Head and neck malignancy is rare in children. However, distinguishing malignant tumours from the more common and numerous benign causes of neck masses in childhood is crucial as many malignant conditions have an excellent prognosis with appropriate oncological management. Ultrasound, computed tomography and magnetic resonance imaging all have crucial roles in the diagnosis of head and neck malignancy in children and there is an emerging role for positron emission tomography, particularly in the management and follow-up of lymphoma. We describe the imaging appearances of the common malignant tumours arising in the extracranial head and neck in children, focusing on lymphoma, rhabdomyosarcoma and nasopharyngeal carcinoma. The clinical presentation and radiological appearances of benign tumours in the head and neck in children may overlap with those seen in malignant disease. We describe the imaging appearances of juvenile angiofibroma, vascular abnormalities involving the extracranial head and neck and cervical teratomas. Advances in both imaging techniques and cancer staging systems, many of the latter aimed at avoiding over-treatment and treatment-related complications, will lead to an increasingly central role for imaging in childhood head and neck cancer.
Improvements in imaging technology allow exploitation of the dual blood supply of the liver to aid in the identification and characterisation of both malignant and benign liver lesions. Imaging techniques available include contrast enhanced ultrasound, computed tomography and magnetic resonance imaging. This review discusses the application of several imaging techniques in the diagnosis and staging of both hepatocellular carcinoma and cholangiocarcinoma and outlines certain characteristics of benign liver lesions. The advantages of each imaging technique are highlighted, while underscoring the potential pitfalls and limitations of each imaging modality.
ABSTRACT. Idiopathic pulmonary fibrosis (IPF) has a more variable clinical course than has been traditionally recognised. Many patients will remain stable over time while others experience relatively rapid deterioration. The prognosis and clinical course of patients with other fibrosing lung diseases is also variable. A number of conditions may complicate the clinical course of the idiopathic fibrosing lung diseases, which results in morbidity and mortality, but also represents potentially treatable causes of worsening symptoms. Infection and malignancy have a long-recognised association with IPF while other conditions, particularly pulmonary hypertension and acute exacerbation of IPF, are being increasingly recognised in this patient population. Many of these patients have serial high-resolution CT (HRCT) examinations that may demonstrate one or more of these supervening conditions. In this article we review the more common conditions that may complicate the course of idiopathic fibrosing lung disease with an emphasis on the HRCT appearance, which the reporting radiologist should be aware of.
ObjectiveThe variation in the anatomy of the iliopsoas tendon is important information for orthopaedic surgeons operating around the hip. The aim of this study was to identify the prevalence of bifid iliopsoas tendons in children on magnetic resonance imaging (MRI).MethodsMRI hip and pelvis images of 50 sequential children aged 7–15 years were retrieved from our radiology database at the Evelina London Children’s Hospital from 2007 to 2013. Included were 37 children with imaging of both hips and 13 children with imaging of one hip only. Therefore, our study was based on a total of 87 hips.ResultsAt least 1 bifid tendon was noted in 13 children (26 %). Five children from a total of 37 (14 %) with both hips adequately imaged had bilateral bifid tendons. Among all 87 adequately imaged hips, 18 (21 %) were found to have two discrete distal iliopsoas tendons.ConclusionsBifid iliopsoas tendon is noted anecdotally by surgeons but was only reported in scattered case reports and a few anatomical studies until very recently. Our finding is that a bifid iliopsoas tendon with two distinct tendinous components at the level of the hip joint is quite common. This has clinical significance, particularly in children’s orthopaedic surgery when an adequate iliopsoas release is important.
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