Pediatric

A free gallery of high-resolution, ultrasound, color doppler and 3D images
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Pediatric abdomen

Ultrasound images of diseases affecting the child:

 

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1) Inguinal hernia in neonate containing ovary:

neonatal hernia       ultrasound image of hernia of ovary

This 6 week old female child had a swelling in the right inguinal region. Ultrasound images reveal a hypoechoic elongated mass (the processus vaginalis) with an oval structure showing cystic areas. This suggests a right inguinal hernia containing the right ovary. Such hernias usually do not resolve spontaneously. Images courtesy of Dr. Nirmali Dutta, UAE. Ultrasound machine used is the Philips HDI 5000.

2) Intraventricular adhesions- in the lateral ventricles:   

lateral ventricle showing adhesions     ultrasound image of the adhesions

sonography of neonatal brain     ultrasound image of lateral ventricles showing adhesions

neonatal lateral ventriculitis

Sonography of the brain in this neonate reveal multiple septae or adhesions within the lateral ventricles. There is no evidence of hydrocephalus or intracranial hematoma. These ultrasound images suggest some form of ventriculitis, causes of which include 1) old intraventricular hemorrhage 2) any form of encephalitis (eg: cytomegalovirus infections). Ultrasound images taken by Dr. Joe Antony, using a Toshiba Xario ultrasound machine.

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3) Pulmonary consolidation with pleural effusion:

ultrasound image of consolidation     ultrasound image of pleural effusion

pleural effusion in child    ultrasound image shows pleural effusion and consolidation

This young child shows an anechoic collection (of fluid) in the left pleural cavity. The left lung (lower lobe) shows echogenicity and texture similar to that of the liver (hepatisation). The spleen is seen below the left hemidiaphragm. These ultrasound images suggest left pulmonary consolidation with left pleural effusion.  Images taken using a Toshiba Xario ultrasound machine, by Dr. Joe Antony, Cochin.

Reference:

http://www.jultrasoundmed.org/cgi/content/full/26/7/985 (an excellent free article with images).

 

4) Intracranial hemorrhage:

a) Germinal matrix hemorrhage (grade1):

neonatal brain sonography      coronal ultrasound section showing intracranial hemorrhage

sagittal section section neonatal brain     ultrasound image showing germinal matrix hemorrhage

These sonographic images of neonatal brain show echogenic material in the caudothalamic groove, the region of the germinal matrix. These ultrasound images suggest grade-1 germinal matrix hemorrhage. The ventricles are of normal size and show no hemorrhage. Images taken by Dr. Joe Antony, using a Toshiba Xario machine.

b) Germinal matrix hemorrhage- Grade 4:

sonography of neonatal brain    image shows grade 4 germinal matrix hematoma

subependymal cyst    

The above 3 ultrasound images (Toshiba Xario machine) show- grade 4 germinal matrix hemorrhage- subependymal bleed with intraventricular hemorrhage (IVH) and intraparenchymal extension. There is also a small subependymal cyst.

Follow -up scan 1 week later:

partial resolution of the germinal matrix bleed    ultrasound image of intracranial bleed

resolving intracranial hematoma

Follow up ultrasound scan (1 week later) show partial resolution of the hematoma and the IVH.

5) Complications of intraparenchymal hemorrhage- porencephalic cyst of brain:

 ultrasound image of cystic lesion of the brain     an ultrasound image of porencephlic cyst

sonographic image show porencephalic cyst      sonography of porencephalic cyst in neonate

an example of subependymal cyst   

Sonography of the brain in this neonate shows a cystic lesion in the periventricular region of the cerebral hemisphere. Measuring 10 x 14 mm., it appears thin walled and may have a communication with the lateral ventricle. These ultrasound images are highly suggestive of a porencephalic cyst of the brain. These are formed after resolution of a hematoma originating from the germinal matrix, with parenchymal extension. The lowermost image shows an associated subependymal cyst.

Reference: http://www.ajronline.org/cgi/reprint/138/3/467.pdf (free- excellent article and images).

Another complication of subependymal hemorrhage- subependymal cysts:

ultrasound image of subependymal cyst     ultrasound image shows subependymal cyst with hemorrhage

sagittal section of the cyst

Sonography of the neonatal brain reveals a large subpendymal cyst of 3.5 mm. in the left caudato-thalamic groove. Sagittal section image also shows the true extent of the cyst. Such subpendymal cysts are a known complication of subependymal hemorrhage in neonates. Other causes of such cysts are intracranial infections. These are known to resolve spontaneously. The right side shows evidence of subependymal hemorrhage.

Reference: http://www.ajronline.org/cgi/reprint/162/4/953

6) Hydrocephalus:

ultrasound image showing hydrocephalus     sonography of hydrocephalus in neonate

In this neonate, there is evidence of considerable enlargement of the lateral ventricles. Measurement at the atria are more than 12 mm. on both sides. These ultrasound images suggest hydrocephalus. Images taken by Joe Antony, MD, using a Toshiba Xario ultrasound machine.

