Ultrasonographic Diagnosis of a Uterine Fusion Anomaly Associated with Neonates with Unilateral, Ectopic, Multicystic, Dysplastic Kidney

PURPOSE: The purpose of this paper is to reinforce the necessity of careful ultrasonographic evaluation of the uterus to detect uterine fusion anomaly in female neonates who were detected as having a unilateral, ectopic, multicystic, dysplastic kidney (MCDK) on fetal US. MATERIALS AND METHODS: We detected eight unilateral ectopic MCDK on fetal US of second trimester and neonatal ultrasonography between October 2003 and February 2009; neonatal US were taken at 2 to 10 days after birth for the initial evaluation of MCDK. Uterine fusion anomaly, vaginal obstruction and other associated urogenital anomalies were evaluated by neonatal US. RESULTS: Four of eight female neonates with unilateral ectopic MCDK showed a double uterus on neonatal US. They all showed hemivaginal fluid collection. Obstruction of the hemivagina and vaginal septum were depicted in two cases. A perivaginal cyst was seen in three cases, and in two cases the cyst was connected with the vaginal cavity. An ipsilateral perivaginal tubular structure was seen in one case, which was indicative of a ureteral remnant. There was no associated anomaly in the contralateral kidney except for a tiny cortical cyst in one case. CONCLUSION: The careful ultrasonographic evaluation of the uterus is important in female neonates who showed the ectopic MCDK on fetal US. In addition, it may help to detect the fusion anomaly that is otherwise difficult to detect on fetal US and to devise a treatment plan to prevent upcoming complications.

Transverse Testicular Ectopia Diagnosed by US and MR Imaging: A Case Report

Transverse testicular ectopia (TTE) is a rare congenital anomaly in which both testes migrate toward the same hemiscrotum. In most cases, the correct diagnosis is not made preoperatively, but it's made during an inguinal herniotomy or during surgical exploration for an undescended testis because TTE is clinically misdiagnosed as an symptomatic inguinal hernia or as a tumor of the testis on the side to which the ectopic testis has migrated or as an undescended testis on the contralateral side. US and MR imaging can detect the transverse testicular ectopia by its characteristic appearance and so provide useful information about any associated anomalies. We report here on a case of transverse testicular ectopia that was diagnosed by US and MR imaging in a 10-month-old boy, and we review the relevant literature.

Transverse Testicular Ectopia Diagnosed by US and MR Imaging: A Case Report

Transverse testicular ectopia (TTE) is a rare congenital anomaly in which both testes migrate toward the same hemiscrotum. In most cases, the correct diagnosis is not made preoperatively, but it's made during an inguinal herniotomy or during surgical exploration for an undescended testis because TTE is clinically misdiagnosed as an symptomatic inguinal hernia or as a tumor of the testis on the side to which the ectopic testis has migrated or as an undescended testis on the contralateral side. US and MR imaging can detect the transverse testicular ectopia by its characteristic appearance and so provide useful information about any associated anomalies. We report here on a case of transverse testicular ectopia that was diagnosed by US and MR imaging in a 10-month-old boy, and we review the relevant literature.

Efficacy of Cyclic Voiding Cystourethrography in Detection of Vesicoureteral Reflux in Young Children

PURPOSE: To evaluate the efficacy of cyclic voiding cystourethrography (VCUG) for the detection of vesicoureteral reflux (VUR) in young children. MATERIALS AND METHODS: Two cycles of cyclic VCUG were performed in 119 kidney-ureter units (KUUs) of 60 children (mean age; 9 months, range; 5 days-2 years). Spot radiographs and fluoroscopic-image captures were obtained. We analyzed the presence of VUR and the grade of VUR according to the standards of the international grading system. We recorded the amount of total contrast material on each cycle and the total fluoroscopic time. RESULTS: VUR was present in 21 (17.6%) KUUs of 13 (21.7%) children. On the first and second cycle, the reflux occurred in 9 (15.0%) children and 13 (12.6%) KUUs. In one hundred-four KUUs of 51 children whose VCUG results were negative on the first cycle, the reflux occurred in 4 (7.8%) children and 6 (5.8%) KUUs during the second cycle. The grading of the reflux was upgraded during a second cycle in one case. A new detection and upgrade of VUR by the second cycle was observed in 5 (9.8%) children and 7 (6.7%) KUUs. In 4 KUUs (53%) of these 7 KUUs, the VUR was higher than grade II. The mean amounts of contrast solution were 28 cc (range; 5-100 cc) on the first cycle and 39 cc (range; 10-100 cc) on the second cycle. The mean of the total fluoroscopic time was 147 seconds (range; 59-338 seconds). CONCLUSION: Cyclic VCUG can enhance the ability of the method to detect and grade VUR in children under 2 years of age.

Horseshoe Adrenal Gland in a Newborn with Right Isomerism

Horseshoe adrenal gland is a rare congenital abnormality associated with multiple congenital anomalies that may involve the cardiovascular, central nervous, and genitourinary systems. In this report, we describe the sonographic findings of horseshoe adrenal gland in a newborn with right isomerism a frequently associated cardiovascular anomaly.

Imaging Findings of Neonatal Adrenal Disorders

In newborn infants, normal adrenal glands are characterized by a relatively thin echogenic center surroundedby a thick, hypoechoic cortical rim as seen on ultrasound (US). Various disorders involving the neonatal adrenalgland include adrenal hemorrhage, hyperplasia, cyst, Wolman's disease, and congenital neuroblastoma. Adrenalhemorrhage is the most common cause of an adrenal mass in the neonate, though differentiation between adrenalhemorrhage and neuroblastoma is in many cases difficult. We describe characteristic US, CT and MR imaging findingsin neonates with various adrenal disorders.

Imaging Findings of Neonatal Adrenal Disorders

In newborn infants, normal adrenal glands are characterized by a relatively thin echogenic center surroundedby a thick, hypoechoic cortical rim as seen on ultrasound (US). Various disorders involving the neonatal adrenalgland include adrenal hemorrhage, hyperplasia, cyst, Wolman's disease, and congenital neuroblastoma. Adrenalhemorrhage is the most common cause of an adrenal mass in the neonate, though differentiation between adrenalhemorrhage and neuroblastoma is in many cases difficult. We describe characteristic US, CT and MR imaging findingsin neonates with various adrenal disorders.