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    There are 15 cases available...

    Go to the top of the page   ID: 20080522125523 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Lissencephaly Type 1
    Johannes Gossner, J Larsen. Lissencephaly Type 1. PedRad [serial online] vol 8, no. 5.
    URL: www.PedRad.info/?search=20080522125523


     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Johannes Gossner (Institut für Radiologie/ Klinkum Braunschweig), J. Larsen (Institut für Radiologie/ Klinikum Braunschweig)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    0 Newborn  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    Head-Brain and brain nerves  

     
     Pediatric Radiology CasesMost likely etiology:

    congenital  

     
     Pediatric Radiology CasesHistory:

    Postpartum hypotrophic and respiratory distressed newborn (intubation required) with rapidly evolving seizures.
    Sonographically decreased sulcal pattern.
    Sibling with known lissencephaly type 1.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Most severe form of neuronal migration disorders (probably in 12th-16th gestational week). Current classification dpendent on when the cortical development was affected. The type 1 lissencephaly belongs to group A. In the setting of a Miller-Diecke syndrome, a monosomy 17p13 can be found, which is mostly a "de Novo" deletion or translocation.
    Without visualized chromosomal abnormality it can be found as an isolated lissencephaly or in the setting of a Norman-Roberts syndrome.
    However, even without visualized chromosomal abnormalities, in up to 40% of cases.a defect of the LIS 1 gene can be found, which regulates the neural migration by forming PAF (platelet activating factor).  

     
     Pediatric Radiology CasesRadiological findings:


    MRI 1 <- view MRI 1

    MRI 1: T2 weighted axial image with markedly decreased sulcal pattern (= pachygyria) and thin cortex. Furthermore seen is a hemorrhage into the right lateral ventricle (hypointense).



    MRI 2 <- view MRI 2

    MRI 2: T1 weighted axial image demonstrates also significant pachygyria and prominent external CSF spaces. The fluid-fluid level containing hemorrhage in the posterior horns of the right lateral ventricle is better deliniated on the T1 weighted sequence.



    MRI 3 <- view MRI 3

    MRI 3: T2 weighted axial image at the level of the basal ganglia, which appear normal.



    MRI 4 <- view MRI 4

    MRI 4: Coronal CSF suppressed T2 weighted sequence (FLAIR) also demonstrates a markedly decreased sulcal pattern.


     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Total constellation (Consens)  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    N/A  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Overall poor prognosis with marked mental retardation and early, partially therpy refractary seizures. Usually the children die before they reach the second year of life. Associated malformations are frequent.
    Lissencephaly is a rare malformation. A study from the Netherlands reports 11.7 cases in 1 million newborns. Girls are slightly more frequently affected.
    The cortical surface is smooth up to the 2nd trimester. First sulci and fissures can be detected by ultrasound in the 20th gestational week. Widening of the ventricles is described to be an indirect sign of a neuronal migration disorder. If this is evident, a follow up exam and/or MRI is recommended. Image findings by MRI is indicatory.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    Miller 1963  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    Barkovich AJ, Kuzniecky RI, Jackson GD, Guerrinen R, Dobyns WB
    Classification system for malformations of cortical development: update 2001
    Neurology 2001; 57:2168- 2178

    2. Medline: Medline
    Ghai S, Fong KW, Toi A, Chitayat A, Pantazi S, Blaser S
    Prenatal US and MR imaging findings of Lissencephaly: review of fetal cerebral sulcal development
    Radiographics 2006; 26: 389- 405

    3. Medline: Medline
    Gressens P
    Mechanisms and Disturbances of Neuronal Migration
    Pediatric Research 2000; 48: 725-730

    4. Medline: Medline
    de Rijk-van Andel JF, Arts WFM, Hofman A, Staal A, Niermeijer MF
    Epidemiology of Lissencephaly Type I.
    Neuroepidemiology 1991;10:200-204
     

     
     Pediatric Radiology CasesKeywords:

    Lissencephaly, neuronal migration disorder, Pachygyria, Agyria, Lissencephaly type I, Miller-Dieker syndrome, Chromosome 17p13 syndrome, Chromosomal deletion 17p13, Norman-Roberts syndrome  

     
     Pediatric Radiology Cases Cite this article:

    Johannes Gossner, J Larsen. Lissencephaly Type 1. PedRad [serial online] vol 8, no. 5.
    URL: www.PedRad.info/?search=20080522125523  

     
     Pediatric Radiology Cases Read similar articles: Norman-Roberts syndrome&type=1-17">corresponding keywords
    in the same field: Head-Brain and brain nerves
    or in the region: Head
    or in the tissue/organ: Brain and brain nerves
    or with the etiology: congenital
     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Lissencephaly Type 1
    Johannes Gossner, J Larsen. Lissencephaly Type 1. PedRad [serial online] vol 8, no. 5.
    URL: www.PedRad.info/?search=20080522125523


     

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    Lissencephaly Type 1
    Other cases by these authors:

    Search Johannes Gossner in Medline Johannes Gossner (2)   
    Search J. Larsen in Medline J. Larsen (1)   

    Lissencephaly Type 1  
     
    Lissencephaly Type 1
    Johannes Gossner, J Larsen. Lissencephaly Type 1. PedRad [serial online] vol 8, no. 5.
    URL: www.PedRad.info/?search=20080522125523


     
     
    Lissencephaly Type 1
    Johannes Gossner, J Larsen. Lissencephaly Type 1. PedRad [serial online] vol 8, no. 5.
    URL: www.PedRad.info/?search=20080522125523


     

    Medical Dictionary
    Search in medical dictionary for
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    1 = less interesting)
     
    Lissencephaly Type 1
    Johannes Gossner, J Larsen. Lissencephaly Type 1. PedRad [serial online] vol 8, no. 5.
    URL: www.PedRad.info/?search=20080522125523


     


    Go to the top of the page   ID: 20060322175555 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Primary sclerosing cholangitis (PSC)
    A Nordwig, N Lorenz, B Biereder, T Haufe, M Kabus. Primary sclerosing cholangitis (PSC). PedRad [serial online] vol 6, no. 3.
    URL: www.PedRad.info/?search=20060322175555


     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are Ultrasound-images available for this case. [ Ultrasound ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    A. Nordwig, N. Lorenz, B. Biereder, T. Haufe, M. Kabus (Städtisches Krankenhaus Dresden-Neustadt-Deutschland)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    15 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    - 15 year old boy, clinically and neurologically unremarkable
    - 03/2005 Diagnosis of rohn's disease, therapy: Azathioprin, Mesalazin
    - 11/2005 generalised pruritus, mild scleric icterus
    - Labs: Leukocytes 4,1 Gpt/l, Thrombocytes 152 Gpt/l, ASAT 2,28 µmol/s*l, ALAT 3,11 µmol/s*l, Gamma-GT 4,11 µmol/s*l, Bilirubin gesamt 40 µmol/l, Bilirubin direct 17 µmol/l, Bile acides 418 µmol/l , BSG, Alpha1-Glycoprotein, AP, Coagulation, Albumin, Protein electrophoresis, Cholinesterase, Ammonia, Alpha1-Antitrypsin, Iron, Ferritin, Copper, Coeruloplasmin within normal limits.
    - Autoantibody screening: pANCA positive, ANA, AMA, SMA, LKM, PBCNA, LC1 negative.
     

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    PSC is associated in 87% with Ulcerative colitis and in 13% with Crohn's disease and precedes the cIBD (chronic inflammatory bowel disease) symptoms in 50% (Wilschanski M et al, 1995). The pathogenesis of the chronic inflammation of the bile ducts is not clear. Discussed are chronische portal bacterimia, toxic bile metabolites from the intestinal flora, ischemic vascular factors and autoimmun processes which lead to an inflammation and scarring with stenosis of the bile ducts. Affected are initially in most cases small intrahepatic and later on also extrahepatic bile ducts.  

     
     Pediatric Radiology CasesRadiological findings:


    MRI 1 <- view MRI 1

    MRI 1: T2 weighted axial image with markedly decreased sulcal pattern (= pachygyria) and thin cortex. Furthermore seen is a hemorrhage into the right lateral ventricle (hypointense).



    MRI 2 <- view MRI 2

    MRI 2: T1 weighted axial image demonstrates also significant pachygyria and prominent external CSF spaces. The fluid-fluid level containing hemorrhage in the posterior horns of the right lateral ventricle is better deliniated on the T1 weighted sequence.



    MRI 3 <- view MRI 3

    MRI 3: T2 weighted axial image at the level of the basal ganglia, which appear normal.



    MRI 4 <- view MRI 4

    MRI 4: Coronal CSF suppressed T2 weighted sequence (FLAIR) also demonstrates a markedly decreased sulcal pattern.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Increased liver echogenicity; Bile ducts partially up to the periphery irregularly dilated.



    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Minimal distended gallbladder with significant wall thickening and shadowing.



    MRI 1 <- view MRI 1

    MRI 1: MRCP: No dilatation of the intra- and extrahepatic bile ducts. Slightly irregularity of the walls of the Ductus choledochus. No changes in caliber of the intrahepatic bile ducts.





    X-Ray 1 <- view X-Ray 1

    X-Ray 1: ERCP: Rarefication of the intrahepatic bile ducts with multiple stenoses of different lenght especially in the right liver lobe. Extrahepatic bile ducts are not significantly dilated, Ductus cysticus serpentinuous.



     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Drug induced hepatopathy (Azathioprin), autoimmunehepatitis, primary biliary cirrhosis.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    PSC leads often to liver transplantation. Feared is PSC within the transplanted organ. Course and grade of PSC are independent of the activity of cIBD. Therapy of choice is ursodesoxycholic acid with a positive, but only transient effect on the symptoms and lab results (Feldstein AE et al, 2003). There is no proven influence on mortality or liver transplant rate by ursodesoxycholic acid (Breuers U et al, 1992). Very high doses of ursodesoxycholic acid improve possible the log time survival in a PSC patient (40 mg/kg KG). The early endoscopic dilatation of stenotic bile ducts and eventual stent implant is effective in addition to drug therapy (Stiehl A et al, 2002).  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Primary sclerosing cholangitis, PSC, Crohn, liver disease, Crohn's disease, generalised pruritus, icterus, scleric icterus  

     
     Pediatric Radiology Cases Cite this article:

    A Nordwig, N Lorenz, B Biereder, T Haufe, M Kabus. Primary sclerosing cholangitis (PSC). PedRad [serial online] vol 6, no. 3.
    URL: www.PedRad.info/?search=20060322175555  

     
     Pediatric Radiology Cases Read similar articles: scleric icterus&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are Ultrasound-images available for this case. [ Ultrasound ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Primary sclerosing cholangitis (PSC)
    A Nordwig, N Lorenz, B Biereder, T Haufe, M Kabus. Primary sclerosing cholangitis (PSC). PedRad [serial online] vol 6, no. 3.
    URL: www.PedRad.info/?search=20060322175555


     

    Search similar cases in:
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    Peer-reviewed Radiology Search



    Primary sclerosing cholangitis (PSC)
    Other cases by these authors:

    Search Johannes Gossner in Medline Johannes Gossner (2)   
    Search J. Larsen in Medline J. Larsen (1)   
    Search A. Nordwig in Medline A. Nordwig (20)   
    Search N. Lorenz in Medline N. Lorenz (1)   
    Search B. Biereder in Medline B. Biereder (1)   
    Search T. Haufe in Medline T. Haufe (4)   
    Search M. Kabus in Medline M. Kabus (1)   

    Primary sclerosing cholangitis (PSC)  
     
    Primary sclerosing cholangitis (PSC)
    A Nordwig, N Lorenz, B Biereder, T Haufe, M Kabus. Primary sclerosing cholangitis (PSC). PedRad [serial online] vol 6, no. 3.
    URL: www.PedRad.info/?search=20060322175555


     

    Which diagnosis have other collegues guessed?


