Pediatric Ultrasonography

1. Antenatal Diagnosis by Ultrasonography.- 1 Introduction.- 2 Ultrasonography of a Normal Pregnancy.- 2.1 Timing of Successive Examinations.- 2.2 Normal Fetal Anatomy.- 2.2.1 Central Nervous System.- 2.2.2 Chest.- 2.2.3 Abdomen.- 2.2.4 Skeletal System.- 2.2.5 Gender.- 2.3 Conclusions from Examinations.- 3 Abnormal Pregnancies.- 3.1 Intrauterine Growth Retardation.- 3.2 Fetal Anatomical Malformations.- 3.2.1 Central Nervous System (CNS).- 3.2.1.1 Malformations Associated with Small Biparietal.- 3.2.1.2 Malformation Associated with Normal or Increased BPD.- 3.2.2 Chest and Neck.- 3.2.3 Abdomen.- 3.2.3.1 Urinary Masses.- 3.2.3.2 Other Urinary Tract Anomalies.- 3.2.3.3 Digestive Masses.- 3.2.3.4 Other Abdominal Masses.- 3.2.3.5 Abdominal Wall Anomalies.- 3.2.3.6 Ascites and Hydrocele.- 3.2.4 Musculoskeletal System.- 3.2.5 Soft Tissue Masses.- 4 What to do in Case of Fetal Malformation.- 5 Implications of the Diagnosis.- 6 Conclusions.- References.- 2. Ultrasonography of the Head in Infancy.- 1 Introduction.- 2 Instruments.- 2.1 Examination Technique and Practical Considerations.- 3 Normal Echoencephalographic Anatomy.- 4 Cerebral Hemorrhages.- 4.1 Subependymal Hemorrhage.- 4.2 Intraventricular Hemorrhage.- 4.3 Intracerebral Hematoma.- 4.4 Subdural Hematoma.- 4.5 Indications and Limitations.- 5 Cerebral Infectious Pathology.- 5.1 Postmeningitis Communicating Hydrocephalus.- 5.2 Ventriculitis.- 5.3 Cerebral Abscess.- 6 Intracranial Tumor Pathology.- 6.1 Structure, Boundary, and Dimensions.- 6.2 Topography.- 6.3 Impact of the Tumor and Accompanying Phenomena.- 7 Cerebral Malformations.- 7.1 Midline Facial Malformations.- 7.2 Midline Cerebral Malformations.- 7.3 Indications for US Examination.- 7.4 US and Myelomeningocele.- 7.4.1 Ventricular Dilatation.- 7.4.2 Diagnosis of Arnold-Chiari Malformation.- 7.4.3 Follow-up of Shunt Function.- 7.5 Conclusion.- References.- 3. Cervical Echography.- 1 Technique and Normal Anatomy.- 1.1 Technique.- 1.2 Normal Echographic Anatomy.- 2 Thyroid Pathology.- 2.1 Goiter.- 2.1.1 Pubertal Goiter.- 2.1.2 Endemic Goiter.- 2.1.3 Family-Linked Goiter, Hereditary Due to Hormonogenesis Disorders.- 2.1.4 Goiter in the Newborn.- 2.1.5 Sporadic Goiter.- 2.2 Thyroiditis.- 2.3 Thyroid Nodule.- 2.4 Echography’s Contribution During Thyroid Dysfunctions.- 2.4.1 In Hypothyroids.- 2.4.2 In Hyperthyroids.- 3 Parathyroid Pathology.- 4 Other Cervical Masses.- 4.1 Cysts of the Thyroglossal Tract.- 4.2 Branchial Cysts.- 4.3 Cystic Lymphangiomas.- 4.4 Malignant Cervical Tumors Exterior to the Thyroid.- 4.5 Other Masses.- References.- 4. Chest.- 1 Material.- 2 Technique.- 3 Indications.- 3.1 Opacification of a Hemithorax.- 3.2 Pleural Effusions.- 3.3 Analysis of Lesions of the Chest Wall, Parenchyma and Mediastinum.- 3.4 Diaphragm and Juxta Diaphragmatic Regions.- 3.5 Diagnosis of Heart Lesions.- 4 Conclusions.- References.- 5. Intraperitoneal Pathology — Abdominal Trauma.- 1 Introduction.- 2 Preparation and Technique.- 3 Diagnosis of an Abdominal Mass.