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Neonatal cranial ultrasound continues to be a popular initial imaging modality because of the safety, low-cost, and portability of the examination. The higher frequency transducers and enhanced ability for signal processing that is possible with current ultrasound machines improves visualization of complex congenital anomalies, complications of pregnancy, and birth and neoplastic processes. This article reviews these conditions so that the reader will have a baseline knowledge of the ultrasound findings. With the use of neonatal cranial ultrasound, recognition of the maximum diagnostic information available on the sonogram and appropriate use of other cross-sectional imaging modalities are improved.

In vivo evaluation of Doppler contrast agent (DCA) enhancement has been principally qualitative. To quantitate the enhancement of the Doppler signal by perflubron emulsion, an investigational DCA, the audio-Doppler signal from the rabbit carotid artery was recorded during 0.5-ml/kg incremental doses to a total dose of 2.5 ml/kg. A representation of the recorded signal intensity, the Doppler power spectrum (DPS), was determined using a personal computer and commercially available software package. The dose related enhancement from perflubron emulsion was linear (r = 0.986, p = 0.0124) with a 710% (8.5 dB) overall enhancement at 2.5 ml/kg (p = 0.0001). Significant differences in enhancement could be detected with doses as low as 1.0 ml/kg and compared favorably with observer assessment of dose-related enhancement. This relatively simple method of computer analysis can quantify in vivo Doppler signal intensity and enhancement by perflubron emulsion and may enable quantitative comparisons between different DCAs.

Ultrasound imaging has become a common method for intraoperative evaluation of the central nervous system. Real-time monitoring aids in guidance for aspiration of fluid collections and placement of catheters as well as the localization and evaluation of masses, and confirmation of their complete removal. Color Doppler is useful in the evaluation of blood flow in arteriovenous malformations, aneurysms, and neoplasms. Consultation among the ultrasound staff, neuroradiologists, and neurosurgeons before the operative procedure maximizes the usefulness of ultrasound, thus aiding in the success of surgery.

The sonogram is a reliable diagnostic tool in the evaluation of acute abdomital disorders in infants and children. Portability, noninvasiveness, and ease of examination make sonography an invaluable diagnostic method. This article considers the principle acute disorders of infancy and childhood that are minimal to sonographic diagnosis. Included are pyloric stenosis, appendicitis, necrotizing enterocolitis, intussusception, as well as unexplained abdominal distention and acutely presenting masses. Although some of these entities have nonspecific sonographic appearances, consideration of age, symptoms, and laboratory results usually permits a specific diagnosis.

While the clinical symptomatology and radiographic findings of acute suppurative infection of the epitrochlear lymph nodes of the arm have been previously described [1], ultrasonographic findings have not been reported. This case report demonstrates that sonograpic identification of enlarged epitrochlear lymph nodes immediately confirms the diagnosis. We summarize the clinical, radiological, and sonographic findings of acute suppurative infection of the epitrochlear lymphnodes.

Experience with color Doppler imaging (CDI) during 16 pediatric intraoperative and one percutaneous neuro-radiologic procedures was reviewed to assess whether CDI increased the success rate or decreased the procedure time, thus contributing substantially to procedure performance. Intraoperative CDI was used to rapidly identify abnormal vessels or displacement of normal vessels and correlated with preoperative studies. In six cases (four vascular malformations, one mycotic aneurysm, and one hamartoma), surgical resection was altered on the basis of flow information obtained. In one case of percutaneous embolization of a Galenic malformation, CDI provided information contributing to the cessation of the procedure. In six cases (debulking of three gliomas, resection of one vascular malformation, and two biopsies of nonneoplastic conditions), information was added but did not alter the surgical approach. In the remaining four cases (three cerebrospinal fluid drainage procedures, one posterior fossa decompression), no additional information was obtained. Consultation among the ultrasound staff, neuroradiologists, and neurosurgeons before the operative procedure maximized the usefulness of CDI, thus aiding in the success of surgery.

Sonography was performed in 30 normal patients, neonatal to 45 years old, to illustrate our technique for complete and rapid examination of the elbow joint. Sonography is an easy, noninvasive method of evaluating the articulating surfaces, tendinous insertions, and supporting soft tissues of the elbow joint. Reliable identification of both normal and diseased anatomy is possible at all ages. Familiarization with the sonographic appearance of the six elbow ossification centers aids in sonographic interpretation.