We know that many cerebral lesions are of circulatory origin and it is now important to study cerebral hemodynamics by pulsed and color Doppler ultrasonography. The revolution in the imaging of vascular physiology, the diagnosis, and the prognostic evaluation of vascular disease are not based on morphological sonographic studies but on the Doppler techniques that can display cerebral vessels in the neonate. The results of the hemodynamic investigation in 491 newborns aged from 32 weeks of gestation to 9 months by means of pulsed and color Doppler are reported. Normal values of the resistive index, peak systolic, end-diastolic, and time-averaged velocities in seven different vessels are determined. Some pathological examples are presented. Doppler techniques play a major role in the diagnosis, follow-up, and management of brain damage, whether ischemo-hemorrhagic, infectious, or developmental or tumoral, and of pericerebral collections.
To assist the radiologist in differentiating the colitis in children, this review proposes a systematic US approach to the disease, presents the US aspect of the normal colon and describes three distinctive US patterns reflecting the intramural extension of the histopathological changes. Each pattern corresponds to one or several diseases producing alterations in the same layer(s). Stratified thickening suggests an inflammatory mucosal process resulting from infection (as in advanced appendicitis or in infectious colitis) or to inflammation (as in IBD). Nonstratified thickening with loss of the haustral folds reflects a marked submucosal infiltrate. Color Doppler is required to distinguish between an inflammatory disease (as advanced CD or neutropenic colitis) and an ischemic colitis (HUS in children). Nonstratified thickening with preservation of the length of the haustral folds is the sign of an intraluminal deposit due to PMC. Correlating the sonographic pattern and the anatomic distribution of the disease with the clinical and laboratory findings often permits to propose a specific diagnosis.
Neonatal sonography seems to be sufficient to identify this specific clinical entity without any additional work-up. This sonographic sign could help determine the therapeutic strategy earlier in this severe and complex form of DDH.
Fetal diastematomyelia, a malformation due to a longitudinal split of the cord, was diagnosed during the third trimester. Diagnosis was based on the visualization of a sagittal bony spur in the thoracolumbar spinal canal, associated with enlargement of the canal, hemivertebrae and spina bifida without a meningocele.
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