- 3.1 Assessing the Intraperitoneal Location of the Mass.- 3.2 Analyzing the Ultrasonic Characteristics of the Mass.- 3.2.1 The Mass is Echogenic.- 3.2.2 The Mass is Anechoic or Hypoechoic but Homogeneous.- 3.2.3 The Mass has Characteristics of a Modified Digestive Structure.- 4 Acute Abdominal Pain with High Temperature.- 4.1 When to Look for an Abscess.- 4.2 What to Look for.- 4.3 Where to Look for an Abscess.- 5 Abdominal Trauma.- 5.1 Where to Look for a Hematoma.- 5.2 Evolution of the Hematoma.- 6 Some Specific Indications.- 6.1 Hypertrophic Pyloric Stenosis (HPS).- 6.1.1 When to Look for the Pyloric Olive.- 6.1.2 What to Look for.- 6.1.3 Where to Look for the Olive.- 6.2 Acute Intestinal Intussusception.- 6.3 Survey of Ventriculoperitoneal Shunts.- References.- 6. Liver, Biliary Tract, and Spleen.- 1 Normal Anatomy on US.- 1.1 Longitudinal Scan Through the Aorta.- 1.2 Longitudinal Scan Through the IVC.- 1.3 Subcostal Obligue Scan Through the Confluence of the Hepatic Vein.- 1.4 Subcostal Obligue Scan Through the Portal Bifurcation.- 1.5 Scan Along the Portal Trunk Axis.- 1.6 Gallbladder.- 1.7 Hepatic Parenchyma.- 1.8 Spleen.- 1.9 Extrahepatic Portal System.- 2 Portal Hypertension.- 2.1 Material.- 2.2 US Diagnosis of Portal Hypertension.- 2.3 Echographic and Fibroscopic Correlations.- 2.4 Discussion.- 2.5 Etiologic Diagnoses.- 2.5.1 Portal Obstruction or Cavernous Transformation of the Portal Vein.- 2.5.2 Budd Chiari Syndrome.- 2.5.3 Intrahepatic Blocks.- 2.5.4 Cirrhoses.- 2.6 Natural Splenorenal Anastomosis.- 2.7 Postoperative US Examination.- 2.7.1 Technique.- 2.7.1.1 Terminolateral Portocaval Anastomoses.- 2.7.1.2 Splenorenal Anastomoses.- 2.7.1.3 Iliomesentericocaval Anastomoses.- 2.7.1.4 Mesentericocaval Anastomoses with Jugular Vein Graft.- 2.7.2 Patent Postosystemic Anastomoses.- 2.7.2.1 Thickness of the Lesser Omentum.- 2.7.2.2 Gastroesophageal Collaterals.- 2.7.2.3 Hepatopetal Collaterals.- 2.7.2.4 Diameter of the IVC.- 2.7.2.5 Thrombosed Portocaval Anastomoses.- 2.8 Conclusion.- 3 Hepatic Tumors.- 3.1 Benign Tumors.- 3.1.1 Angiomas.- 3.1.1.1 Localized Tumors.- 3.1.1.2 Multinodular Angiomas.- 3.1.2 Hamartomas.- 3.1.3 Hepatic Adenomas.- 3.1.4 Cystic Tumors.- 3.1.5 Hydatid Cysts.- 3.2 Malignant Tumors.- 3.2.1 Hepatoblastoma.- 3.2.2 Hepatocarcinoma.- 3.2.3 Pepper Syndrome.- 3.2.4 Hepatic Metastases.- 4 Infectious and Inflammatory Diseases.- 4.1 Liver Abscesses.- 4.2 Hepatitis.- 5 Metabolic Diseases.- 5.1 Glycogen Storage Disease.- 5.2 Other Metabolic Disorders.- 6 Abdominal Traumatism.- 7 Cardiac Liver.- 8 Splenomegaly.- 8.1 Isolated Splenomegaly.- 8.2 Splenic Tumors.- 8.2.1 Benign Tumors.- 8.2.2 Malignant Tumors.- 9 Biliary Tract.- 9.1 Cholestatic Jaundice.- 9.1.1 Cholestasis in Newborns and Infants.- 9.1.2 Cholestasis in Childhood.- 9.2 Gallbladder Disease.- 9.2.1 Cholelithiasis.- 9.2.2 Acute Hydrops of the Gallbladder.- 9.2.3 Acute Cholecystitis.- 9.3 Diagnostic Policy.- References.- 7. Pancreas.- 1 Introduction.- 2 Measurements.- 3 Pancreatitis.- 3.1 Iatrogenic Medical Pancreatitis.