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One hundred consecutive patients being investigated for scoliosis were studied using a double cassette containing a conventional film screen and a stimulable phosphor plate. The images were separated, randomised and scored thrice by three radiologists for anatomic structure visualisation. The exposure to the plate and film and repeat rate were measured. Scoliosis angles were comparable on both sets of images, however, visualisation of vertebrae, vertebral end plates, pedicles, spinous processes and other structures were significantly improved (p < 0.0001). Intra- and inter-observer reliability was high with good intraclass correlation. There was a 40% potential exposure reduction, and retakes were decreased from 3 to 0%. We conclude that stimulable phosphor images give better anatomic structure visualisation with potential radiation exposure reduction and lower repeat rate. [ABSTRACT FROM AUTHOR]

Duplex spectral or color Doppler sonography demonstrated major abdominal vessel blocks affecting 18 vessels in 16 infants aged between 23 and 56 weeks postconceptional age. The portal vein was affected in 8 infants, the renal vein in 3, the renal vein and inferior vena cava in 1, the renal artery in 1, the inferior vena cava and hepatic vein in 1, and the aorta in 2 infants. Doppler sonography confirmed the grey-scale findings and often demonstrated the extent of vascular flow, providing functional information not available from the grey-scale scan. It facilitated the follow-up of thrombosis during therapy. Most important of all, in many instances it enabled a rapid and reliable specific diagnosis often not possible on the grey-scale study alone and hence altered patient management. [ABSTRACT FROM AUTHOR]

Of 60 renal transplant patients who underwent 134 duplex Doppler sonograms, 38 had normal frequency shift profiles and 8 showed only minimal disturbances, within normal post-transplantation limits. Fourteen patients had hypertension and showed a very abnormal profile. In 3 of the 14 the hypertension was controllable medically, and the remaining 11 underwent angiography. Duplex Doppler sonography showed gross turbulence (spectral broadening, bidirectional flow) and high frequency shift confirmed on angiography to represent 50 to 75% main renal artery stenosis in 8 of these 11, and major renal intrahilar vessel stenosis in 2. In the remaining patient, no Doppler signal was found and 95% stenosis was present. In 1 patient with intrahilar stenosis, arterial signals detected in the renal veins indicated the presence of a post-biopsy arteriovenous fistula. One patient with main renal artery stenosis also had a fistula, which was masked by a 70% stenosis. All patients with angiographically proven renal artery stenosis had a distinctive abnormality of the Doppler arterial flow pattern. [ABSTRACT FROM AUTHOR]

Colonoscopic and double-contrast high-density barium enema (DCBE) findings were correlated in 68 patients (39 boys and 29 girls) aged 6 months to 18 years (mean 11.6 years) evaluated over a 24-month period. There was excellent correlation in 53 patients (78.0%) and good correlation in another 3 (4.4%) who had identical diagnoses and only slightly differing extent of disease reported. In 2 of these, DCBE showed more extensive disease, confirmed histologically in 1. Distal colitis seen on colonoscopy as reddening and neovascularity was missed on DCBE in 6 patients. Colonoscopy and DCBE failed to show a polyp in 1 patient each. One patient who had a normal DCBE and colonoscopy demonstrated a histological abnormality, and 1 patient with an abnormality on histology and DCBE was normal on colonoscopy. A disparity resulted from the time between procedures in 1 patient and observer error in another. This high correlation is far better than any previously reported in children, supporting the use of high-density barium sulfate and double-contrast barium enemas in pediatric patients. [ABSTRACT FROM AUTHOR]

A case report is presented of a child who died in the neonatal period and who had the sonographic findings of multiple, tubular, fluid-filled spaces in the liver characteristic of Caroli's disease. There was an echodense renal cortex and pyramids. Necropsy findings were consistent with Caroli's disease but the liver also showed evidence of congenital hepatic fibrosis and there was infantile type polycystic disease of the kidneys. [ABSTRACT FROM AUTHOR]

Behçet's syndrome is very rare in children, especially those under 10 years of age. Clinical and radiological features are described in 4 children, including 2 under the age of 5 years, with the syndrome. As in other pediatric cases reported, the incomplete form of Behçet's syndrome was present in each case. All 4 patients had oral and genital mucosal effects, arthritis and gastrointestinal and dermatological manifestations. Ophthalmological symptoms occurred in only 1 patient. Radiologically, the 4 cases demonstrated the spectrum of gastrointestinal involvement, from minimal irregularity and thickening of the terminal ileum to gross irregularity and deformity of the terminal ileum and cecum. Because of the difficulty in differentiating Behçet's syndrome from other forms of inflammatory bowel disease it is suggested that in children with gastrointestinal involvement, 3 major criteria be present before the diagnosis of Behçet's syndrome is made. [ABSTRACT FROM AUTHOR]

Interposition of the gallbladder is a rare anomaly, but its diagnosis is important since it represents a surgically correctable cause of jaundice. The patients present with jaundice, abdominal pain and sometimes an enlarged gallbladder. Radiological diagnosis may be difficult since the condition may be mistaken for a choledochal cyst, hydrops of the gallbladder or Caroli's disease. The ultrasound, cholangiogram and surgical findings of dilated intrahepatic ducts adjacent to a normal or enlarged gallbladder with no dilatation of the common bile duct are presented in two children with this condition. [ABSTRACT FROM AUTHOR]

The use of Gruntzig angioplasty balloon catheters in the dilatation of a tight esophageal stricture in an infant is presented. [ABSTRACT FROM AUTHOR]

Background: In conventional radiography, a film-screen system serves as the X-ray detector and the film also functions as an archival and display medium. Unlike film-screen radiography, these functions are uncoupled in computed radiography (CR). CR uses conventional radiographic equipment to expose an image on a storage phosphor plate instead of a film-screen combination., Objective: To review the basic concepts of CR and to provide a background for discussion of specific musculoskeletal applications of CR in children., Materials and Methods: Various aspects of musculoskeletal CR in children are presented based on our 4 years' experience and a review of the literature., Results: A greater amount of scatter capture occurs with storage phosphor CR than with a film-screen system in the 70- to 120-kVp range. This is attributed to a lower K-absorption edge of barium in the barium fluorohalide (BaFBr) compound used in the imaging plate. A significant reduction of scatter to primary radiation, improvement in bony trabecular sharpness, and improvement in line pair resolution can be achieved in pediatric musculoskeletal imaging using an air gap without an increase in the skin entrance dose as compared to the non-grid table top technique. With CR, in addition to proper radiographic exposure technique, one needs to preprogram and select the optimal processing technique for each anatomic region, projection and age group of the child., Conclusion: The main advantages of CR in pediatric musculoskeletal imaging consist of a reduction in radiation dose for many applications, improved contrast resolution, near elimination of repeat radiographs related to exposure errors, and digital processing capabilities for image enhancement, storage, retrieval, display and transmission. The current limitations of CR include the moderately high start-up cost, the long learning curve to produce optimal films, and the reduced spatial resolution.