ABSTRACT
Objective To investigate the diagnostic values of different imaging techniques in congenital esophageal atresia and tra-cheoesophageal fistula.Methods Imaging findinfs of 34 infants with congenital esophageal atresia and tracheoesophageal fistula were retrospectively analyzed.34 infants undertook X-ray and esophageal imaging,and 1 7 infants also undertook CT examination.Results Based on Gross classification,there were 2,32,9 and 23 cases for type I,Ⅲ,Ⅲa and Ⅲb,respectively.Coexistence of other de-formity was observed in 10 cases.Plain chest and abdomen X-ray film showed gastric pneumatosis in 32 cases,varied degrees of pneumonia in 25 cases and right upper pulmonary atelectasis in 3 cases.Esophagography showed a cecum in upper esophageal in 34 cases,distal tracheoesophageal fistula in one case.CT examination indicated distal tracheoesophageal fistula and orificium fistulae in 14 cases.Conclusion Combination of X-ray and CT imaging results with clinical symptoms can aid early detection and typing of con-genital esophageal atresia,furthermore provides guidance for operation and finally improves the survival rate of infants.
ABSTRACT
Objective To investigate the MRI features of pilomyxoid astrocytoma ( PMA ) in children.Methods MRI features of seven children with pathologically proven PMA in 2011-2013 were retrospectively analyzed.The ages of the patients ranged from 10 months to 32 months at initial diagnosis.Results All tumors were well-circumscribed masses.Six tumors were located in the hypothalamic-chiasmatic-third ventricular region , two tumor involved the bilateral temporal lobe , and one tumor was associated with NF-I.One occurred in the basal ganglia region.Four tumors were solid masses , whereas the other three showed cystic components.Six tumors were hypointense and one was isointense on T 1-weighted image.Five tumors were hyperintense and three were isointense on T 2-weighted image.Four tumors were hypointense , one was iso-hypointense and one was isointense on DWI.After contrast administration , four tumors enhanced homogenously and three tumors enhanced heterogeneously , with intratumoral irregular hypointense region in two tumors and rim enhancement in one tumor.Cerebrospinal fluid ( CSF ) dissemination, hydrocephalus and peritumor edema were observed in 2, 4 and 1 of cases, respectively.Proton magnetic resonance spectrum of two PMA showed elevated Cho /Cr ratios and decreased NAA/Cr ratios.Conclusions The imaging features of pilomyxoid astrocytoma include common origination from the midline of the neuroaxis in younger children about 2-3 years old.The CSF dissemination is common.The presence of hemorrhage and peritumor edema is not common.
ABSTRACT
Objective To investigate the value of susceptibility weighted imaging in grading brain tumors in children.Methods Twenty-eight children with surgically or pathologically proved primary brain tumor were recruited during 2010 to 201 1.All patients were scanned with conventional MRI and SWI sequences on a 1.5T or 3.0T scanner before surgery.The cases of tumors were divid-ed into low grade (9 males and 2 females)and high grade groups (10 males and 7 females),according to the WHO classification of the tumors of the central nervous system in 2007.The low-intense signals within the abnormalities on SWI images were analyzed and classified into the different shapes,including punctuate,tubular,cluster-like,linear signal,irregular patchy signal.As for the num-ber of low-intense signals,we applied the four-score system.The irregular patchy signals were considered to be artifacts of SWI, namely hemorrhage,after exclusion of the isolated veins and calcification.The differences of rate of hemorrhage and scores between the two groups in SWI were analyzed statistically.Results The low-signal scores were significantly different between two groups with higher scores in high grade tumors than in low grade tumors(P <0.001).The rate of intratumor hemorrhage was also signifi-cantly different between two groups.The rate is higher in high-grade group than low-grade group,given the fact that the hemor-rhage was showed in 2 low grade tumors (18.18%),while in 1 1 high grade tumors (76.37%)(P =0.01 5 9<0.001).Conclusion Different grades of pediatric brain tumors manifest significant difference on susceptibility weighted imaging(SWI).It may be helpful in the preoperative classification of brain tumors by analyzing the relevant signals on SWI.