    • Primary sclerosing cholangitis
      Votes: 16 (88 %)


    • Caroli syndrome
      Votes: 1 (5 %)


    • Obstructing concrement in the ductus choledochus
      Votes: 0 (0 %)


    • Hepatitis
      Votes: 0 (0 %)


    • Liver cirrhosis
      Votes: 1 (5 %)



        Total answers: 18

     
    Primary sclerosing cholangitis (PSC)
    A Nordwig, N Lorenz, B Biereder, T Haufe, M Kabus. Primary sclerosing cholangitis (PSC). PedRad [serial online] vol 6, no. 3.
    URL: www.PedRad.info/?search=20060322175555


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Primary sclerosing cholangitis (PSC)
    A Nordwig, N Lorenz, B Biereder, T Haufe, M Kabus. Primary sclerosing cholangitis (PSC). PedRad [serial online] vol 6, no. 3.
    URL: www.PedRad.info/?search=20060322175555


     


    Go to the top of the page   ID: 20041222171655 Original case in english  More links about this topic on Pubmed (PubMed Reader)
    Add this case to your RSS feeder: Subscribe to RSS feed Add to Yahoo Add to Google Add to AOL Add to Furl Subscribe to Feed Burner feed

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    Discussion
     
    Hepatoblastoma
    G Hahn. Hepatoblastoma. PedRad [serial online] vol 4, no. 12.
    URL: www.PedRad.info/?search=20041222171655


     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    G. Hahn (Bereich Kinderradiologie/Uniklinikum Dresden/Deutschland)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    6 Months  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    In a routine sonographical examination in a child with previously known Beckwith-Wiedemann Syndrome, a large tumor of the liver was found. Proof of slight scleral jaundice. Markedly increased alpha-fetoprotein in the blood.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Hepatoblastomas is a malignant embryonal mixed tumor, which derives from epithelial and/or mesechymal cellular elements. It occurs in early childhood.
    In Beckwith-Wiedemann Syndrome, one findes more commonly nephroblastomas and hepatoblastomas.
    In increased alpha-fetoprotein in the blood and proof of a typical hepatic tumor in MRI, the diagnosis is relatively easy and there is no histological proof needed before starting chemotherapy.  

     
     Pediatric Radiology CasesRadiological findings:


    MRI 1 <- view MRI 1

    MRI 1: T2 weighted axial image with markedly decreased sulcal pattern (= pachygyria) and thin cortex. Furthermore seen is a hemorrhage into the right lateral ventricle (hypointense).



    MRI 2 <- view MRI 2

    MRI 2: T1 weighted axial image demonstrates also significant pachygyria and prominent external CSF spaces. The fluid-fluid level containing hemorrhage in the posterior horns of the right lateral ventricle is better deliniated on the T1 weighted sequence.



    MRI 3 <- view MRI 3

    MRI 3: T2 weighted axial image at the level of the basal ganglia, which appear normal.



    MRI 4 <- view MRI 4

    MRI 4: Coronal CSF suppressed T2 weighted sequence (FLAIR) also demonstrates a markedly decreased sulcal pattern.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Increased liver echogenicity; Bile ducts partially up to the periphery irregularly dilated.



    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Minimal distended gallbladder with significant wall thickening and shadowing.



    MRI 1 <- view MRI 1

    MRI 1: MRCP: No dilatation of the intra- and extrahepatic bile ducts. Slightly irregularity of the walls of the Ductus choledochus. No changes in caliber of the intrahepatic bile ducts.





    X-Ray 1 <- view X-Ray 1

    X-Ray 1: ERCP: Rarefication of the intrahepatic bile ducts with multiple stenoses of different lenght especially in the right liver lobe. Extrahepatic bile ducts are not significantly dilated, Ductus cysticus serpentinuous.




    MRI 1 <- view MRI 1

    MRI 1: T2 transverse: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe. The vena portae is considerably compressed ventrally and is pushed to the left, as is the pancreas. The gall bladder is no longer demarcated.
    The right kidney is compressed from above and thus has moved caudally. The vena cava's lumen is reduced to a slit due to compression in the region of the tumor.




    MRI 2 <- view MRI 2

    MRI 2: T2 coronal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.




    MRI 3 <- view MRI 3

    MRI 3: T1 transversal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.The right kidney is compressed from above and thus has moved caudally.




    MRI 4 <- view MRI 4

    MRI 4: T1 sagittal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 5 <- view MRI 5

    MRI 5: T1 coronar, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 6 <- view MRI 6

    MRI 6: T1 transversal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.



     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Hepatocellular carcinoma, in childhood rare.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    In good size reduction through chemotherapy and following complete surgical resection, the prognosis is very good.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Beckwith-Wiedemann Syndrome, Hepatoblastoma, malignant embryonal mixed tumor  

     
     Pediatric Radiology Cases Cite this article:

    G Hahn. Hepatoblastoma. PedRad [serial online] vol 4, no. 12.
    URL: www.PedRad.info/?search=20041222171655  

     
     Pediatric Radiology Cases Read similar articles: malignant embryonal mixed tumor&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Hepatoblastoma
    G Hahn. Hepatoblastoma. PedRad [serial online] vol 4, no. 12.
    URL: www.PedRad.info/?search=20041222171655


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Hepatoblastoma
    Other cases by these authors:

    Search Johannes Gossner in Medline Johannes Gossner (2)   
    Search J. Larsen in Medline J. Larsen (1)   
    Search A. Nordwig in Medline A. Nordwig (20)   
    Search N. Lorenz in Medline N. Lorenz (1)   
    Search B. Biereder in Medline B. Biereder (1)   
    Search T. Haufe in Medline T. Haufe (4)   
    Search M. Kabus in Medline M. Kabus (1)   
    Search G. Hahn in Medline G. Hahn (38)   

    Hepatoblastoma  
     
    Hepatoblastoma
    G Hahn. Hepatoblastoma. PedRad [serial online] vol 4, no. 12.
    URL: www.PedRad.info/?search=20041222171655


     

    Which diagnosis have other collegues guessed?


    • Primary sclerosing cholangitis
      Votes: 16 (88 %)


    • Caroli syndrome
      Votes: 1 (5 %)


    • Obstructing concrement in the ductus choledochus
      Votes: 0 (0 %)


    • Hepatitis
      Votes: 0 (0 %)


    • Liver cirrhosis
      Votes: 1 (5 %)


    • Liver cirrhosis
      Votes: 0 (0 %)


    • Hepatocellular carcinoma
      Votes: 0 (0 %)


    • Hepatoblastoma
      Votes: 13 (40 %)


    • Follicular nodular hyperplasia
      Votes: 1 (3 %)


    • Hemangioma
      Votes: 0 (0 %)



        Total answers: 32

     
    Hepatoblastoma
    G Hahn. Hepatoblastoma. PedRad [serial online] vol 4, no. 12.
    URL: www.PedRad.info/?search=20041222171655


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Hepatoblastoma
    G Hahn. Hepatoblastoma. PedRad [serial online] vol 4, no. 12.
    URL: www.PedRad.info/?search=20041222171655


     


    Go to the top of the page   ID: 20040507125455 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Connatal Cytomegaly
    D Weber, Wolfgang Hirsch. Connatal Cytomegaly. PedRad [serial online] vol 4, no. 5.
    URL: www.PedRad.info/?search=20040507125455


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    D. Weber, Wolfgang Hirsch (Universität Leipzig)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    0 Months  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    Hypoplastic newborn, 37th +5 week,
    prenatal ventriculomegaly and plexus cysts bilateral found  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    - Virus infection (aerosol/droplet infection)
    - Transmission: diaplacental
    - Primary infections during the pregnancy have more often organ defects as sequelae than reactivations or reinfections
    - Virus multiplication results in lymphocytary-plasmacellulary interstitial inflammation  

     
     Pediatric Radiology CasesRadiological findings:


    MRI 1 <- view MRI 1

    MRI 1: T2 weighted axial image with markedly decreased sulcal pattern (= pachygyria) and thin cortex. Furthermore seen is a hemorrhage into the right lateral ventricle (hypointense).



    MRI 2 <- view MRI 2

    MRI 2: T1 weighted axial image demonstrates also significant pachygyria and prominent external CSF spaces. The fluid-fluid level containing hemorrhage in the posterior horns of the right lateral ventricle is better deliniated on the T1 weighted sequence.



    MRI 3 <- view MRI 3

    MRI 3: T2 weighted axial image at the level of the basal ganglia, which appear normal.



    MRI 4 <- view MRI 4

    MRI 4: Coronal CSF suppressed T2 weighted sequence (FLAIR) also demonstrates a markedly decreased sulcal pattern.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Increased liver echogenicity; Bile ducts partially up to the periphery irregularly dilated.



    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Minimal distended gallbladder with significant wall thickening and shadowing.



    MRI 1 <- view MRI 1

    MRI 1: MRCP: No dilatation of the intra- and extrahepatic bile ducts. Slightly irregularity of the walls of the Ductus choledochus. No changes in caliber of the intrahepatic bile ducts.





    X-Ray 1 <- view X-Ray 1

    X-Ray 1: ERCP: Rarefication of the intrahepatic bile ducts with multiple stenoses of different lenght especially in the right liver lobe. Extrahepatic bile ducts are not significantly dilated, Ductus cysticus serpentinuous.




    MRI 1 <- view MRI 1

    MRI 1: T2 transverse: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe. The vena portae is considerably compressed ventrally and is pushed to the left, as is the pancreas. The gall bladder is no longer demarcated.
    The right kidney is compressed from above and thus has moved caudally. The vena cava's lumen is reduced to a slit due to compression in the region of the tumor.




    MRI 2 <- view MRI 2

    MRI 2: T2 coronal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.




    MRI 3 <- view MRI 3

    MRI 3: T1 transversal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.The right kidney is compressed from above and thus has moved caudally.




