Congenital neuroblastoma: evaluation with multimodality imaging

Article Abstract:

Neuroblastoma is a type of malignant tumor involving embryonic nerve cells. It is most commonly found in children and often spreads to the liver, lymph nodes, and other organs. It is hard to diagnose in its early stages. This disease is sometimes found in newborn infants. Although it is similar in characteristics to the tumor when found in older infants and children, its outcome is much more favorable in newborns. Detection of neuroblastoma in newborns has been traditionally by X-rays of the chest and abdomen, which usually reveal the disease only in its later stages. Ultrasound (US), computed tomography (CT), and magnetic resonance (MR) imaging techniques are now available to detect these tumors earlier in newborns. Neuroblastoma in 12 newborns was evaluated using the various imaging techniques, including prenatal US (four infants), postnatal US (11 infants), CT (seven infants), and MR (three infants). Results of clinical findings included enlarged livers in four of the infants, masses in the abdomen that could be felt in five of the infants, and increased urinary catecholamine levels in four of the infants. In the prenatal US performed on four of the infants, specific findings of tumors were seen in two. Postnatal US found the primary tumor in 10 of the 11 infants examined. It also found liver involvement in 5 of 7 cases, but gave false-negative results in two of these cases, that is, indicated the absence of tumor that was in fact present. CT correctly found the primary tumor in 6 of 7 cases, found evidence of liver involvement in 4 of 4 cases, and found no liver involvement in three cases that were found not to involve the liver by other diagnostic methods. MR imaging used in three infants was highly useful in finding and characterizing disease. Ten of the 12 infants (83 percent) survived the disease. These results indicate that because the outcome of this disease is highly favorable in newborns, even when diagnosis is delayed, US imaging is usually the only imaging technique needed, considering its accuracy, ease of performance, and ability to be used prenatally. CT and MR, although possible more accurate and detailed, are probably only needed in specific cases. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, CT imaging, CAT scans, Magnetic resonance imaging, Neuroblastoma, Tumors in children, Pediatric tumors

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Spontaneous perforation of the common bile duct in children

Article Abstract:

Researchers used diagnostic imaging methods including ultrasound and radionuclide studies to evaluate four infants and one child under the age of 2.5 years suffering from perforation of the common bile duct (passage conveying bile from the gallbladder and the liver to the duodenum). Although it is rare, bile duct perforation is a major cause of jaundice and vague abdominal distension (enlargement due to the accumulation of fluid) in infants. There is no known cause of spontaneous perforation of the common bile duct, but researchers theorize that a weakness in the bile duct walls may be responsible. Although no solid evidence exists, it has also been speculated that trauma, possibly due to child abuse, may play a role in some cases of bile duct perforation. Diagnostic imaging techniques enabled physicians to make a prompt diagnosis of this life-threatening condition in all five patients. The perforation was confirmed and corrected during surgery and required a healing period of about one month.

Usage, Injuries, Causes of, Children, Surgery, Pediatric surgery, Common bile duct, Bile ducts, Jaundice, Diagnosis, Ultrasonic, Diagnostic ultrasonography, Biliary tract

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Complicated appendiceal inflammatory disease in children: pylephlebitis and liver abscess

Article Abstract:

Children often suffer from inflammation of the appendix. Pylephlebitis (inflammation of veins supplying blood to the kidney) can be one of the complications resulting from appendiceal inflammatory disease. Pylephlebitis, if left untreated, may cause the spread of bacteria to the liver, resulting in liver abscess (collection of pus, displacement or disintegration of tissue). Five children with complications resulting from appendicitis were studied. Ultrasound (US) and computed tomography (CT) are suggested as the diagnostic tools useful in assessing the involvement of the portal vein in cases of pylephlebitis and liver abscess. The disease should be treated with antibiotics. When portal vein thrombosis (clot formation) or portal hypertension (increased pressure in the vein supplying blood to the liver) are found, the radiologist should suggest the presence of an inflamed disease of the appendix.

Complications and side effects, Liver, Appendicitis

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