Purpose. To check whether primary involvement of brain/spinal cord by bone/soft tissue sarcomas' metastases in children is as rare as described and to present various morphological forms of bone/soft tissue sarcomas' CNS metastases. Methods. Patients with first diagnosis in 1999–2014 treated at single center were included with whole course of disease evaluation. Brain/spinal canal magnetic resonance imaging (MRI)/computed tomography were performed in cases suspicious for CNS metastases. Extension from skull/vertebral column metastases was excluded. Results. 550 patients were included. MRI revealed CNS metastases in 19 patients (incidence 3.45%), 14 boys, aged 5–22 years. There were 12/250 osteosarcoma cases, 2/200 Ewing's sarcoma, 1/50 chondrosarcoma, 3/49 rhabdomyosarcoma (RMS), and 1/1 malignant mesenchymoma. There were 10 single metastases and 7 cases of multiple ones; in 2 RMS cases only leptomeningeal spread in brain and spinal cord was found. Calcified metastases were found in 3 patients and hemorrhagic in 4. In one RMS patient there were numerous solid, cystic, hemorrhagic lesions and leptomeningeal spread. Conclusions. CNS metastases are rare and late in children with bone/soft tissue sarcomas, although in our material more frequent (3.45%) than in other reports (0.7%). Hematogenous spread to brain and hemorrhagic and calcified lesions dominated in osteosarcoma. Ewing sarcoma tended to metastasize to skull bones. Soft tissue sarcomas presented various morphological forms.

Congenital tumors form a unique group among pediatric neoplasms. They are different from other tumor groups in this population not only due to the onset time but also to their histopathology, anatomic location, biologic behavior and prognosis. The development of fetal MRI allowed early diagnosis of these tumors. Three fetuses with congenital central nervous system (CNS) tumors were diagnosed prenatally and confirmed with histopathology. Prenatal ultrasonography (US) and magnetic resonance imaging (MRI) were performed. After birth MRI or computed tomography (CT) were carried out. In one case a large intra-axial brain tumor was diagnosed with solid, cystic and hemorrhagic elements. After surgery the tumor turned out to be choroid plexus carcinoma. In the second case craniopharyngioma arising from the suprasellar region was diagnosed on the basis of prenatal MRI and confirmed. In the third case extra-axial meningioma-like tumor was visualized on fetal MRI. After surgery it turned out to be desmoplastic infantile astrocytoma. Intracranial teratoma, the most typical CNS congenital tumor, was not diagnosed in our material. Our cases were rarely encountered neoplasms: choroid plexus carcinoma, craniopharyngioma and desmoplastic infantile astrocytoma. The examinations were repeated after birth and did not add significant information. In utero diagnostics is easier and safer than postnatal imaging of the sick baby that may require life-support equipment, and provides information of equal value.

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SummaryMiliary brain metastases are very rarely described in the literature but if they are, they are quite obvious on magnetic resonance imaging (MRI) and enhance after intravenous administration of the contrast medium. The authors presented a case of miliary metastatic spread to the brain which was invisible on computed tomography and hardly visible on MRI, i.e. as countless, tiny, slightly T1-hyperintense foci that did not enhance. The authors discussed a few T1-hyperintense brain lesions which did not include metastases (except for metastatic melanoma which was a radiological suggestion after brain MRI). Autopsy revealed papillary adenocarcinoma of the lung with numerous metastatic lesions in both cerebral and cerebellar hemispheres and the meninges.

Background. The use of a specialized MR-compatible incubator (INC) is very poorly described in the literature and only with regard to brain imaging. Objectives. To present our own experience with brain and body magnetic resonance imaging (MRI) in the INC in a large cohort of neonates. Material and methods. A total of 555 examinations were performed in 530 newborns with the use of a 1.5T system and Nomag IC 1.5 incubator, equipped with head and body coils. Results. More than half of neonates (54%) were prematurely born at 22 + 6-36 + 6 gestational weeks. They were examined from the first to 153 days of life (median: 18.5, mean: 37.7) with body weights 600-5000 g (mean: 3051 g), 23% of less than 2500 g. The proportion of brain MRIs to other body regions was 533:85 = 86%:14%. In 36.6% of cases, MRI showed more abnormalities than ultrasound (USG), in a further 21.8%, MRI diagnosis was completely different, in 4.7%, a pathology described on a USG was ruled out on MRI. The superiority of MRI over USG was 63. 1%. Conclusions. MR-compatible incubator significantly increased the availability of MRI to newborns, especially to premature and unstable newborns. The integration of body coils into the INC increased the spectrum of examinations and made possible the scanning not only of the brain but also the body. Dedicated neonatal coils improved image quality and allowed more accurate diagnosis than the previously used adult coils. Immobilization of the babies in the INC by means of Velcro belts and head fixation inserts is better than in adult coils. The closed space of the INC isolates newborns to a greater extent from the negative influence of noise in the MR environment.