    MRI 4 <- view MRI 4

    MRI 4: T1 sagittal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 5 <- view MRI 5

    MRI 5: T1 coronar, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 6 <- view MRI 6

    MRI 6: T1 transversal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronary slice: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles (Arrow). Pronounced lateral ventricles with preserved angulation bilat. and slight asymmetry to the left.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Subependymal, cystic structures bilat. left larger than right in the nucleothalamic groove of the lateral ventricles as sequel of a subependymal cerebral hemorrhage I°.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Coronary slice: Subependymal, cystic structures bilat. left larger than right in the lateral ventricles. Multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    other connatal infections like, Toxoplasmosis, Rubella  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    - classic Cytomegaly syndrom with microcephalus, chorioretinitis, periventricular calcifications,
    severe psychomotoric retardation are rare
    - later sequelae after intruterine infection: deafness, motoric impairment, retarded development of speech  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Cytomegaly, Connatal infection, Hydrocephalus, Cerebral hemorrhage, Connatal cytomegaly  

     
     Pediatric Radiology Cases Cite this article:

    D Weber, Wolfgang Hirsch. Connatal Cytomegaly. PedRad [serial online] vol 4, no. 5.
    URL: www.PedRad.info/?search=20040507125455  

     
     Pediatric Radiology Cases Read similar articles: Connatal cytomegaly&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     
    Connatal Cytomegaly
    D Weber, Wolfgang Hirsch. Connatal Cytomegaly. PedRad [serial online] vol 4, no. 5.
    URL: www.PedRad.info/?search=20040507125455


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

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    Connatal Cytomegaly
    Other cases by these authors:

    Search Johannes Gossner in Medline Johannes Gossner (2)   
    Search J. Larsen in Medline J. Larsen (1)   
    Search A. Nordwig in Medline A. Nordwig (20)   
    Search N. Lorenz in Medline N. Lorenz (1)   
    Search B. Biereder in Medline B. Biereder (1)   
    Search T. Haufe in Medline T. Haufe (4)   
    Search M. Kabus in Medline M. Kabus (1)   
    Search G. Hahn in Medline G. Hahn (38)   
    Search D. Weber in Medline D. Weber (20)   
    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   

    Connatal Cytomegaly  
     
    Connatal Cytomegaly
    D Weber, Wolfgang Hirsch. Connatal Cytomegaly. PedRad [serial online] vol 4, no. 5.
    URL: www.PedRad.info/?search=20040507125455


     

    Which diagnosis have other collegues guessed?


    • Primary sclerosing cholangitis
      Votes: 16 (88 %)


    • Caroli syndrome
      Votes: 1 (5 %)


    • Obstructing concrement in the ductus choledochus
      Votes: 0 (0 %)


    • Hepatitis
      Votes: 0 (0 %)


    • Liver cirrhosis
      Votes: 1 (5 %)


    • Liver cirrhosis
      Votes: 0 (0 %)


    • Hepatocellular carcinoma
      Votes: 0 (0 %)


    • Hepatoblastoma
      Votes: 13 (40 %)


    • Follicular nodular hyperplasia
      Votes: 1 (3 %)


    • Hemangioma
      Votes: 0 (0 %)



        Total answers: 32

     
    Connatal Cytomegaly
    D Weber, Wolfgang Hirsch. Connatal Cytomegaly. PedRad [serial online] vol 4, no. 5.
    URL: www.PedRad.info/?search=20040507125455


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Connatal Cytomegaly
    D Weber, Wolfgang Hirsch. Connatal Cytomegaly. PedRad [serial online] vol 4, no. 5.
    URL: www.PedRad.info/?search=20040507125455


     


    Go to the top of the page   ID: 20031123165503 Original case in english  More links about this topic on Pubmed (PubMed Reader)
    Add this case to your RSS feeder: Subscribe to RSS feed Add to Yahoo Add to Google Add to AOL Add to Furl Subscribe to Feed Burner feed

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    Discussion
     
    Pheochromocytoma
    Ina Sorge. Pheochromocytoma. PedRad [serial online] vol 3, no. 11.
    URL: www.PedRad.info/?search=20031123165503


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Ina Sorge (Leipzig)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    13 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    13 year old boy, admission due to persisting headaches. Episodes of sweating for 2 months. Paleness and mild loss of weight, occasional palpitations.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    In 90% of the cases, a pheochromocytoma originates in the chromaffinic cells of the medulla of the suprarenal gland (as in our patient). In about 10% of the cases, the origin is the sympathetic trunk.

    In our patient, epinephrine and norepinephrine was increased. Often in pheochromocytomas originating in the sympathetic trunk, only norepinephrine is increased.

    Futher symptoms that were seen in our patient were: hyperglycemia & leucocytosis.

    In young patients, a pheochromocytoma is often the first sign of a MEN-Syndrome (multiple endocrine neoplasia).  

     
     Pediatric Radiology CasesRadiological findings:


    MRI 1 <- view MRI 1

    MRI 1: T2 weighted axial image with markedly decreased sulcal pattern (= pachygyria) and thin cortex. Furthermore seen is a hemorrhage into the right lateral ventricle (hypointense).



    MRI 2 <- view MRI 2

    MRI 2: T1 weighted axial image demonstrates also significant pachygyria and prominent external CSF spaces. The fluid-fluid level containing hemorrhage in the posterior horns of the right lateral ventricle is better deliniated on the T1 weighted sequence.



    MRI 3 <- view MRI 3

    MRI 3: T2 weighted axial image at the level of the basal ganglia, which appear normal.



    MRI 4 <- view MRI 4

    MRI 4: Coronal CSF suppressed T2 weighted sequence (FLAIR) also demonstrates a markedly decreased sulcal pattern.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Increased liver echogenicity; Bile ducts partially up to the periphery irregularly dilated.



    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Minimal distended gallbladder with significant wall thickening and shadowing.



    MRI 1 <- view MRI 1

    MRI 1: MRCP: No dilatation of the intra- and extrahepatic bile ducts. Slightly irregularity of the walls of the Ductus choledochus. No changes in caliber of the intrahepatic bile ducts.





    X-Ray 1 <- view X-Ray 1

    X-Ray 1: ERCP: Rarefication of the intrahepatic bile ducts with multiple stenoses of different lenght especially in the right liver lobe. Extrahepatic bile ducts are not significantly dilated, Ductus cysticus serpentinuous.




    MRI 1 <- view MRI 1

    MRI 1: T2 transverse: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe. The vena portae is considerably compressed ventrally and is pushed to the left, as is the pancreas. The gall bladder is no longer demarcated.
    The right kidney is compressed from above and thus has moved caudally. The vena cava's lumen is reduced to a slit due to compression in the region of the tumor.




    MRI 2 <- view MRI 2

    MRI 2: T2 coronal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.




    MRI 3 <- view MRI 3

    MRI 3: T1 transversal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.The right kidney is compressed from above and thus has moved caudally.




    MRI 4 <- view MRI 4

    MRI 4: T1 sagittal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 5 <- view MRI 5

    MRI 5: T1 coronar, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 6 <- view MRI 6

    MRI 6: T1 transversal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronary slice: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles (Arrow). Pronounced lateral ventricles with preserved angulation bilat. and slight asymmetry to the left.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Subependymal, cystic structures bilat. left larger than right in the nucleothalamic groove of the lateral ventricles as sequel of a subependymal cerebral hemorrhage I°.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Coronary slice: Subependymal, cystic structures bilat. left larger than right in the lateral ventricles. Multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: transversal: relatively homogenously round tumor. Not above, but rather ventromedial to the left kidney (but above the kidney hilus).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: No increased perfusion in the colored doppler ultrasound is seen. This finding is not typical for this diagnosis.




    MRI 1 <- view MRI 1

    MRI 1: T2-weighted, transversal: hyperintense, slightly inhomogenously round tumor, ventromedial to the left kidney (but above the kidney hilus) .




    MRI 2 <- view MRI 2

    MRI 2: T1-weigted without contrast media, sagittal: isointense- (centrally slightly inhomogenously hypointense). Tumor is ventromedial to the left kidney. After contrast media was given, an obvious contrast enhancement was seen (here without picture).

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    neuroblastoma, adrenal carcinoma, neurofibroma  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Surgery needed, good anesthesia is needed (because of the danger of a critical hypertonic crisis). Pre-treatment with alpha-receptor blockers, fluid substitution to normalize the plasma volume.  

     
     Pediatric Radiology CasesComments of the author about the case:

    The shown pheochromocytoma looked homogenous in the ultrasound examination and did not show hyperperfusion. Typically, smaller pheochromocytomas also have the tendency to show necrosis centrally. Hemorrhaging and calcifications (30%) are seen relatively often.  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Pheochromocytoma, Adrenal gland, Sympathetic trunk, hypertonic crisis, headaches, sweating, palpitations, weight loss  

     
     Pediatric Radiology Cases Cite this article:

    Ina Sorge. Pheochromocytoma. PedRad [serial online] vol 3, no. 11.
    URL: www.PedRad.info/?search=20031123165503  

     
     Pediatric Radiology Cases Read similar articles: weight loss&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Pheochromocytoma
    Ina Sorge. Pheochromocytoma. PedRad [serial online] vol 3, no. 11.
    URL: www.PedRad.info/?search=20031123165503


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Pheochromocytoma
    Other cases by these authors:

    Search Johannes Gossner in Medline Johannes Gossner (2)   
    Search J. Larsen in Medline J. Larsen (1)   
    Search A. Nordwig in Medline A. Nordwig (20)   
    Search N. Lorenz in Medline N. Lorenz (1)   
    Search B. Biereder in Medline B. Biereder (1)   
    Search T. Haufe in Medline T. Haufe (4)   
    Search M. Kabus in Medline M. Kabus (1)   
    Search G. Hahn in Medline G. Hahn (38)   
    Search D. Weber in Medline D. Weber (20)   
    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   
    Search Ina Sorge in Medline Ina Sorge (24)   

    Pheochromocytoma  
     
    Pheochromocytoma
    Ina Sorge. Pheochromocytoma. PedRad [serial online] vol 3, no. 11.
    URL: www.PedRad.info/?search=20031123165503


     

    Which diagnosis have other collegues guessed?


    • Primary sclerosing cholangitis
      Votes: 16 (88 %)


    • Caroli syndrome
      Votes: 1 (5 %)


    • Obstructing concrement in the ductus choledochus
      Votes: 0 (0 %)


    • Hepatitis
      Votes: 0 (0 %)


    • Liver cirrhosis
      Votes: 1 (5 %)


    • Liver cirrhosis
      Votes: 0 (0 %)


    • Hepatocellular carcinoma
      Votes: 0 (0 %)


    • Hepatoblastoma
      Votes: 13 (40 %)


    • Follicular nodular hyperplasia
      Votes: 1 (3 %)


    • Hemangioma
      Votes: 0 (0 %)


    • Neuroblastoma
      Votes: 3 (5 %)


    • Ganglioneuroblastoma
      Votes: 2 (3 %)


    • Pheochromozytoma
      Votes: 16 (28 %)


    • Adrenal adenoma
      Votes: 3 (5 %)


    • Neurofibroma
      Votes: 1 (1 %)



        Total answers: 57

     
    Pheochromocytoma
    Ina Sorge. Pheochromocytoma. PedRad [serial online] vol 3, no. 11.
    URL: www.PedRad.info/?search=20031123165503


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Pheochromocytoma
    Ina Sorge. Pheochromocytoma. PedRad [serial online] vol 3, no. 11.
    URL: www.PedRad.info/?search=20031123165503


     


    Go to the top of the page   ID: 20030904201557 Original case in english  More links about this topic on Pubmed (PubMed Reader)
    Add this case to your RSS feeder: Subscribe to RSS feed Add to Yahoo Add to Google Add to AOL Add to Furl Subscribe to Feed Burner feed

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    Discussion
     
    Submucous hemangioma of the subglottic trachea
    A Nordwig, A Jassoy, J Waldschmidt, W Lässig. Submucous hemangioma of the subglottic trachea. PedRad [serial online] vol 3, no. 9.
    URL: www.PedRad.info/?search=20030904201557


     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] There are Endoscopy-images available for this case. [ Endoscopy ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    A. Nordwig, A. Jassoy, J. Waldschmidt, W. Lässig (Halle-Dölau)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    N/A  

     
     Pediatric Radiology CasesGender:

    N/A  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    History: since the 10th week of life, worsening inspiratory stridor with changing appearance.

