[Nuclear spin tomography studies (MRI) of joints in juvenile chronic arthritis]. / Kernspintomographische Untersuchungen (MRT) von Gelenken bei juveniler chronischer Arthritis (JCA).

MRT (magnetic resonance imaging) is a new method of producing pictures of internal organs; the main advantage compared to radiography is the ability to subtly differentiate soft tissues. 14 children suffering from juvenile chronic arthritis of different subgroups are described. MRT pictures of knee joints show clearly the structure and form of the articular cartilage, ligaments as well as the nature, density and thickness of the inflammatory tissue. MRT permits a very early diagnosis of a progression in the inflammatory articular process without accompanying ionising radiation, an advantage in childhood.

Intracranial chondroma. Case report.

We present a rare case of intracranial chondroma originating from the falx cerebri. Diagnostic procedures and surgical management are discussed, with special reference to computed tomography, magnetic resonance imaging, and pathologic findings.

Identification by MRI.

A semi-skeletted water-lodged corpse was supposed to be an 82-year-old missed man. Fifteen years ago this person underwent an operation of a trimalleolar fracture of the left ankle joint. Conventional X-ray photograms of the left ankle joint of the water-lodged corpse showed no evidence of an operation. A T-1 weighted spin-echo sequence revealed the entire aspect of the osteosynthesis as documented in the previously performed post-operative X-ray photograms.

[Herpes encephalitis in infancy]. / Herpes-Enzephalitis im Säuglingsalter.

Since antiviral chemotherapy is available herpes encephalitis has become of great importance among viral affections of the central nervous system. Five young infants are presented with special problems of this disease and its diagnostic possibilities especially serological and imaging methods (CT scan, nuclear magnetic resonance tomography, ultrasonography of the brain) as well as electroencephalography. Clinical symptoms are very important since all those methods are not sufficient for early diagnosis and prompt onset of antiviral chemotherapy. Herpes encephalitis should be considered after apparent febrile seizures with focal symptoms as well as increasing disturbance of consciousness as manifestation of acute encephalopathy.

[Astrocytoma in a premature twin]. / Astrozytom bei einem Zwillingsfrühgeborenen.

In a premature twin boy (gestational age 34 weeks) two-dimensional echoencephalography, computed tomography, and NMR tomography revealed a brain tumor. The exact diagnosis was confirmed by stereotactic biopsy from the brain. Up to now the clinical course of the child has been surprisingly benign.

Asymptomatic primary empty sella in a 14-year-old girl: comparison of computer tomography and nuclear magnetic resonance imaging.

An enlarged, balloon-shaped sella was detected by chance in a completely asymptomatic 14-year-old girl, who presented with tall stature. While all endocrine functions were found to be normal, metrizamide cisternography with computer tomography revealed a flattened pituitary at the bottom of an empty sella. This could be compared later with nuclear magnetic resonance tomography, thus avoiding intrathecal contrast material and radiation exposure for the patient. The new technique depicts the sellar contents very well.

[Sonographic detection of post-meningitis subdural effusion]. / Sonographischer Nachweis postmeningitischer Subduralergüsse.

Subdural effusions in childhood are most often seen during the first year of life. In this age group two-dimensional echoencephalography gives excellent images of the brain due to the open fontanelle and the relatively low mineralisation of the cranium. The sonographic findings of two infants with postmeningeal subdural effusions are demonstrated and compared with CT-scan results. The sector-scan is much more useful than the linear-array. Computerized tomography remains necessary but it should be possible to reduce the number of examinations.

[Reconstruction in coronal and sagittal planes of CT scans compared with two-dimensional echo-encephalography in neonates and infants (author's transl)]. / Rekonstruktion koronaler und sagittaler Ebenen von CT-Bildern im Vergleich zur zweidimensionalen Echoenzephalographie bei Neugeborenen und Säulgligen.

Two-dimensional echo-encephalography using the fontanelle and open sutures as an "acoustic window" for the skull has offered a new possibility of investigating at least in part the morphological conditions inside the skull. We considered it necessary to examine the value of these new methods by checking the sonographic findings by means of cranial CT. The possibility of modern data processing when employing CT enables the visualisation of the coronal and sagittal planes which can be covered by echo-encephalography. Since it involves low stress for the patient and since it is a practicable method, two-dimensional echo-encephalography is very suitable for screening and for checking on the status of the patient. Since CT can visualise the overall situation inside the skull with greater accuracy, it remains indispensable as a basic examination method, depending on the overall clinical signs and symptoms.

[Two-dimensional ultrasonic examination of the cerebral ventricles (parallel-scan) in newborns and infants (author's transl)]. / Zweidimensionale Ultraschalluntersuchung (Parallel-Scan) der Hirnventrikel bei Neugeborenen und Säuglingen.

Computer tomography of the head is now firmly established as an examination procedure in pediatric radiology. It is non-invasive, but on the other hand time-consuming and above all costly. Repeated follow-ups represent a level of radiation exposure which should not be underestimated. Two-dimensional sonography (B-scan) has extended the range of possibilities in intracranial diagnostics in neonates and infants, especially since the large fontanelle and the still-open cranial sutures were recognized as "acoustic windows". Five cases are presented, which show that the cranial cavity can be demonstrated reliably and reproducibly, in particular the lateral ventricles. Determining vascular pulsations (real-time) aids orientation and permits conclusions to be drawn regarding the intracranial circulation. Follow-ups can be carried out simply, without submitting the child to exposure stress, and permitting early identification of a developing hydrocephalus. The examination can be performed with standard commercially available parallel-scan units, such as are already used in many clinics for abdominal diagnosis.