7) Basal ganglia calcification in neonate with Down syndrome:

neonatal intracranial calcification    ultrasound image coronal section of neonatal brain

sagittal section shows the linear calcification    sagittal section (color doppler) shows no flow in the linear echoes

This male neonate showed evidence of Down's syndrome. Sonography of the brain showed linear calcific lesions in the basal ganglia, bilaterally. Color doppler imaging showed the linear echoes not to be of vascular nature. Such linear calcific lesions are known to occur in Down's syndrome, as well as other common conditions as prematurity, cerebral anoxia and intrauterine infections. Upper 2 ultrasound images show coronal section through the brain. Lower 2 ultrasound images show linear calcification in sagittal section. All images were taken by Joe Antony, MD, using a Toshiba Xario ultrasound machine.

References: 1) http://journals.elsevierhealth.com/periodicals/ymai/medline/record/MDLN.157246

2) http://www.ncbi.nlm.nih.gov/pubmed/7094616

8) Sacral meningocele in neonate:

sacral meningocele    low tethering of cord is seen

spinal cord is well seen    the sac is visualized

color doppler image of sacral meningocele  

This neonate had a small swelling on the dorsum of the sacral region. Sonography of the swelling revealed:

1) a sac measuring 1.0 x 3.2 cms. posterior to the sacrum, containing clear fluid (CSF), 2) communicating with the spinal canal through a defect (spinal dysraphism), measuring 1.1 cms. 3) low tethering of the spinal cord. These ultrasound images of the neonatal spine are diagnostic of sacrococcygeal meningocele. Note that the sac does not contain neural tissue. Images taken by Dr. Joe Antony, MD, using a Toshiba Xario machine.

Reference: http://bjr.birjournals.org/cgi/content/full/75/892/384 (free article and images) .. excellent

9) Sacral myelomeningocele in neonate:

normal brain    hydronephrotic kidney in sacral myelomeningocele

bilateral hydronephrosis    sac within the sac

the sacral bony defect is seen with the myelomeningocele    meningocele in neonate

This neonate showed a large sac on the dorsal aspect of the sacrum, extending to the coccyx. Sonography of the sac revealed a large fluid filled mass with a sac like structure (sac) within the main sac. A defect is seen in the sacral vertebrae. The inner sac measures 5.2 cms. approximately while the outer one measures 8 cms. The defect is 1.5 cms. in width. These ultrasound images favor a diagnosis of sacral myelomeingocele (with the inner sac being the herniated, expanded spinal cord). The neonatal brain showed normal ultrasound appearance whilst the kidneys appeared hydronephrotic (possibly due to a neurogenic urinary bladder, a consequence of the myelomeningocele).

Images by Joe Antony, MD using a Toshiba Xario ultrasound machine.

Reference: http://bjr.birjournals.org/cgi/content/full/75/892/384 (free article and images) .. excellent

10) AGENESIS OF THE CORPUS CALLOSUM in AICARDI SYNDROME:

neonate with aicardi syndrome    ultrasound image shows the Probst bundle

showing ventricles in Corpus callosum agenesis    coronal image of agenesis of corpus callosum

showing the posterior fossa in Agenesis of corpus callosum    Dandy walker malformation

This young female neonate presented with infantile spasms and anophthalmia. Sonography of the brain revealed a) absence of the corpus callosum b) prominent, dilated and elevated 3rd ventricle c) sharply angled lateral peaks of the lateral ventricles which lie far apart d) colpocephaly- prominence of the occipital horns of the lateral ventricles e) echogenic mass in the medial part of the lateral ventricles (Probst bundles)  f) posterior fossa cyst which communicates with the dilated 4th ventricle with agenesis of the cerebellar vermis (DANDY WALKER MALFORMATION). These ultrasound images suggest agenesis of the corpus callosum, as part of the AICARDI syndrome. Ultrasound images by Joe Antony, MD, using a Toshiba Xario ultrasound machine.

Reference: 1) http://emedicine.medscape.com/article/941426-overview (free article on Aicardi syndrome).

                     2) Agenesis of the corpus callosum (free article). 

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  This page was last edited on: Monday March 23, 2009 02:02 PM  

Copyright ©   2007- All rights reserved- www.ultrasound-images.com Dr. Joe Antony, MD,    265, Girinagar, Cochin- 20, India.

Scan centre: ULTRASCAN CENTRE, AL-FIA Building, Opp. Reserve Bank of India, ERNAKULAM,

COCHIN (KOCHI)- 682018, KERALA.

Ph: (Off.) 91-484-2403058, (Residence) 91-484-2311416, (Cell) 91- 93886-23088

Contact: joe@ultrasound-images.com or drjoea (at) gmail.com