    Findings: 12 week old boy in reduced general condition; tachypnea; partially opisthotonic posture; jugulary retractions; inspiratory stridor in rest; Pulmo: bilateral same ventilation, in- and expiratory rhonchi.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    The inspiratory stridor results from serious (>70%) constriction of the larynx in the glottic and/or subglottic area, or rather the extrathoracic part of the trachea. A subglottic hematoma (benign angiogenesis) as the cause should always be considered, if the course is an acute or slowly worsening one (inspiratory stridor) in the 1st - 3rd month of life and if the intensity is worsening. Because of infection, the patients are in severe danger because of accompanying mucosal swelling in the subglottic area.  

     
     Pediatric Radiology CasesRadiological findings:


    MRI 1 <- view MRI 1

    MRI 1: T2 weighted axial image with markedly decreased sulcal pattern (= pachygyria) and thin cortex. Furthermore seen is a hemorrhage into the right lateral ventricle (hypointense).



    MRI 2 <- view MRI 2

    MRI 2: T1 weighted axial image demonstrates also significant pachygyria and prominent external CSF spaces. The fluid-fluid level containing hemorrhage in the posterior horns of the right lateral ventricle is better deliniated on the T1 weighted sequence.



    MRI 3 <- view MRI 3

    MRI 3: T2 weighted axial image at the level of the basal ganglia, which appear normal.



    MRI 4 <- view MRI 4

    MRI 4: Coronal CSF suppressed T2 weighted sequence (FLAIR) also demonstrates a markedly decreased sulcal pattern.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Increased liver echogenicity; Bile ducts partially up to the periphery irregularly dilated.



    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Minimal distended gallbladder with significant wall thickening and shadowing.



    MRI 1 <- view MRI 1

    MRI 1: MRCP: No dilatation of the intra- and extrahepatic bile ducts. Slightly irregularity of the walls of the Ductus choledochus. No changes in caliber of the intrahepatic bile ducts.





    X-Ray 1 <- view X-Ray 1

    X-Ray 1: ERCP: Rarefication of the intrahepatic bile ducts with multiple stenoses of different lenght especially in the right liver lobe. Extrahepatic bile ducts are not significantly dilated, Ductus cysticus serpentinuous.




    MRI 1 <- view MRI 1

    MRI 1: T2 transverse: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe. The vena portae is considerably compressed ventrally and is pushed to the left, as is the pancreas. The gall bladder is no longer demarcated.
    The right kidney is compressed from above and thus has moved caudally. The vena cava's lumen is reduced to a slit due to compression in the region of the tumor.




    MRI 2 <- view MRI 2

    MRI 2: T2 coronal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.




    MRI 3 <- view MRI 3

    MRI 3: T1 transversal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.The right kidney is compressed from above and thus has moved caudally.




    MRI 4 <- view MRI 4

    MRI 4: T1 sagittal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 5 <- view MRI 5

    MRI 5: T1 coronar, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 6 <- view MRI 6

    MRI 6: T1 transversal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronary slice: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles (Arrow). Pronounced lateral ventricles with preserved angulation bilat. and slight asymmetry to the left.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Subependymal, cystic structures bilat. left larger than right in the nucleothalamic groove of the lateral ventricles as sequel of a subependymal cerebral hemorrhage I°.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Coronary slice: Subependymal, cystic structures bilat. left larger than right in the lateral ventricles. Multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: transversal: relatively homogenously round tumor. Not above, but rather ventromedial to the left kidney (but above the kidney hilus).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: No increased perfusion in the colored doppler ultrasound is seen. This finding is not typical for this diagnosis.




    MRI 1 <- view MRI 1

    MRI 1: T2-weighted, transversal: hyperintense, slightly inhomogenously round tumor, ventromedial to the left kidney (but above the kidney hilus) .




    MRI 2 <- view MRI 2

    MRI 2: T1-weigted without contrast media, sagittal: isointense- (centrally slightly inhomogenously hypointense). Tumor is ventromedial to the left kidney. After contrast media was given, an obvious contrast enhancement was seen (here without picture).


    MRI 1 <- view MRI 1

    MRI 1: T2-weigted transversal: subglottic hyperintense intratracheal soft tissue mass with a maximal length of ca. 10 mm craniocaudal. Also a 4 mm x 4 mm diameter. This causes the tracheal lumen to be about 10% of what it usually should be.




    MRI 2 <- view MRI 2

    MRI 2: T1-weighted after contrast media: strong homogenous contrast media absprbtion of the subglottic intratracheal soft tissue mass after dose of Gadolinium-DTPA




    Endoscopy 1 <- view Endoscopy 1

    Endoscopy 1: Bronchoscopy: subglottic, starting dorsally, compressed tumor, which seriously restricted the tracheal lumen.


     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    The most common cause of inspiratory in babies is the infantile larynx itself. Further differential diagnoses are the congenital and acquired structural subglottic stenosis, the paralysis of the recurrens nerve, and more uncommonly the stenosis of the ring cartilage, a larynx cyst, the subglottic flap, the larynx papillomatosis as well as an esophageal and vascular malformations.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    In spontaneous course, the intensity of the symptoms (inspiratory stridor to dyspnea) increases in the first months of life. Towards the end of the 1st year of life, the symptoms decrease and are completely gone after age 2 or 3. With this, the clinical image of growth and regression of the tumor can be followed.

    Our patient underwent a subtotal coagulation with a ND:YAG-Laser by means of a tracheoscopy in the 14th week of life. The follow-up examination after 4 weeks showed a minimal residual finding in the left Paries memranaceus trachae, for which no treatment was needed. Clinically, the further course showed no abnormalities.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    hemangioma, neovascularisation, larynx, subglottis, submucous hemangioma, subglottic trachea  

     
     Pediatric Radiology Cases Cite this article:

    A Nordwig, A Jassoy, J Waldschmidt, W Lässig. Submucous hemangioma of the subglottic trachea. PedRad [serial online] vol 3, no. 9.
    URL: www.PedRad.info/?search=20030904201557  

     
     Pediatric Radiology Cases Read similar articles: subglottic trachea&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] There are Endoscopy-images available for this case. [ Endoscopy ] View all modalities [ All ]   
     
    Submucous hemangioma of the subglottic trachea
    A Nordwig, A Jassoy, J Waldschmidt, W Lässig. Submucous hemangioma of the subglottic trachea. PedRad [serial online] vol 3, no. 9.
    URL: www.PedRad.info/?search=20030904201557


     

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    Submucous hemangioma of the subglottic trachea
    Other cases by these authors:

    Search Johannes Gossner in Medline Johannes Gossner (2)   
    Search J. Larsen in Medline J. Larsen (1)   
    Search A. Nordwig in Medline A. Nordwig (20)   
    Search N. Lorenz in Medline N. Lorenz (1)   
    Search B. Biereder in Medline B. Biereder (1)   
    Search T. Haufe in Medline T. Haufe (4)   
    Search M. Kabus in Medline M. Kabus (1)   
    Search G. Hahn in Medline G. Hahn (38)   
    Search D. Weber in Medline D. Weber (20)   
    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   
    Search Ina Sorge in Medline Ina Sorge (24)   
    Search A. Nordwig in Medline A. Nordwig (20)   
    Search A. Jassoy in Medline A. Jassoy (6)   
    Search J. Waldschmidt in Medline J. Waldschmidt (1)   
    Search W. Lässig in Medline W. Lässig (2)   

    Submucous hemangioma of the subglottic trachea  
     
    Submucous hemangioma of the subglottic trachea
    A Nordwig, A Jassoy, J Waldschmidt, W Lässig. Submucous hemangioma of the subglottic trachea. PedRad [serial online] vol 3, no. 9.
    URL: www.PedRad.info/?search=20030904201557


     

    Which diagnosis have other collegues guessed?


    • Primary sclerosing cholangitis
      Votes: 16 (88 %)


    • Caroli syndrome
      Votes: 1 (5 %)


    • Obstructing concrement in the ductus choledochus
      Votes: 0 (0 %)


    • Hepatitis
      Votes: 0 (0 %)


    • Liver cirrhosis
      Votes: 1 (5 %)


    • Liver cirrhosis
      Votes: 0 (0 %)


    • Hepatocellular carcinoma
      Votes: 0 (0 %)


    • Hepatoblastoma
      Votes: 13 (40 %)


    • Follicular nodular hyperplasia
      Votes: 1 (3 %)


    • Hemangioma
      Votes: 0 (0 %)


    • Neuroblastoma
      Votes: 3 (5 %)


    • Ganglioneuroblastoma
      Votes: 2 (3 %)


    • Pheochromozytoma
      Votes: 16 (28 %)


    • Adrenal adenoma
      Votes: 3 (5 %)


    • Neurofibroma
      Votes: 1 (1 %)


    • Laryngomalacia
      Votes: 1 (1 %)


    • Cricoid cartilage stenosis
      Votes: 1 (1 %)


    • Larynxcyst
      Votes: 4 (5 %)


    • subglottic valve
      Votes: 2 (2 %)


    • Larynxpapillomatosis
      Votes: 0 (0 %)


    • Hemangioma
      Votes: 12 (15 %)



        Total answers: 77

     
    Submucous hemangioma of the subglottic trachea
    A Nordwig, A Jassoy, J Waldschmidt, W Lässig. Submucous hemangioma of the subglottic trachea. PedRad [serial online] vol 3, no. 9.
    URL: www.PedRad.info/?search=20030904201557


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Submucous hemangioma of the subglottic trachea
    A Nordwig, A Jassoy, J Waldschmidt, W Lässig. Submucous hemangioma of the subglottic trachea. PedRad [serial online] vol 3, no. 9.
    URL: www.PedRad.info/?search=20030904201557


     


    Go to the top of the page   ID: 20030413111550 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Gallbladder hydrops with evolving cholecystitis
    Dirk Schaper, V Hofmann. Gallbladder hydrops with evolving cholecystitis. PedRad [serial online] vol 3, no. 4.
    URL: www.PedRad.info/?search=20030413111550


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are OP-Situs-images available for this case. [ OP-Situs ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Dirk Schaper, V. Hofmann (Halle/S)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    14 Years  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    14 year-old girl with trisomy 21. Known cholecystolithiasis for two years, but shows no symptoms. Acute stomach aches with vomiting for three days. The patient currently shows right-sided upper quadrant pain. No fever, slightly elevated ESR, ASAT and gGT.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    N/A  

     
     Pediatric Radiology CasesRadiological findings:


    MRI 1 <- view MRI 1

    MRI 1: T2 weighted axial image with markedly decreased sulcal pattern (= pachygyria) and thin cortex. Furthermore seen is a hemorrhage into the right lateral ventricle (hypointense).



