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BACKGROUND: Diffuse neonatal hemangiomatosis (DNH) is a rare disorder first recognized at birth or during the neonatal period. DNH is characterized by numerous cutaneous and visceral hemangiomas involving three or more organ systems. MATERIALS AND METHODS: Although the skin and liver are most frequently affected, we present a case of DNH demonstrating an unusual predilection for the central nervous system (CNS). RESULTS AND CONCLUSION: We report the imaging findings in a patient with this disorder, paying particular attention to the features seen on cranial sonography and spinal MR imaging.

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We report a newborn with an esophageal lung, a rare type of communicating bronchopulmonary foregut malformation (CBPFM). Associated findings included esophageal atresia, tracheoesophageal fistula (TEF) to the distal esophagus, duodenal stenosis with annular pancreas, imperforate anus, vertebral anomalies and ambiguous genitalia. Radiologic evaluation included chest radiographs, esophagrams, chest ultrasound and chest CT. After colostomy and surgical repair of duodenal stenosis and TEF, a right thoracotomy was performed to treat an esophageal lung. Radiologic features of this unusual variant of CBPFM are presented. Accurate preoperative imaging diagnosis is essential for planning surgical treatment of an esophageal lung.

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In the CT evaluation of children with blunt abdominal trauma, bowel injury may represent the most problematic condition that the radiologist encounters. In cases where there is a large, unexplained pneumoperitoneum or extravasation of oral contrast, the diagnosis is straightforward. Significant, potentially life-threatening injuries, however, may be manifest only by focal bowel wall thickening and peritoneal fluid accumulation. Meticulous attention to detail with regard to scanning, administration of contrast, and review of the images along with the recognition of patterns and sites of more common injuries can improve the sensitivity of the radiologist in the detection of bowel trauma.

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Intussusception in the pediatric patient may have a varied clinical presentation depending on its location, presence of lead point, intermittent occurrence, or underlying systemic disease. Computed tomography (CT) may be used at times in the evaluation of children with complicated presentations. The purpose of this investigation was to review the findings of CT images obtained in children with intussusception. Five patients with intussusception were diagnosed by CT at our institution between 1989 and 1994. An intraluminal mass was found in all patients. Intraluminal eccentrically located fat, as well as the target sign of alternating layers of high and low attenuation, was seen in most patients. In patients with a more long-standing process, fluid-distended loops, inflammation, and loss of tissue planes were seen and corresponded with necrosis and areas of nonviable bowel found at surgery. Finally, potential pitfalls with the layered or target appearance are discussed in the form of two patients who were initially felt to have intussusception at CT, but in whom the target appearance was later found to be due to other processes.

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The objective of this study was to compare the quality of conventional and helical computed tomography (CT) images in children unable to breath-hold. Sixteen patients (age range 1.1-7.5 years) underwent both conventional and helical chest CT on a General Electric HiSpeed Advantage scanner at a mean study interval of 3.8 months. Conventional 0.6-s scans were reconstructed with standard algorithm while 1.0-s helical studies were reconstructed with standard and bone algorithms. Three blinded observers retrospectively evaluated the images. There was no significant difference in motion, image sharpness and anatomic resolution for helical and conventional scans reconstructed with standard algorithm. Furthermore, image sharpness (P < 0.001) and visibility of bronchi (P < 0.001) were improved when helical images were reconstructed with bone algorithm. We conclude that motion artifact severity, image sharpness and anatomic resolution for helical and conventional 0.6-s chest CT are similar when the images are reconstructed with an identical algorithm. Helical CT may be preferable because of the faster examination times and the ability to reconstruct overlapping images as an adjunct for problem solving. Also, with the scanner used, bone algorithm reconstruction can be employed to improve image sharpness and anatomic resolution.

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Magnetic resonance images of the pituitary glands in 48 endocrinologically normal neonates and infants were analyzed to determine the changes in pituitary gland size, shape, and signal intensity that occur during the 1st year of life. A progressive increase in the length--but not height--of the gland was seen throughout the 1st year. When corrections for total brain size were made, the pituitary gland was found to diminish in relative cross-sectional area throughout infancy. Upward convexity of the gland was seen in 63% of neonates less than 1 month of age, but in only 4% of infants older than 2 months. Hyperintensity of the adenohypophysis relative to the brain stem was visualized on T1-weighted images in 18 of the 24 (75%) neonates and infants less than 2 months old; this appearance was never seen in older infants. An area of high signal intensity was visualized in the posterior pituitary in 32 of 48 cases (67%), and its visualization was unrelated to age. The neonatal and young infant pituitary gland is thus significantly rounder, brighter, and relatively larger during the first 2 months of life than in later infancy.

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