Pediatric Imaging Flashcards
Indications for pediatric imaging
Congenital anomalies/syndrome
Infectious process
Tumors
Trauma
Principle of Radiation
ALARA as low as reasonably achievable radiation dose
Most frequently performed radiological study in children
Chest x Ray
Check for mediastinal and lung base lesions and localization of lesions seen in frontal view
Lateral view
Most common cause of asymmetry in translucency of the two lungs
Rotation
Ski folds between baby and cassette may mimic
Pneumothorax
Resulting from interdigitation of thymic tissue in the intercostal spaces
Sail sign/ wavy margins
Most common cause of widening of mediastinum
Thymus gland
Presenting a straight course at the right side of the thoracolumbar spine
Umbilical venous catheter
Complex substance composed of phospholipids, protein, and neutral lipids
Surfactant
Other diseases also produce hyaline membrane
Meconium aspiration
Bronchopulmonary Dysplasia
Other name HMD
Respiratory distress syndrome of newborn
Imaging. Diffuse ground glass or finely granular apperance
HMD
True or false. HMD has hyperinflation
False. Hypo inflation
HMD treatment
Positive end-expiratory pressure
Continuous positive airway pressure
Surfactant administered by endotracheal tube
Oxygen and diuretics
Complications arise from treatment HMD
Pulmonary interstitial emphysema
Worsening opacification
Chronic complication
Common cause is administration of oxygen under positive pressure
Bronchopulmonary Dysplasia
Imaging finding. Coarse, irregular, rope like linear densities represent atelectasia or fibrosis
Bronchopulmonary Dysplasia
Honey comb appearance
Bronchopulmonary Dysplasia
Bronchopulmonary Dysplasia complications
Sudden death infant
Pulmonary arterial HPN
Inc. risk of pulmonary infection
Development of asthma
Usually full term or slightly preterm
Mild respiratory distress immediately after birth
Transient tachypnea of newborn
Imaging finding. Hyperinflation of lungs, fluid in the fissures, laminar effusions, fuzzy vessels
Transient tachypnea of newborn
True or false. Hyperaeration is typical in Transient tachypnea of newborn
True
Transient tachypnea of newborn treatment
Oxygen
Maintenance of body temp
Improvement generally occurs w/in 24 hours
Most common cause of respiratory distress syndrome in full term/ postmature infant
Meconium aspiration syndrome
Diffuse “ropey” densities (similar BPD)
Hyperinflation of lungs
No air bronchogram
Meconium aspiration syndrome
Infection either intrauterine or during delivery
Most are bacterial in origin
Grp A beta non-hemolytic streptococci
Now E. coli
Neonatal pneumonia
Non febrile
Metabolic acidosis
Septicemia and shock
Neonatal pneumonia
Diffuse relatively homogenous infiltrates resembling ground glass appearance of HMD a
Neonatal pneumonia
Most often at the level of ileocecal junction in a neonate
Meconium ileus
Almost all pt with cystic fibrosis has Meconium ileus and 10-15% pt with Meconium ileus has cystic fibrosis
False.
Frothy or soap bubble pattern bowel gas in RLQ a
Meconium ileus
Treatment in Meconium ileus
Barium enema
Surgery
Absence in continuity of esophagus due to an inappropriate division of the primitive foregut into trachea and esophagus leads to
Esophageal atresia
Incomplete separation of the esophagus from the laryngotracheal tube results
Tracheoesophageal fistula
Most common congenital anomaly of the esophagus
Esophageal atresia
No air-bubble in the stomach or bowel loops
Isolated esophageal atresia
Late in diagnosis due to fistula long and direct upwards. Otherwise there is aspiration pneumonia due to aspiration of food in the lungs.
Isolated fistula H-type
aspiration pneumonia, distension of bowel loops
Double fistula with esophaguel atresia
Commonest cause of fetal bowel obstruction
Duodenal atresia
Idiopathic thickening of the gastric pyloric musculature,progressive gastric outlet obstruction,first week to 3months of age
Hypertrophic pyloric stenosis
May appear duplicated due to puckering of mucosa
Double track sign
Pylorus indents the contrast filled antrum
Shoulder sign
Base of the duodenal bulb
Mushroom sign
Entrance of pylorus may be beak shaped
Beak sign
Elongated pylorus with narrow lumen
String sign