    MRI 2 <- view MRI 2

    MRI 2: T1 weighted axial image demonstrates also significant pachygyria and prominent external CSF spaces. The fluid-fluid level containing hemorrhage in the posterior horns of the right lateral ventricle is better deliniated on the T1 weighted sequence.



    MRI 3 <- view MRI 3

    MRI 3: T2 weighted axial image at the level of the basal ganglia, which appear normal.



    MRI 4 <- view MRI 4

    MRI 4: Coronal CSF suppressed T2 weighted sequence (FLAIR) also demonstrates a markedly decreased sulcal pattern.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Increased liver echogenicity; Bile ducts partially up to the periphery irregularly dilated.



    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Minimal distended gallbladder with significant wall thickening and shadowing.



    MRI 1 <- view MRI 1

    MRI 1: MRCP: No dilatation of the intra- and extrahepatic bile ducts. Slightly irregularity of the walls of the Ductus choledochus. No changes in caliber of the intrahepatic bile ducts.





    X-Ray 1 <- view X-Ray 1

    X-Ray 1: ERCP: Rarefication of the intrahepatic bile ducts with multiple stenoses of different lenght especially in the right liver lobe. Extrahepatic bile ducts are not significantly dilated, Ductus cysticus serpentinuous.




    MRI 1 <- view MRI 1

    MRI 1: T2 transverse: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe. The vena portae is considerably compressed ventrally and is pushed to the left, as is the pancreas. The gall bladder is no longer demarcated.
    The right kidney is compressed from above and thus has moved caudally. The vena cava's lumen is reduced to a slit due to compression in the region of the tumor.




    MRI 2 <- view MRI 2

    MRI 2: T2 coronal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.




    MRI 3 <- view MRI 3

    MRI 3: T1 transversal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.The right kidney is compressed from above and thus has moved caudally.




    MRI 4 <- view MRI 4

    MRI 4: T1 sagittal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 5 <- view MRI 5

    MRI 5: T1 coronar, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 6 <- view MRI 6

    MRI 6: T1 transversal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronary slice: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles (Arrow). Pronounced lateral ventricles with preserved angulation bilat. and slight asymmetry to the left.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Subependymal, cystic structures bilat. left larger than right in the nucleothalamic groove of the lateral ventricles as sequel of a subependymal cerebral hemorrhage I°.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Coronary slice: Subependymal, cystic structures bilat. left larger than right in the lateral ventricles. Multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: transversal: relatively homogenously round tumor. Not above, but rather ventromedial to the left kidney (but above the kidney hilus).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: No increased perfusion in the colored doppler ultrasound is seen. This finding is not typical for this diagnosis.




    MRI 1 <- view MRI 1

    MRI 1: T2-weighted, transversal: hyperintense, slightly inhomogenously round tumor, ventromedial to the left kidney (but above the kidney hilus) .




    MRI 2 <- view MRI 2

    MRI 2: T1-weigted without contrast media, sagittal: isointense- (centrally slightly inhomogenously hypointense). Tumor is ventromedial to the left kidney. After contrast media was given, an obvious contrast enhancement was seen (here without picture).


    MRI 1 <- view MRI 1

    MRI 1: T2-weigted transversal: subglottic hyperintense intratracheal soft tissue mass with a maximal length of ca. 10 mm craniocaudal. Also a 4 mm x 4 mm diameter. This causes the tracheal lumen to be about 10% of what it usually should be.




    MRI 2 <- view MRI 2

    MRI 2: T1-weighted after contrast media: strong homogenous contrast media absprbtion of the subglottic intratracheal soft tissue mass after dose of Gadolinium-DTPA




    Endoscopy 1 <- view Endoscopy 1

    Endoscopy 1: Bronchoscopy: subglottic, starting dorsally, compressed tumor, which seriously restricted the tracheal lumen.



     Ultrasound <- view Ultrasound

    Ultrasound 1: Widened gall bladder without emptying, thickening of the gall bladder wall with increased echogenicity. Depiction of a concrement giving an acoustic shadow at the transition to the cystic duct.





     OP-Situs <- view OP-Situs

    OP-Situs 1: Laparoscopic resected gall bladder with thickened walls and concrement.


     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Cholecystolithiasis  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    After pain management, laparoscopic choecystectomy. Intraoperative confirmation of the hydroptic, filled gall bladder. The concrement was in front of the ductus cysticus.
    After aspiration of the gall bladder and reduction of pressure, no problems with the laparoscopic removal of the gall bladder.  

     
     Pediatric Radiology CasesComments of the author about the case:

    The preoperative sonogram allows the exact assessment of the position of the stone. The gall bladder wall thickness and the extent of filling of the gall bladder is also assessible. The intraoperative aspiration and drainage of the gall bladder should be considered, particularly with missing drainage after adequate stimulation.  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    5. Medline: Medline
    Daradkeh, S.S.,Suwan,Z., Abu-Khalaf, M.
    Preoperative ultrasonography and prediction of technical difficulties during laparoscopic cholecystectomy.
    World J Surg 1998 Jan;22(1):75-7

    6. Medline: Medline
    DE Caluwe, D., Akl, U., Corbally M.
    Cholecystectomy versus cholecystolithotomy for cholelithiasis in childhood: long-term outcome
    J Pediatr Surg 2001 Oct;36(19):1518-21  

     
     Pediatric Radiology CasesKeywords:

    Cholecystitis, Cholecystolithiasis, Hydrops, gallbladder hydrops, cholecystitis, cholecystolithiasis, abdominal pain  

     
     Pediatric Radiology Cases Cite this article:

    Dirk Schaper, V Hofmann. Gallbladder hydrops with evolving cholecystitis. PedRad [serial online] vol 3, no. 4.
    URL: www.PedRad.info/?search=20030413111550  

     
     Pediatric Radiology Cases Read similar articles: abdominal pain&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are OP-Situs-images available for this case. [ OP-Situs ] View all modalities [ All ]   
     
    Gallbladder hydrops with evolving cholecystitis
    Dirk Schaper, V Hofmann. Gallbladder hydrops with evolving cholecystitis. PedRad [serial online] vol 3, no. 4.
    URL: www.PedRad.info/?search=20030413111550


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Gallbladder hydrops with evolving cholecystitis
    Other cases by these authors:

    Search Johannes Gossner in Medline Johannes Gossner (2)   
    Search J. Larsen in Medline J. Larsen (1)   
    Search A. Nordwig in Medline A. Nordwig (20)   
    Search N. Lorenz in Medline N. Lorenz (1)   
    Search B. Biereder in Medline B. Biereder (1)   
    Search T. Haufe in Medline T. Haufe (4)   
    Search M. Kabus in Medline M. Kabus (1)   
    Search G. Hahn in Medline G. Hahn (38)   
    Search D. Weber in Medline D. Weber (20)   
    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   
    Search Ina Sorge in Medline Ina Sorge (24)   
    Search A. Nordwig in Medline A. Nordwig (20)   
    Search A. Jassoy in Medline A. Jassoy (6)   
    Search J. Waldschmidt in Medline J. Waldschmidt (1)   
    Search W. Lässig in Medline W. Lässig (2)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search V. Hofmann in Medline V. Hofmann (17)   

    Gallbladder hydrops with evolving cholecystitis  
     
    Gallbladder hydrops with evolving cholecystitis
    Dirk Schaper, V Hofmann. Gallbladder hydrops with evolving cholecystitis. PedRad [serial online] vol 3, no. 4.
    URL: www.PedRad.info/?search=20030413111550


     

    Which diagnosis have other collegues guessed?


    • Primary sclerosing cholangitis
      Votes: 16 (88 %)


    • Caroli syndrome
      Votes: 1 (5 %)


    • Obstructing concrement in the ductus choledochus
      Votes: 0 (0 %)


    • Hepatitis
      Votes: 0 (0 %)


    • Liver cirrhosis
      Votes: 1 (5 %)


    • Liver cirrhosis
      Votes: 0 (0 %)


    • Hepatocellular carcinoma
      Votes: 0 (0 %)


    • Hepatoblastoma
      Votes: 13 (40 %)


    • Follicular nodular hyperplasia
      Votes: 1 (3 %)


    • Hemangioma
      Votes: 0 (0 %)


    • Neuroblastoma
      Votes: 3 (5 %)


    • Ganglioneuroblastoma
      Votes: 2 (3 %)


    • Pheochromozytoma
      Votes: 16 (28 %)


    • Adrenal adenoma
      Votes: 3 (5 %)


    • Neurofibroma
      Votes: 1 (1 %)


    • Laryngomalacia
      Votes: 1 (1 %)


    • Cricoid cartilage stenosis
      Votes: 1 (1 %)


    • Larynxcyst
      Votes: 4 (5 %)


    • subglottic valve
      Votes: 2 (2 %)


    • Larynxpapillomatosis
      Votes: 0 (0 %)


    • Hemangioma
      Votes: 12 (15 %)


    • Cholecystitis in Cholecystolithiasis
      Votes: 12 (13 %)


    • Infected choleodochus cyst
      Votes: 1 (1 %)


    • Infected intestinal duplicature
      Votes: 1 (1 %)


    • Ovarian cyst
      Votes: 1 (1 %)



        Total answers: 92

     
    Gallbladder hydrops with evolving cholecystitis
    Dirk Schaper, V Hofmann. Gallbladder hydrops with evolving cholecystitis. PedRad [serial online] vol 3, no. 4.
    URL: www.PedRad.info/?search=20030413111550


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Gallbladder hydrops with evolving cholecystitis
    Dirk Schaper, V Hofmann. Gallbladder hydrops with evolving cholecystitis. PedRad [serial online] vol 3, no. 4.
    URL: www.PedRad.info/?search=20030413111550


     


    Go to the top of the page   ID: 20021110223558 Original case in english  More links about this topic on Pubmed (PubMed Reader)
    Add this case to your RSS feeder: Subscribe to RSS feed Add to Yahoo Add to Google Add to AOL Add to Furl Subscribe to Feed Burner feed

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    Discussion
     
    Respiratory distress syndrome (grade 1-4) of the premature and newborn (IRDS)
    M Paetzel. Respiratory distress syndrome (grade 1-4) of the premature and newborn (IRDS). PedRad [serial online] vol 2, no. 11.
    URL: www.PedRad.info/?search=20021110223558


     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    M. Paetzel (Cleveland/USA)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    Newborn  

     
     Pediatric Radiology CasesGender:

    N/A  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    The images shown here were obtained from various premature infants of the 25th-29th gestational week. Postpartally, a respiratory deficiency was noted (moaning). Sometimes a retraction was seen. In the fourth case, cyanosis was noted initially.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    IRDS (idiopathic respiratory distress syndrome. Earlier: Hyaline-Membrane Syndrome) is based on underdeveloped pulmonary surfactant production. The deficiency of the mainly pospholipid surfactant leads to a collapse of the alveoles, which leads to atelectasic ventilation.

