. Occurs centrally at foramen ovale. Ostium primum: Endocardial cushion defect. Commonly occurs in trisomy 21.
• Overcirculation. increased arterial flow. and increased vascularity suggest Left-to-right shunt.
• Passive congestion Increased pulmonary venous pressure. Commonly caused by left heart failure. Progressed from dilated veins to indistinct pulmonary vessels to interstitial edema to alveolar edema and pleural effusions.
• PDA heart chamber changes Enlarged LA, LV, PA, and proximal Aorta.
• Pediatric neoplasms that cause caval tumor thrombus. Wilms tumor. Hepatoblastoma.
• Persistence of fetal circulation after birth is called Persistent pulmonary hypertension.
• Plain film findings of intussusception? Abdominal mass. Signs of bowel obstruction: dilated bowel and air-fluid levels.

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