- 3.1.1 Asparaginase.- 3.2 Acute Pancreatitis Associated with Schönlein-Henoch Allergic Purpura.- 3.3 Familial Pancreatitis.- 4 Exocrine Pancreas Insufficiency.- 4.1 Cystic Fibrosis.- 4.2 Schwachman-Diamond Syndrome.- 5 Traumatic Pseudocysts.- 6 Pancreatic Tumors.- 7 Conclusion.- References.- 8. Urinary Tract Abnormalities.- 1 Investigation of the Urinary Tract.- 2 The Normal Kidney.- 3 Aplasia, Ectopia, and Fused Kidneys.- 3.1 Aplasia and Ectopia.- 3.2 Fused Kidneys.- 4 Malformative Uropathies.- 4.1 Multicystic Dysplasia.- 4.1.1 Pseudotumoral form.- 4.1.2 Hypoplastic Forms.- 4.2 Hydronephrosis.- 4.2.1 Moderate Hydronephrosis.- 4.2.2 More Significant Hydronephrosis.- 4.2.3 Severe Hydronephrosis.- 4.2.4 The Differential Diagnosis.- 4.3 Ureterohydronephrosis.- 4.4 Bladder Outlet Obstruction.- 4.4.1 The Bladder.- 4.4.2 The Consequences of Bladder Outlet Obstruction on the Upper Urinary Tract.- 4.4.3 Possible Etiologies.- 4.5 Duplication of the Excretory Tract.- References.- 9. Ultrasound in Pediatric Nephrology.- 1 Introduction.- 2 Technical Considerations and Normal Anatomy.- 3 Acute Renal Failure.- 3.1 Hemolytic-Uremic Syndrome (HUS).- 3.2 Renal Vein Thrombosis (RVT).- 3.3 Shock Kidneys (9 cases).- 3.4 Acute Tubulonephritis.- 3.5 Acute Glomerulonephritis (AGN) (44 cases) and Nephrotic Syndrome (NS) (57 cases).- 3.6 Renal Agenesis (Potter Syndrome).- 3.7 Urinary Obstruction.- 4 Chronic Renal Failure.- 4.1 Renal Hypoplasia (68 cases).- 4.2 End-Stage Kidneys.- 4.3 Glomerular Diseases.- 4.4 Chronic Pyelonephritis.- 4.5 Cystic Hereditary Diseases.- 4.5.1 Recessive Polycystic Kidneys (RPK).- 4.5.2 Dominant Polycystic Kidneys.- 4.5.3 Hereditary Syndromes with Renal Cysts.- 4.5.4 Juvenile Nephronophtisis.- 4.5.5 Unclassified Hereditary Cystic Disease.- 4.6 Miscellaneous Conditions.- 4.6.1 Renal Artery Thrombosis.- 4.6.2 Nephrocalcinosis.- 4.6.3 Nephromegalies.- 4.6.4 Cystinosis (8 cases).- 4.6.5 Corticomedullary and Perimedullary Dotted Line.- 4.6.6 Transient Anuria in the Newborn.- 4.6.7 Acute Bacterial Focal Nephritis (3 cases).- 4.6.8 Kidney Transplant.- References.- 10. Retroperitoneal Tumors.- 1 Material.- 2 Technical Aspects.- 3 Malignant Tumors.- 3.1 Wilms’ Tumor.- 3.1.1 Bilateral Wilms’ Tumors (12 cases).- 3.1.2 Nephroblastomatosis (6 cases).- 3.2 Neuroblastoma.- 3.3 Other Malignant Renal Tumors.- 3.4 Other Malignant Extrarenal Tumors.- 4 Benign Tumors.- 4.1 Tumors of the Kidney.- 4.2 Extrarenal Tumors.- 5 Differential Diagnosis.- References.- 11. Pelvic Echography.- 1 Technique.- 2 Normal Echographic Anatomy.- 3 Sexual Ambiguities.- 4 Precocious Puberty.- 5 Delayed Puberty.- 6 Menstrual Problems.- 6.1 Primary Amenorrhea.- 6.2 Secondary Amenorrhea.- 6.3 Stein-Leventhal Syndrome.- 6.4 Endometriosis.- 7 Pelvic Masses.- 7.1 Pelvic Neonatal Masses.- 7.2 Pelvic Masses Outside the Neonatal Period.- 8 Congenital Malformations.- References.- 12. Ultrasound of the Scrotum.- 1 Technique.- 2 Material.- 3 Comments.- References.- 13. Ultrasound of the Spine.- 1 Technical Aspects.- 2 Results.- References.