    Also, through the course of the disease, there is an excretion of underdeveloped proteins seen, which deposit themselves in a membrane-like manner (Therefore the old name "hyaline membranes"). This stage is through early treatment now rarely seen.  

     
     Pediatric Radiology CasesRadiological findings:


    MRI 1 <- view MRI 1

    MRI 1: T2 weighted axial image with markedly decreased sulcal pattern (= pachygyria) and thin cortex. Furthermore seen is a hemorrhage into the right lateral ventricle (hypointense).



    MRI 2 <- view MRI 2

    MRI 2: T1 weighted axial image demonstrates also significant pachygyria and prominent external CSF spaces. The fluid-fluid level containing hemorrhage in the posterior horns of the right lateral ventricle is better deliniated on the T1 weighted sequence.



    MRI 3 <- view MRI 3

    MRI 3: T2 weighted axial image at the level of the basal ganglia, which appear normal.



    MRI 4 <- view MRI 4

    MRI 4: Coronal CSF suppressed T2 weighted sequence (FLAIR) also demonstrates a markedly decreased sulcal pattern.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Increased liver echogenicity; Bile ducts partially up to the periphery irregularly dilated.



    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Minimal distended gallbladder with significant wall thickening and shadowing.



    MRI 1 <- view MRI 1

    MRI 1: MRCP: No dilatation of the intra- and extrahepatic bile ducts. Slightly irregularity of the walls of the Ductus choledochus. No changes in caliber of the intrahepatic bile ducts.





    X-Ray 1 <- view X-Ray 1

    X-Ray 1: ERCP: Rarefication of the intrahepatic bile ducts with multiple stenoses of different lenght especially in the right liver lobe. Extrahepatic bile ducts are not significantly dilated, Ductus cysticus serpentinuous.




    MRI 1 <- view MRI 1

    MRI 1: T2 transverse: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe. The vena portae is considerably compressed ventrally and is pushed to the left, as is the pancreas. The gall bladder is no longer demarcated.
    The right kidney is compressed from above and thus has moved caudally. The vena cava's lumen is reduced to a slit due to compression in the region of the tumor.




    MRI 2 <- view MRI 2

    MRI 2: T2 coronal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.




    MRI 3 <- view MRI 3

    MRI 3: T1 transversal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.The right kidney is compressed from above and thus has moved caudally.




    MRI 4 <- view MRI 4

    MRI 4: T1 sagittal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 5 <- view MRI 5

    MRI 5: T1 coronar, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 6 <- view MRI 6

    MRI 6: T1 transversal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronary slice: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles (Arrow). Pronounced lateral ventricles with preserved angulation bilat. and slight asymmetry to the left.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Subependymal, cystic structures bilat. left larger than right in the nucleothalamic groove of the lateral ventricles as sequel of a subependymal cerebral hemorrhage I°.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Coronary slice: Subependymal, cystic structures bilat. left larger than right in the lateral ventricles. Multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: transversal: relatively homogenously round tumor. Not above, but rather ventromedial to the left kidney (but above the kidney hilus).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: No increased perfusion in the colored doppler ultrasound is seen. This finding is not typical for this diagnosis.




    MRI 1 <- view MRI 1

    MRI 1: T2-weighted, transversal: hyperintense, slightly inhomogenously round tumor, ventromedial to the left kidney (but above the kidney hilus) .




    MRI 2 <- view MRI 2

    MRI 2: T1-weigted without contrast media, sagittal: isointense- (centrally slightly inhomogenously hypointense). Tumor is ventromedial to the left kidney. After contrast media was given, an obvious contrast enhancement was seen (here without picture).


    MRI 1 <- view MRI 1

    MRI 1: T2-weigted transversal: subglottic hyperintense intratracheal soft tissue mass with a maximal length of ca. 10 mm craniocaudal. Also a 4 mm x 4 mm diameter. This causes the tracheal lumen to be about 10% of what it usually should be.




    MRI 2 <- view MRI 2

    MRI 2: T1-weighted after contrast media: strong homogenous contrast media absprbtion of the subglottic intratracheal soft tissue mass after dose of Gadolinium-DTPA




    Endoscopy 1 <- view Endoscopy 1

    Endoscopy 1: Bronchoscopy: subglottic, starting dorsally, compressed tumor, which seriously restricted the tracheal lumen.



     Ultrasound <- view Ultrasound

    Ultrasound 1: Widened gall bladder without emptying, thickening of the gall bladder wall with increased echogenicity. Depiction of a concrement giving an acoustic shadow at the transition to the cystic duct.





     OP-Situs <- view OP-Situs

    OP-Situs 1: Laparoscopic resected gall bladder with thickened walls and concrement.



    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Stage 1: slight reticular (slight granular) decrease in transparency of the lung, no certain difference to normal findings. (The matches are used to show size)




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Stage 2: Soft decrease in transparency with an aerobronchogram, which overlaps the heart (= always a sign of an alveolar lung reaction!)




    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Stage 3: like stage 2, but with gradual stronger decrease in transparency, as well as a blurry diaphragm and heart.




    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Stage 4: White lung: practically homogenic lung opacity.




    X-Ray 5 <- view X-Ray 5

    X-Ray 5: Synopsis of the changes in Stages I - IV.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Alveolar respiratory deficiency, wet lung, infection, ARDS (also in newborns, i.e. after infection or blood transfusion), pleural effusion of both sides, pulmonary edema.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    N/A  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    IRDS, premature infant, surfactant deficiency, infantile respiratory distress syndrome, ARDS  

     
     Pediatric Radiology Cases Cite this article:

    M Paetzel. Respiratory distress syndrome (grade 1-4) of the premature and newborn (IRDS). PedRad [serial online] vol 2, no. 11.
    URL: www.PedRad.info/?search=20021110223558  

     
     Pediatric Radiology Cases Read similar articles: ARDS&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] View all modalities [ All ]   
     
    Respiratory distress syndrome (grade 1-4) of the premature and newborn (IRDS)
    M Paetzel. Respiratory distress syndrome (grade 1-4) of the premature and newborn (IRDS). PedRad [serial online] vol 2, no. 11.
    URL: www.PedRad.info/?search=20021110223558


     

    Search similar cases in:
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    Respiratory distress syndrome (grade 1-4) of the premature and newborn (IRDS)
    Other cases by these authors:

    Search Johannes Gossner in Medline Johannes Gossner (2)   
    Search J. Larsen in Medline J. Larsen (1)   
    Search A. Nordwig in Medline A. Nordwig (20)   
    Search N. Lorenz in Medline N. Lorenz (1)   
    Search B. Biereder in Medline B. Biereder (1)   
    Search T. Haufe in Medline T. Haufe (4)   
    Search M. Kabus in Medline M. Kabus (1)   
    Search G. Hahn in Medline G. Hahn (38)   
    Search D. Weber in Medline D. Weber (20)   
    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   
    Search Ina Sorge in Medline Ina Sorge (24)   
    Search A. Nordwig in Medline A. Nordwig (20)   
    Search A. Jassoy in Medline A. Jassoy (6)   
    Search J. Waldschmidt in Medline J. Waldschmidt (1)   
    Search W. Lässig in Medline W. Lässig (2)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search V. Hofmann in Medline V. Hofmann (17)   
    Search M. Paetzel in Medline M. Paetzel (26)   

    Respiratory distress syndrome (grade 1-4) of the premature and newborn (IRDS)  
     
    Respiratory distress syndrome (grade 1-4) of the premature and newborn (IRDS)
    M Paetzel. Respiratory distress syndrome (grade 1-4) of the premature and newborn (IRDS). PedRad [serial online] vol 2, no. 11.
    URL: www.PedRad.info/?search=20021110223558


     

    Which diagnosis have other collegues guessed?


    • Primary sclerosing cholangitis
      Votes: 16 (88 %)


    • Caroli syndrome
      Votes: 1 (5 %)


    • Obstructing concrement in the ductus choledochus
      Votes: 0 (0 %)


    • Hepatitis
      Votes: 0 (0 %)


    • Liver cirrhosis
      Votes: 1 (5 %)


    • Liver cirrhosis
      Votes: 0 (0 %)


    • Hepatocellular carcinoma
      Votes: 0 (0 %)


    • Hepatoblastoma
      Votes: 13 (40 %)


    • Follicular nodular hyperplasia
      Votes: 1 (3 %)


    • Hemangioma
      Votes: 0 (0 %)


    • Neuroblastoma
      Votes: 3 (5 %)


    • Ganglioneuroblastoma
      Votes: 2 (3 %)


    • Pheochromozytoma
      Votes: 16 (28 %)


    • Adrenal adenoma
      Votes: 3 (5 %)


    • Neurofibroma
      Votes: 1 (1 %)


    • Laryngomalacia
      Votes: 1 (1 %)


    • Cricoid cartilage stenosis
      Votes: 1 (1 %)


    • Larynxcyst
      Votes: 4 (5 %)


    • subglottic valve
      Votes: 2 (2 %)


    • Larynxpapillomatosis
      Votes: 0 (0 %)


    • Hemangioma
      Votes: 12 (15 %)


    • Cholecystitis in Cholecystolithiasis
      Votes: 12 (13 %)


    • Infected choleodochus cyst
      Votes: 1 (1 %)


    • Infected intestinal duplicature
      Votes: 1 (1 %)


    • Ovarian cyst
      Votes: 1 (1 %)


    • Wet lung
      Votes: 0 (0 %)


    • Pulmonary edema
      Votes: 3 (2 %)


    • ARDS
      Votes: 5 (4 %)


    • Pleural effusion
      Votes: 1 (0 %)


    • IRDS
      Votes: 4 (3 %)


    • Bronchopulmonary dysplasia
      Votes: 0 (0 %)



        Total answers: 105

     
    Respiratory distress syndrome (grade 1-4) of the premature and newborn (IRDS)
    M Paetzel. Respiratory distress syndrome (grade 1-4) of the premature and newborn (IRDS). PedRad [serial online] vol 2, no. 11.
    URL: www.PedRad.info/?search=20021110223558


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Respiratory distress syndrome (grade 1-4) of the premature and newborn (IRDS)
    M Paetzel. Respiratory distress syndrome (grade 1-4) of the premature and newborn (IRDS). PedRad [serial online] vol 2, no. 11.
    URL: www.PedRad.info/?search=20021110223558


     


    Go to the top of the page   ID: 20021024095545 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Fallot tetralogy with additional pulmonary artery loop and isolated upper lobe bronchus
    N Abolmaali. Fallot tetralogy with additional pulmonary artery loop and isolated upper lobe bronchus. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021024095545


     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] There are Pathology-images available for this case. [ Pathology ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    N. Abolmaali (Frankfurt am Main)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    5 Months  

     
     Pediatric Radiology CasesGender:

    N/A  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    5 month-old infant with cyanosis (O2-saturation 85-90%). Moderate difficulties in drinking, normal weight.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Fallot Tetralogy

    Most common "Fallot-variants" are composed of:
    1. Stenosis of the pulmonal artery.
    2. Interventricular septum defect. (VSD)
    3. Dextroposition of the aorta (caveat! No transposition!) In 25% of cases with a left-sided aortic arch.
    4. Hypertrophy of the right ventricle.

