Seventeen lymphangiomas in 15 patients were imaged with magnetic resonance (MR) to define the nature, extent, and anatomic relationships of these lesions. The MR and pathologic findings were then compared to determine the histologic basis for the signal-intensity characteristics of these lesions. The signal intensity of 13 lesions was similar to or slightly less than that of muscle on T1-weighted images and greater than that of fat on T2-weighted images. This appearance correlated with the presence of ectatic lymphatic channels containing clear fluid on histologic section. Four lymphangiomas had high signal intensity, approximately equal to that of fat, on T1-weighted images, reflecting the presence of clotted blood or small cystic spaces with a higher ratio of fat to fluid. Sixteen of 17 lesions had visible septations on MR images. The authors' experience suggests that most lymphangiomas have a characteristic appearance on MR images. The information obtained with MR imaging can help in providing a preoperative diagnosis, in planning surgical resection, and in defining recurrence.

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An intramedullary linear echo is frequently visible on real-time intraoperative ultrasound images of the spinal cord. An ultrasonographic-anatomic correlative study of the normal spinal cord of a cadaver demonstrated that these intramedullary reflections correspond to the central canal. Twenty-one cases of spinal surgery employing ultrasound in an adjunctive role are reviewed. In cases of intramedullary lesions this echo is absent or disrupted in the scanning plane of the mass, but it is preserved when the process is extramedullary.

Moderate or severe hypertension occurs in a small percentage of hypertensive children, but it is within this group that the surgically correctable causes of hypertension are found. Since cure rates up to 90% have been reported, it is important to diagnose a secondary cause of hypertension. Excretory urography is recommended to screen for renovascular hypertension and renal parenchymal disease. Renal scintigraphy can be substituted for the urogram, but the anatomical resolution is poorer. If renovascular hypertension is suggested by abnormal results of screening examination, arteriography should be part of the evaluation. Ultrasonography is reserved primarily for evaluating neonatal hypertension which most frequently is related to thrombosis. If this diagnosis is documented, renal function should be assessed with radionuclide techniques. If a hormonally active tumor is suspected, evaluation of the adrenals and retroperitoneum is accomplished best by CT.