ABSTRACT
OBJECTIVE: The authors reviewed available evidence on neonatal neuroimaging strategies for evaluating both very low birth weight preterm infants and encephalopathic term neonates. IMAGING FOR THE PRETERM NEONATE: Routine screening cranial ultrasonography (US) should be performed on all infants of <30 weeks' gestation once between 7 and 14 days of age and should be optimally repeated between 36 and 40 weeks' postmenstrual age. This strategy detects lesions such as intraventricular hemorrhage, which influences clinical care, and those such as periventricular leukomalacia and low-pressure ventriculomegaly, which provide information about long-term neurodevelopmental outcome. There is insufficient evidence for routine MRI of all very low birth weight preterm infants with abnormal results of cranial US. IMAGING FOR THE TERM INFANT: Noncontrast CT should be performed to detect hemorrhagic lesions in the encephalopathic term infant with a history of birth trauma, low hematocrit, or coagulopathy. If CT findings are inconclusive, MRI should be performed between days 2 and 8 to assess the location and extent of injury. The pattern of injury identified with conventional MRI may provide diagnostic and prognostic information for term infants with evidence of encephalopathy. In particular, basal ganglia and thalamic lesions detected by conventional MRI are associated with poor neurodevelopmental outcome. Diffusion-weighted imaging may allow earlier detection of these cerebral injuries. RECOMMENDATIONS: US plays an established role in the management of preterm neonates of <30 weeks' gestation. US also provides valuable prognostic information when the infant reaches 40 weeks' postmenstrual age. For encephalopathic term infants, early CT should be used to exclude hemorrhage; MRI should be performed later in the first postnatal week to establish the pattern of injury and predict neurologic outcome.
Subject(s)
Brain Injuries/diagnosis , Infant, Newborn , Neonatal Screening/standards , Academies and Institutes/standards , Brain Injuries/diagnostic imaging , Humans , Infant, Premature , Magnetic Resonance Imaging/methods , Neonatal Screening/methods , Neurology/standards , Radiography , UltrasonographySubject(s)
Child Abuse/diagnosis , Radiology , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Public Policy , United StatesABSTRACT
The objective of this report was to study the elimination pharmacokinetics of iodixanol in children. Iodixanol (Visipaque, Nycomed Inc., Wayne, PA, USA) is a new iso-osmolar iodinated radiocontrast agent. We hypothesized that elimination of this agent would be dependent on age-related differences in renal clearance. Seven centers enrolled 43 patients. Cardiac catheterization was performed in 41 patients and cranial computed tomography in 2. Patients were entered into 5 age groups: newborn to <2 months, 2 to <6 months, 6 months to <1 year, 1 to <3 years, and 3 to
Subject(s)
Contrast Media/pharmacokinetics , Triiodobenzoic Acids/pharmacokinetics , Age Factors , Angiocardiography , Child , Child, Preschool , Contrast Media/administration & dosage , Drug Interactions , Female , Humans , Infant , Infant, Newborn , Linear Models , Male , Metabolic Clearance Rate , Tomography, X-Ray Computed , Triiodobenzoic Acids/administration & dosageABSTRACT
Spinal cord compression secondary to metastases is an infrequent complication of childhood cancer. We describe an infant with hepatoblastoma in whom cord compression developed because of extensive epidural metastases during treatment. This is a hitherto undescribed metastatic site for hepatoblastoma.
Subject(s)
Hepatoblastoma/secondary , Liver Neoplasms/diagnosis , Spinal Cord Compression/etiology , Spinal Neoplasms/secondary , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cisplatin/therapeutic use , Embolization, Therapeutic , Fatal Outcome , Fluorouracil/administration & dosage , Hepatoblastoma/diagnosis , Hepatoblastoma/drug therapy , Humans , Infant , Liver Neoplasms/drug therapy , Magnetic Resonance Imaging , Male , Spinal Cord Compression/therapy , Spinal Neoplasms/diagnosis , Spinal Neoplasms/drug therapy , Vincristine/therapeutic useSubject(s)
Diagnostic Imaging , Gastrointestinal Diseases/congenital , Vomiting/etiology , Diagnosis, Differential , Female , Gastroesophageal Reflux/congenital , Gastroesophageal Reflux/diagnosis , Gastrointestinal Diseases/diagnosis , Humans , Infant , Infant, Newborn , Male , Predictive Value of TestsSubject(s)
Brain Diseases/diagnosis , Diagnostic Imaging , Epilepsy/etiology , Seizures/etiology , Brain/pathology , Child , Child, Preschool , Diagnosis, Differential , Epilepsy/diagnosis , Humans , Infant , Infant, Newborn , Predictive Value of Tests , Seizures/diagnosis , Spasms, Infantile/diagnosis , Spasms, Infantile/etiologySubject(s)
Bacterial Infections/diagnostic imaging , Fever of Unknown Origin/etiology , Child, Preschool , Diagnosis, Differential , Fever of Unknown Origin/diagnostic imaging , Humans , Infant , Infant, Newborn , Opportunistic Infections/diagnostic imaging , Predictive Value of Tests , Radiography, ThoracicSubject(s)
Diagnostic Imaging/trends , Radiology/trends , Acquired Immunodeficiency Syndrome/prevention & control , Acquired Immunodeficiency Syndrome/transmission , Ambulatory Care , Child , Child Health Services/organization & administration , Disease Susceptibility , Female , Genome, Human , Hospitals, Pediatric/organization & administration , Humans , Infant , Infant, Newborn , Infant, Premature , Infectious Disease Transmission, Vertical/prevention & control , Interprofessional Relations , Medically Uninsured , Patient Admission , Pediatrics/education , Pediatrics/statistics & numerical data , Pediatrics/trends , Pregnancy , Prenatal Care , Radiology/education , Radiology/statistics & numerical data , Radiology Information Systems , Research/trends , Technology, Radiologic/trendsABSTRACT
We report two neonates with anemia, hemoperitoneum, and bilateral palpable abdominal masses. Both developed bleeding: a hemoperitoneum in one and visceral hemorrhages secondary to disseminated intravascular coagulation in the other. Each child was thought to have an unusual complication of adrenal hemorrhage, as the masses were of mixed echogenicity. However, histological evaluation revealed neuroblastoma. These cases point out the diagnostic dilemma of a mixed echogenicity suprarenal mass in the neonatal period and emphasize that local and disseminated bleeding can occur as a major manifestation of neuroblastoma.
Subject(s)
Adrenal Gland Neoplasms/congenital , Adrenal Gland Neoplasms/complications , Disseminated Intravascular Coagulation/etiology , Hemoperitoneum/etiology , Neuroblastoma/congenital , Neuroblastoma/complications , Female , Humans , Infant, Newborn , MaleABSTRACT
OBJECTIVE: This report discusses the relationship of supradiaphragmatic hepatic tissue that is fused to the lung (through a diaphragmatic defect) with pulmonary hypoplasia-a new constellation of findings. CONCLUSION: Hepatic pulmonary fusion should be suspected in instances of apparent diaphragmatic hernia characterized by mediastinal shift towards the hypoplastic lung or when the mediastinum does not shift away from the mass.