    Fallot-Pentalogy
    As in the Fallot-Tetralogy, but also
    5. Intraatrial septum defect (ASD)

    Fallot-Trilogy
    1. Pulmonary artery stenosis
    2. Hypertrophy of the right ventricle.
    3. Intraatrial septum defect (ASD) (caveat! No VSD!)

    Pulmonary artery sling (see also the image in Pathology 1):
    Normally the branching of the pulmonary trunk is ventral to the trachea. In a pulmonary artery sling, the branching is shifted dorsally, and crosses the tracheo-bronchial system dorsally. Depending on the area of crossing, the types are categorized in IA, IB, IIA and IIB.  

     
     Pediatric Radiology CasesRadiological findings:


    MRI 1 <- view MRI 1

    MRI 1: T2 weighted axial image with markedly decreased sulcal pattern (= pachygyria) and thin cortex. Furthermore seen is a hemorrhage into the right lateral ventricle (hypointense).



    MRI 2 <- view MRI 2

    MRI 2: T1 weighted axial image demonstrates also significant pachygyria and prominent external CSF spaces. The fluid-fluid level containing hemorrhage in the posterior horns of the right lateral ventricle is better deliniated on the T1 weighted sequence.



    MRI 3 <- view MRI 3

    MRI 3: T2 weighted axial image at the level of the basal ganglia, which appear normal.



    MRI 4 <- view MRI 4

    MRI 4: Coronal CSF suppressed T2 weighted sequence (FLAIR) also demonstrates a markedly decreased sulcal pattern.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Increased liver echogenicity; Bile ducts partially up to the periphery irregularly dilated.



    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Minimal distended gallbladder with significant wall thickening and shadowing.



    MRI 1 <- view MRI 1

    MRI 1: MRCP: No dilatation of the intra- and extrahepatic bile ducts. Slightly irregularity of the walls of the Ductus choledochus. No changes in caliber of the intrahepatic bile ducts.





    X-Ray 1 <- view X-Ray 1

    X-Ray 1: ERCP: Rarefication of the intrahepatic bile ducts with multiple stenoses of different lenght especially in the right liver lobe. Extrahepatic bile ducts are not significantly dilated, Ductus cysticus serpentinuous.




    MRI 1 <- view MRI 1

    MRI 1: T2 transverse: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe. The vena portae is considerably compressed ventrally and is pushed to the left, as is the pancreas. The gall bladder is no longer demarcated.
    The right kidney is compressed from above and thus has moved caudally. The vena cava's lumen is reduced to a slit due to compression in the region of the tumor.




    MRI 2 <- view MRI 2

    MRI 2: T2 coronal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.




    MRI 3 <- view MRI 3

    MRI 3: T1 transversal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.The right kidney is compressed from above and thus has moved caudally.




    MRI 4 <- view MRI 4

    MRI 4: T1 sagittal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 5 <- view MRI 5

    MRI 5: T1 coronar, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 6 <- view MRI 6

    MRI 6: T1 transversal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronary slice: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles (Arrow). Pronounced lateral ventricles with preserved angulation bilat. and slight asymmetry to the left.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Subependymal, cystic structures bilat. left larger than right in the nucleothalamic groove of the lateral ventricles as sequel of a subependymal cerebral hemorrhage I°.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Coronary slice: Subependymal, cystic structures bilat. left larger than right in the lateral ventricles. Multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: transversal: relatively homogenously round tumor. Not above, but rather ventromedial to the left kidney (but above the kidney hilus).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: No increased perfusion in the colored doppler ultrasound is seen. This finding is not typical for this diagnosis.




    MRI 1 <- view MRI 1

    MRI 1: T2-weighted, transversal: hyperintense, slightly inhomogenously round tumor, ventromedial to the left kidney (but above the kidney hilus) .




    MRI 2 <- view MRI 2

    MRI 2: T1-weigted without contrast media, sagittal: isointense- (centrally slightly inhomogenously hypointense). Tumor is ventromedial to the left kidney. After contrast media was given, an obvious contrast enhancement was seen (here without picture).


    MRI 1 <- view MRI 1

    MRI 1: T2-weigted transversal: subglottic hyperintense intratracheal soft tissue mass with a maximal length of ca. 10 mm craniocaudal. Also a 4 mm x 4 mm diameter. This causes the tracheal lumen to be about 10% of what it usually should be.




    MRI 2 <- view MRI 2

    MRI 2: T1-weighted after contrast media: strong homogenous contrast media absprbtion of the subglottic intratracheal soft tissue mass after dose of Gadolinium-DTPA




    Endoscopy 1 <- view Endoscopy 1

    Endoscopy 1: Bronchoscopy: subglottic, starting dorsally, compressed tumor, which seriously restricted the tracheal lumen.



     Ultrasound <- view Ultrasound

    Ultrasound 1: Widened gall bladder without emptying, thickening of the gall bladder wall with increased echogenicity. Depiction of a concrement giving an acoustic shadow at the transition to the cystic duct.





     OP-Situs <- view OP-Situs

    OP-Situs 1: Laparoscopic resected gall bladder with thickened walls and concrement.



    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Stage 1: slight reticular (slight granular) decrease in transparency of the lung, no certain difference to normal findings. (The matches are used to show size)




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Stage 2: Soft decrease in transparency with an aerobronchogram, which overlaps the heart (= always a sign of an alveolar lung reaction!)




    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Stage 3: like stage 2, but with gradual stronger decrease in transparency, as well as a blurry diaphragm and heart.




    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Stage 4: White lung: practically homogenic lung opacity.




    X-Ray 5 <- view X-Ray 5

    X-Ray 5: Synopsis of the changes in Stages I - IV.


    MRI 1 <- view MRI 1

    MRI 1: T1-transversal: Depiction of the VSD as well as the dextropositioned aortic root (arrow), the right ventricular hypertrophy is also seen.




    MRI 2 <- view MRI 2

    MRI 2: Phase-contrast image (VENC 130 cm/s) measured vertical to the stenotic pulmonary trunk. Flow accelleration in the pulmonary trunk is seen in aliasing. In adjusted VENC (300 cm/s), a flow speed of 2.4 m/s was measured.




    MRI 3 <- view MRI 3

    MRI 3: T1-sagittal: Pulmonary sling with severe compression of the trachia and carina. Broncioscopic tracheomalacia. The ventrally located vessel is the pulmonary trunk, dorsally, the left pulmonary artery can be seen.




    MRI 4 <- view MRI 4

    MRI 4: T1-Short axis slice through the ventricle. Obvious right ventricular hypertrophy (arrow)




    MRI 5 <- view MRI 5

    MRI 5: T1-transversal. Pulmonary sling (long arrow) with severe compression of the trachea (short arrow) and carina (bronchioscopic tracheomalacia). Stenosis of the pulmonary trunk (also seen in the Fallot-Tetralogy symptom of the pulmonary stenosis) - within this stenosis, the phase-contrast flow measurement was made (see 2nd image).




    MRI 6 <- view MRI 6

    MRI 6: T1-transversal : Isolated upper lobe bronchus (right, arrow). This isolated bronchus, as well as the further course of the trachea and carina defined in this case of a Type IB (See classification in the picture "Pathology 1").




    Pathology 1 <- view Pathology 1

    Pathology 1: Sling-Classification of chages of the tracheobroncial system in pulmonary slings in Types IA through IIB

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    N/A  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    The Fallot-Tetrology makes up about 10% of all congenital heart defects, and that makes it relatively frequent. An isolated upper lobe bronchus is relative frequent. Statistic proof does not occur in literature, as far as we know. The pulmonal loop is a relatively rare defect.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    Potts WJ, Holinger PH, Rosenblum AH
    Anomalous left pulmonary artery causing obstruction to right main bronchus: report of a case.
    JAMA 1954;155:1409–11.  

     
     Pediatric Radiology CasesLiterature:

    7. Medline: Medline
    Hodina M, Wicky S, Payot M, Sekarski N, Gudinchet F
    Non-invasive imaging of the ring-sling complex in children
    Pediatr Cardiol. 2001 Jul-Aug;22(4):333-7

    8. Medline: Medline
    Lee KH, Yoon CS, Choe KO, Kim MJ, Lee HM, Yoon HK, Kim B
    Use of imaging for assessing anatomical relationships of tracheobronchial anomalies associated with left pulmonary artery sling
    Pediatr Radiol. 2001 Apr;31(4):269-78

    9. Medline: Medline
    Berdon WE
    Rings, slings, and other things: vascular compression of the infant trachea updated from the midcentury to the millennium--the legacy of Robert E. Gross, MD, and Edward B. D. Neuhauser, MD
    Radiology. 2000 Sep;216(3):624-32

    10. Medline: Medline
    Lorenz CH
    The range of normal values of cardiovascular structures in infants, children, and adolescents measured by magnetic resonance imaging
    Pediatr Cardiol. 2000 Jan-Feb;21(1):37-46  

     
     Pediatric Radiology CasesKeywords:

    Fallot, tetralogy, pulmonary artery, Fallot tetralogy, pulmonary artery loop, isolated upper lobe bronchus  

     
     Pediatric Radiology Cases Cite this article:

    N Abolmaali. Fallot tetralogy with additional pulmonary artery loop and isolated upper lobe bronchus. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021024095545  

     
     Pediatric Radiology Cases Read similar articles: isolated upper lobe bronchus&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] There are Pathology-images available for this case. [ Pathology ] View all modalities [ All ]   
     
    Fallot tetralogy with additional pulmonary artery loop and isolated upper lobe bronchus
    N Abolmaali. Fallot tetralogy with additional pulmonary artery loop and isolated upper lobe bronchus. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021024095545


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Fallot tetralogy with additional pulmonary artery loop and isolated upper lobe bronchus
    Other cases by these authors:

    Search Johannes Gossner in Medline Johannes Gossner (2)   
    Search J. Larsen in Medline J. Larsen (1)   
    Search A. Nordwig in Medline A. Nordwig (20)   
    Search N. Lorenz in Medline N. Lorenz (1)   
    Search B. Biereder in Medline B. Biereder (1)   
    Search T. Haufe in Medline T. Haufe (4)   
    Search M. Kabus in Medline M. Kabus (1)   
    Search G. Hahn in Medline G. Hahn (38)   
    Search D. Weber in Medline D. Weber (20)   
    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   
    Search Ina Sorge in Medline Ina Sorge (24)   
    Search A. Nordwig in Medline A. Nordwig (20)   
    Search A. Jassoy in Medline A. Jassoy (6)   
    Search J. Waldschmidt in Medline J. Waldschmidt (1)   
    Search W. Lässig in Medline W. Lässig (2)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search V. Hofmann in Medline V. Hofmann (17)   
    Search M. Paetzel in Medline M. Paetzel (26)   
    Search N. Abolmaali in Medline N. Abolmaali (18)   

    Fallot tetralogy with additional pulmonary artery loop and isolated upper lobe bronchus  
     
    Fallot tetralogy with additional pulmonary artery loop and isolated upper lobe bronchus
    N Abolmaali. Fallot tetralogy with additional pulmonary artery loop and isolated upper lobe bronchus. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021024095545


     

    Which diagnosis have other collegues guessed?


