Tuberculous abdominal aortic aneurysm in a 14-year-old child.

Abdominal aortic aneurysms are rare in childhood. We present a case of aneurysm of the abdominal aorta in a child with tuberculous para-aortic lymphadenitis.

Large-cell calcifying Sertoli cell tumour of the testis: associated organ anomalies.

A case is reported of unilateral, focal large-cell calcifying Sertoli cell tumour (LCCSCT) of the testis associated with complex endocrine disorders and cardiac myxomas. It is believed that there are two distinct groups of patients with this tumour: those who have complex dysplastic syndromes and bilateral and multifocal tumours; and those without any syndromes but who have unilateral and focal tumours. The presented case differs in that, although the patient has a unilateral focal tumour, unique organ anomalies, such as renal agenesis and inferior vena cava duplication, are also present. These anomalies with LCCSCT have not been reported before.

Diagnosis of liver cirrhosis in children based on colour Doppler ultrasonography with histopathological correlation.

BACKGROUND: Changes in hepatic architecture in cirrhosis and chronic active hepatitis affect liver vascular haemodynamics. OBJECTIVE: To determine the criteria for the diagnosis of liver cirrhosis using Doppler US. MATERIALS AND METHODS: Twenty-two children with liver disease of unknown histology were prospectively examined and compared with eight normal children. Doppler US of portal vein velocity, arterio-portal velocity ratio, loss of reverse flow component in the hepatic vein and hepatic artery visualisation were examined prior to liver biopsy. Doppler results were compared with histological activity indices. Twelve patients had cirrhosis and ten had chronic active hepatitis. RESULTS: The most sensitive method (83%) for the assessment of cirrhosis was portal vein velocity less than 20 cm/sec. Arterio-portal velocity ratio (greater than 3) and hepatic artery visualisation were less sensitive (75% and 33% respectively) but specificity was 100% for all three methods. When these three methods were evaluated together, sensitivity increased to 91% and accuracy to 96%. Loss of reverse flow component was less specific (77%) but was sensitive (75%). CONCLUSIONS: Portal vein velocity, arterio-portal vein ratio and hepatic artery visualisation together were reliable in diagnosis of cirrhosis in the paediatric age group.

Inverted Y ureter anomaly and associated distal yo-yo phenomenon.

Duplication of the distal ureter is a very rare anomaly. A case is reported here in which the lower ectopic limb of the duplicated distal ureter presents with a ureterocele, and shows a different pattern of backflow.

Arteriovenous malformation of the choroid plexus.

A case of a 55-year-old female with arteriovenous malformation (AVM) of the choroid plexus within the right ventricle is reported. Arteriovenous malformation of the choroid plexus is a rare occurrence. The MR findings of this malformation are discussed.

Magnetic resonance imaging in evaluation of congenital and acquired superior oblique palsy.

BACKGROUND: According to the recently popularized classification of superior oblique (SO) palsy based on congenital variations of the tendon, the primary pathology is the abnormality of the SO tendon rather than an innervational problem in congenital cases. If this hypothesis is true, denervation atrophy of SO muscle should not occur in patients with congenital SO palsy. METHODS: Eight patients with traumatic and nine patients with definite congenital SO palsy underwent magnetic resonance imaging (MRI) of the orbit. SO muscle width and cross-sectional area measurements were taken from coronal images and compared with the clinically uninvolved superior oblique muscles. RESULTS: Atrophy of varying degrees was observed in the SO muscle both in congenital and acquired cases. No significant difference was found in the appearance of the SO muscle between acquired and congenital SO palsy groups. CONCLUSION: We have been unable to demonstrate abnormalities of the SO tendon in both groups. The MRI appearance of the SO muscle suggested that in congenital SO palsy, the pathology is not limited to the tendon; there also is an abnormality of the muscle itself.

Evaluation of congenital Brown's syndrome with magnetic resonance imaging.

The magnetic resonance (MR) findings in congenital Brown's syndrome were investigated. Sixteen involved eyes of 12 patients were compared with 20 eyes of 10 controls. An enlargement of the tendon-trochlea complex was observed in congenital Brown's syndrome. In addition, the appearance of the tendon-trochlea complex was irregular in shape and of intermediate signal intensity. The MR appearances in patients with a satisfactory or poor response to surgery did not show any significant differences from each other or from those in patients who had not undergone surgery. This was also the case for the patient with spontaneous improvement. The MR examination in congenital Brown's syndrome suggested that the abnormality was located at the tendon-trochlea complex but clinically it does not give a clue about the outcome of the disease.