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Summary Background Gray matter heterotopia (GMH) is a malformation of the central nervous system characterized by interruption of normal neuroblasts migration between the 7th and 16th week of fetal development. The aim of the study was the analysis of clinical symptoms, prevalence rate and the most common concurrent central nervous system (CNS) developmental disorders as well as assessment of characteristic morphological changes of gray matter heterotopia in children hospitalized in our institution between the year 2001 and 2012. Material/Methods We performed a retrospective analysis of patients’ data who were hospitalized in our institution between the year 2001 and 2012. We assessed clinical data and imaging exams in children diagnosed with gray matter heterotopia confirmed in MRI (magnetic resonance imaging). Results GMH occurred in 26 children hospitalized in our institution between the year 2001 and 2012. Among children with gray matter heterotopia most common clinical symptoms were: epilepsy, intellectual disability and hemiparesis. The commonest location of heterotopic gray matter were fronto-parietal areas of brain parenchyma, mostly subependymal region. Gray matter heterotopia occurred with other developmental disorders of the central nervous system rather than solely and in most cases it was bilateral. Schizencephaly and abnormalities of the corpus callosum were the most often developmental disorders accompanying GMH. Conclusions 1. Subependymal gray matter heterotopia was more common than subcortical GMH. Subependymal GMH showed tendency to localize in the region of the bodies of the lateral ventricles. The least common was laminar GMH. 2. Gray matter heterotopia occurred more often with other developmental disorders of the central nervous system rather than solely. The most frequent concurrent disorders of the central nervous system were: schizencephaly, developmental abnormalities of the corpus callosum, arachnoid cyst, abnormalities of the septum pellucidum and the fornix. 3. GMH foci were more often bilateral than unilateral. 4. In the diagnostics of cell migration abnormalities, gray matter heterotopia included, MR imaging remains the method of choice.

Background Tuberous sclerosis complex is a genetic disorder in which multiple hamartomas develop in the central nervous system and skin, as well as in internal organs such as kidneys, heart, eye bulb and lungs. Epilepsy and mental retardation are characteristic clinical manifestations. The aim of this work is to summarize types of lesions present in diagnostic imaging examinations of patients hospitalized in Provincial Hospital No. 2 in Rzeszow. Material/Methods In retrospective analysis we examined children who were diagnosed in Department of Radiology in Provincial Hospital No. 2 in Rzeszow in the period from 2004 to 2012. The clinical material consists of 14 children – 7 girls and 7 boys, aged 6 months–16 years. We interpreted the results of CT, MRI, US and DSA examination and evaluated abnormalities typical for TSC in different localizations. Results In the central nervous system we found: subependymal nodules and white matter abnormalities in 13 out of 14 children (93%), cortical tubers in 8 patients (57%), and subependymal giant cell astrocytomas in 2 boys (14%). Two types of lesions were found in kidneys, i.e. angiomyolipomas (AML) in 7 children and cysts in 5 patients. In the heart tubers ( rhabdomyomas ) were diagnosed with echocardiography in 6 patients. Lesions (retinal nodular hamartomas – phakomas) were also found in the eye bulb in 4 boys. Conclusions 1. In order to confirm the diagnosis of Bourneville–Pringle disease, brain MRI, CT and US of other organs need to be performed. 2. The confirmation of existence of calcified subependymal nodules within supratentorial ventricular system in CT examination is typical for tuberous sclerosis complex. 3. Detecting the presence of numerous angiomyolipomas in kidneys should implicate further diagnostic with brain imaging examination to diagnose TSC.

Summary Background Necrotizing enterocolitis (NEC) is one of the most serious disorders of gastrointestinal tract during neonatal period. Early diagnosis and adequate treatment are essential in the presence of clinical suspicion of NEC. Plain abdominal radiography is currently the modality of choice for initial evaluation of gastrointestinal tract in neonates. However, when the diagnosis is uncertain, abdominal ultrasound with bowel assessment might be an important complementary examination. The aim of the study was to evaluate usefulness of ultrasound in the diagnosis of NEC and its value for implementation of proper treatment. Material/Methods The data of nine neonates diagnosed with NEC, hospitalized at the Provincial Hospital No. 2 in Rzeszow in the period from September 2009 to April 2013 was retrospectively analyzed. Apart from abdominal radiography, abdominal ultrasound with bowel assessment was performed in all nine cases. Imaging findings, epidemiological data, coexisting risk factors and disease course were assessed. Results Most children in the group were preterm neonates. Findings in plain abdominal radiography were normal or nonspecific. A wider spectrum of findings was demonstrated in all ultrasound examinations and intestinal pneumatosis, a pathognomonic sign for NEC, was more frequently noted than in plain abdominal x-ray. Most children were treated by surgical intervention with resection of necrotic bowel loops and in more than half of the cases location of changes identified during surgery was concordant with ultrasonographic findings. Conclusions Abdominal ultrasound examination might be helpful in the diagnosis of NEC, especially when plain abdominal radiography findings do not correlate with clinical symptoms. However, abdominal radiography is still considered the modality of choice. The range of morphological changes detectable on ultrasound examination is much wider than in plain abdominal radiography. Ultrasound examination allows for more accurate assessment of changes within intestines and adjacent tissues, which aids clinicians in making more accurate therapeutic decisions and implementing proper treatment.

Summary Background Schizencephaly is a rare developmental malformation of the central nervous system associated with cell migration disturbances. Schizencephaly can be uni- or bilateral and is divided into two morphological types. The cleft is defined as type I (“closed lips”) if there are fused clefts in cerebral mantle. In type II (“open lips”) the clefts are separated and filled with cerebrospinal fluid connecting lateral ventricle with the subarachnoid space. Material/Methods We retrospectively analysed data of patients hospitalized in the Clinical Pediatric Neurology Department of Provincial Hospital No. 2 in Rzeszow between 1998–2011. Clinical data and imaging exams were analysed in the group of children with confirmed schizencephaly. Results Schizencephaly was recognized in 32 children. Diagnosis was made in children at the ages between 2 weeks and 15 years – the majority of older children were born before the year 2000. Diagnostic imaging, most often magnetic resonance imaging, was performed in all of the children. In most cases coexistence of other CNS malformations was discovered. In only one patient there were no neurological symptoms, most of the children presented different developmental disorders and neurological symptoms – most often cerebral palsy and epilepsy. In the group of children with bilateral and type II schizencephaly certain symptoms occurred more often. Conclusions Schizencephaly is a rare central nervous system developmental disorder, which is very often associated with other severe brain malformations and in most of the cases subsequent multiple neurological symptoms. The method of choice in diagnosis of schizencephaly is magnetic resonance, which shows the degree and type of cleft, coexisting abnormalities and allows differential diagnosis. With the increased availability of this method it is possible to recognize schizencephaly more often and earlier.