Skin sonography in children: a review.

Skin lesions are not uncommon in children, and most of them are benign. However, they can be a matter of concern. Although in most cases the diagnosis can be suspected based on clinical history and physical examination, in some cases clinical findings are nonspecific. High-frequency color Doppler US is a noninvasive technique that can play a relevant role in these cases and give important anatomical information for final clinical management. US can be helpful to avoid unnecessary surgery, plan a surgical excision and avoid advanced imaging studies such as MRI and CT, which have a lower resolution for the skin. Different lesions can look similar on US, and clinical correlation is always important. The purpose of this article is to show a variety of skin lesions that occur in children, emphasizing clinical-sonographic correlation, and to familiarize pediatric radiologists with the US technique and sonographic appearance of common skin lesions in children.

Ultrasound findings in 156 children with 169 pilomatricomas.

BACKGROUND: Cutaneous lesions present a diagnostic challenge to radiologists and clinicians alike. Pilomatricoma is the second most common skin neoplasm in childhood, yet there are limited reports in the literature focusing on imaging in pediatric patients. OBJECTIVE: To characterize the typical and atypical US features of pilomatricoma in pediatric patients and to determine the performance of the adult-based Solivetti classification for assessing pilomatricomas in children. MATERIALS AND METHODS: We retrospectively reviewed 169 US scans of pathologically proven pilomatricomas in 156 children performed over a period of 66 months. We evaluated images for the size of the lesion, borders, morphology, content, calcification, location on the skin and Doppler characteristics. RESULTS: Most of the pilomatricomas presented as single dermohypodermic lesions with peripheral vascularity on color Doppler interrogation. The cheek was the most common location, followed by the arm. Solivetti type 2 US pattern was the most frequent, and peripheral hypoechoic halo was only observed in this type. One child had an anetodermic pilomatricoma, and 11 children had multiple lesions. CONCLUSION: We showed that pilomatricomas exhibit variable sonographic patterns. In our cohort, less than 50% of the lesions showed the characteristic hypoechoic rim and less than 30% of the cases presented as diffusely hyperechoic masses with posterior acoustic shadowing. Our results show that the Solvetti classification for the US assessment of pilomatricomas can be of value in children.

Complete bilateral vitreous detachment after LASIK retreatment.

We describe a case of a 47-year-old woman who underwent bilateral laser in situ keratomileusis (LASIK) for the correction of myopia and astigmatism. Two months later a residual refractive error was present in both eyes. LASIK retreatment was decided and performed the following day. Twenty-four hours after the procedure, the patient reported myodesopsia in both eyes. Funduscopic examination revealed a complete bilateral posterior vitreous detachment confirmed by kinetic ultrasound. Visual disturbance in both eyes continued to be present after 10 months of follow-up. Sudden changes in intraocular pressure related to suction ring use might be the cause of posterior vitreous detachment in this patient.

Evaluación por resonancia magnética de resultados a mediano plazo de angioplastias en coartaciones y recoartaciones aórticas / Angioplasty in aortic Coartation and recoartation MR Imaging

Se estudiaron por resonancia magnética 10 niños para valorar los resultados a mediano plazo del tratamiento de coartación y recoartación de aorta torácica con angioplastia percutánea transluminal, entre 1 y 5 años postprocedimiento. Los Pacientes explorados en secuencias axiales y sagitales oblicuos (eje aórtico) ponderadas en T1 (TR 600, TE 30) en equipo de 0,5 Tesla. Los resultados inmediatos mostraron una reducción del gradiente de 42 ñ 13 a 8 ñ 6 mmHg (p<0,0001). El diámetro de la coartación aumentó de 6 ñ 3 a 12 ñ 4 mm(p,0,001) y de la coartación/aorta descendente (C/D) de 0,4 ñ 0,2 a 0,9 ñ 0,2 (p<0.001). El seguimiento objetivó un diámetro estable en la coartación de 12 ñ 5 mm (NS) y un índice C/10,9 ñ 0,3 (NS) y C/CD 0,8 ñ 0,2 (NS). La RM aparece como un excelente método no invasivo para evaluar los resultados de la angioplastía percutánea transluminal en coartaciones y recoartaciones de aorta torácica

Evaluación por resonancia magnética de resultados a mediano plazo de angioplastias en coartaciones y recoartaciones aórticas / Angioplasty in aortic Coartation and recoartation MR Imaging

Se estudiaron por resonancia magnética 10 niños para valorar los resultados a mediano plazo del tratamiento de coartación y recoartación de aorta torácica con angioplastia percutánea transluminal, entre 1 y 5 años postprocedimiento. Los Pacientes explorados en secuencias axiales y sagitales oblicuos (eje aórtico) ponderadas en T1 (TR 600, TE 30) en equipo de 0,5 Tesla. Los resultados inmediatos mostraron una reducción del gradiente de 42 ñ 13 a 8 ñ 6 mmHg (p<0,0001). El diámetro de la coartación aumentó de 6 ñ 3 a 12 ñ 4 mm(p,0,001) y de la coartación/aorta descendente (C/D) de 0,4 ñ 0,2 a 0,9 ñ 0,2 (p<0.001). El seguimiento objetivó un diámetro estable en la coartación de 12 ñ 5 mm (NS) y un índice C/10,9 ñ 0,3 (NS) y C/CD 0,8 ñ 0,2 (NS). La RM aparece como un excelente método no invasivo para evaluar los resultados de la angioplastía percutánea transluminal en coartaciones y recoartaciones de aorta torácica (AU)