    • Primary sclerosing cholangitis
      Votes: 16 (88 %)


    • Caroli syndrome
      Votes: 1 (5 %)


    • Obstructing concrement in the ductus choledochus
      Votes: 0 (0 %)


    • Hepatitis
      Votes: 0 (0 %)


    • Liver cirrhosis
      Votes: 1 (5 %)


    • Liver cirrhosis
      Votes: 0 (0 %)


    • Hepatocellular carcinoma
      Votes: 0 (0 %)


    • Hepatoblastoma
      Votes: 13 (40 %)


    • Follicular nodular hyperplasia
      Votes: 1 (3 %)


    • Hemangioma
      Votes: 0 (0 %)


    • Neuroblastoma
      Votes: 3 (5 %)


    • Ganglioneuroblastoma
      Votes: 2 (3 %)


    • Pheochromozytoma
      Votes: 16 (28 %)


    • Adrenal adenoma
      Votes: 3 (5 %)


    • Neurofibroma
      Votes: 1 (1 %)


    • Laryngomalacia
      Votes: 1 (1 %)


    • Cricoid cartilage stenosis
      Votes: 1 (1 %)


    • Larynxcyst
      Votes: 4 (5 %)


    • subglottic valve
      Votes: 2 (2 %)


    • Larynxpapillomatosis
      Votes: 0 (0 %)


    • Hemangioma
      Votes: 12 (15 %)


    • Cholecystitis in Cholecystolithiasis
      Votes: 12 (13 %)


    • Infected choleodochus cyst
      Votes: 1 (1 %)


    • Infected intestinal duplicature
      Votes: 1 (1 %)


    • Ovarian cyst
      Votes: 1 (1 %)


    • Wet lung
      Votes: 0 (0 %)


    • Pulmonary edema
      Votes: 3 (2 %)


    • ARDS
      Votes: 5 (4 %)


    • Pleural effusion
      Votes: 1 (0 %)


    • IRDS
      Votes: 4 (3 %)


    • Bronchopulmonary dysplasia
      Votes: 0 (0 %)



        Total answers: 105

     
    Fallot tetralogy with additional pulmonary artery loop and isolated upper lobe bronchus
    N Abolmaali. Fallot tetralogy with additional pulmonary artery loop and isolated upper lobe bronchus. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021024095545


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Fallot tetralogy with additional pulmonary artery loop and isolated upper lobe bronchus
    N Abolmaali. Fallot tetralogy with additional pulmonary artery loop and isolated upper lobe bronchus. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021024095545


     


    Go to the top of the page   ID: 20021023155928 Original case in english  More links about this topic on Pubmed (PubMed Reader)
    Add this case to your RSS feeder: Subscribe to RSS feed Add to Yahoo Add to Google Add to AOL Add to Furl Subscribe to Feed Burner feed

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    Discussion
     
    Multicystic medullary degeneration after meningitis
    R Haase, Wolfgang Hirsch. Multicystic medullary degeneration after meningitis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021023155928


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    R. Haase, Wolfgang Hirsch (Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    3 Weeks  

     
     Pediatric Radiology CasesGender:

    N/A  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    3 week-old infant, which was admitted because the mother was admitted for one week for acute mastitis in the gynecology department (Streptococcus agalacticae).

    After the mother and child were discharged: Sudden shock and generalized seizures set in.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    The cause of the multicystic encephalopathy following meningitis is contributed to the edema and consecutive decrease in perfusion. It is still unclear if this is a local encephalitic concurring reaction of the brain (and therefore a local inflammatory edema), or if the origin of the edema is caused by a) a decreased local venous flow (stasis edema) or b) a vasogenic (arterial) spasm (insufficient perfusion edema).  

     
     Pediatric Radiology CasesRadiological findings:


    MRI 1 <- view MRI 1

    MRI 1: T2 weighted axial image with markedly decreased sulcal pattern (= pachygyria) and thin cortex. Furthermore seen is a hemorrhage into the right lateral ventricle (hypointense).



    MRI 2 <- view MRI 2

    MRI 2: T1 weighted axial image demonstrates also significant pachygyria and prominent external CSF spaces. The fluid-fluid level containing hemorrhage in the posterior horns of the right lateral ventricle is better deliniated on the T1 weighted sequence.



    MRI 3 <- view MRI 3

    MRI 3: T2 weighted axial image at the level of the basal ganglia, which appear normal.



    MRI 4 <- view MRI 4

    MRI 4: Coronal CSF suppressed T2 weighted sequence (FLAIR) also demonstrates a markedly decreased sulcal pattern.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Increased liver echogenicity; Bile ducts partially up to the periphery irregularly dilated.



    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Minimal distended gallbladder with significant wall thickening and shadowing.



    MRI 1 <- view MRI 1

    MRI 1: MRCP: No dilatation of the intra- and extrahepatic bile ducts. Slightly irregularity of the walls of the Ductus choledochus. No changes in caliber of the intrahepatic bile ducts.





    X-Ray 1 <- view X-Ray 1

    X-Ray 1: ERCP: Rarefication of the intrahepatic bile ducts with multiple stenoses of different lenght especially in the right liver lobe. Extrahepatic bile ducts are not significantly dilated, Ductus cysticus serpentinuous.




    MRI 1 <- view MRI 1

    MRI 1: T2 transverse: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe. The vena portae is considerably compressed ventrally and is pushed to the left, as is the pancreas. The gall bladder is no longer demarcated.
    The right kidney is compressed from above and thus has moved caudally. The vena cava's lumen is reduced to a slit due to compression in the region of the tumor.




    MRI 2 <- view MRI 2

    MRI 2: T2 coronal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.




    MRI 3 <- view MRI 3

    MRI 3: T1 transversal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.The right kidney is compressed from above and thus has moved caudally.




    MRI 4 <- view MRI 4

    MRI 4: T1 sagittal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 5 <- view MRI 5

    MRI 5: T1 coronar, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 6 <- view MRI 6

    MRI 6: T1 transversal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronary slice: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles (Arrow). Pronounced lateral ventricles with preserved angulation bilat. and slight asymmetry to the left.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Subependymal, cystic structures bilat. left larger than right in the nucleothalamic groove of the lateral ventricles as sequel of a subependymal cerebral hemorrhage I°.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Coronary slice: Subependymal, cystic structures bilat. left larger than right in the lateral ventricles. Multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: transversal: relatively homogenously round tumor. Not above, but rather ventromedial to the left kidney (but above the kidney hilus).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: No increased perfusion in the colored doppler ultrasound is seen. This finding is not typical for this diagnosis.




    MRI 1 <- view MRI 1

    MRI 1: T2-weighted, transversal: hyperintense, slightly inhomogenously round tumor, ventromedial to the left kidney (but above the kidney hilus) .




    MRI 2 <- view MRI 2

    MRI 2: T1-weigted without contrast media, sagittal: isointense- (centrally slightly inhomogenously hypointense). Tumor is ventromedial to the left kidney. After contrast media was given, an obvious contrast enhancement was seen (here without picture).


    MRI 1 <- view MRI 1

    MRI 1: T2-weigted transversal: subglottic hyperintense intratracheal soft tissue mass with a maximal length of ca. 10 mm craniocaudal. Also a 4 mm x 4 mm diameter. This causes the tracheal lumen to be about 10% of what it usually should be.




    MRI 2 <- view MRI 2

    MRI 2: T1-weighted after contrast media: strong homogenous contrast media absprbtion of the subglottic intratracheal soft tissue mass after dose of Gadolinium-DTPA




    Endoscopy 1 <- view Endoscopy 1

    Endoscopy 1: Bronchoscopy: subglottic, starting dorsally, compressed tumor, which seriously restricted the tracheal lumen.



     Ultrasound <- view Ultrasound

    Ultrasound 1: Widened gall bladder without emptying, thickening of the gall bladder wall with increased echogenicity. Depiction of a concrement giving an acoustic shadow at the transition to the cystic duct.





     OP-Situs <- view OP-Situs

    OP-Situs 1: Laparoscopic resected gall bladder with thickened walls and concrement.



    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Stage 1: slight reticular (slight granular) decrease in transparency of the lung, no certain difference to normal findings. (The matches are used to show size)




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Stage 2: Soft decrease in transparency with an aerobronchogram, which overlaps the heart (= always a sign of an alveolar lung reaction!)




    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Stage 3: like stage 2, but with gradual stronger decrease in transparency, as well as a blurry diaphragm and heart.




    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Stage 4: White lung: practically homogenic lung opacity.




    X-Ray 5 <- view X-Ray 5

    X-Ray 5: Synopsis of the changes in Stages I - IV.


    MRI 1 <- view MRI 1

    MRI 1: T1-transversal: Depiction of the VSD as well as the dextropositioned aortic root (arrow), the right ventricular hypertrophy is also seen.




    MRI 2 <- view MRI 2

    MRI 2: Phase-contrast image (VENC 130 cm/s) measured vertical to the stenotic pulmonary trunk. Flow accelleration in the pulmonary trunk is seen in aliasing. In adjusted VENC (300 cm/s), a flow speed of 2.4 m/s was measured.




    MRI 3 <- view MRI 3

    MRI 3: T1-sagittal: Pulmonary sling with severe compression of the trachia and carina. Broncioscopic tracheomalacia. The ventrally located vessel is the pulmonary trunk, dorsally, the left pulmonary artery can be seen.




    MRI 4 <- view MRI 4

    MRI 4: T1-Short axis slice through the ventricle. Obvious right ventricular hypertrophy (arrow)




    MRI 5 <- view MRI 5

    MRI 5: T1-transversal. Pulmonary sling (long arrow) with severe compression of the trachea (short arrow) and carina (bronchioscopic tracheomalacia). Stenosis of the pulmonary trunk (also seen in the Fallot-Tetralogy symptom of the pulmonary stenosis) - within this stenosis, the phase-contrast flow measurement was made (see 2nd image).




    MRI 6 <- view MRI 6

    MRI 6: T1-transversal : Isolated upper lobe bronchus (right, arrow). This isolated bronchus, as well as the further course of the trachea and carina defined in this case of a Type IB (See classification in the picture "Pathology 1").




    Pathology 1 <- view Pathology 1

    Pathology 1: Sling-Classification of chages of the tracheobroncial system in pulmonary slings in Types IA through IIB


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: upper series: Beginning findings on the first day of treatment: a: parasagittal slice: punctuated hyperechogenicities in the marrow (5 MHz). b & c: Part (12 MHz) coronal (b) and sagittal (c): confluent hyperechogenicities (Marrow edema)

    Lower series: Follow-up examination on the 14th day of treatment: d: parasagittal slice: in the close-up with a sector transducer there are no echogenicity increases seen (5 MHz); e & f: (12 MHz) coronal (e) and sagittal (f): obvious multicystic cerebral parenchymal degeneration.




    MRI 1 <- view MRI 1

    MRI 1: Upper series: Beginning findings on the first day of treatment: a: T2-TSE transversal: frontal and parietal marrow edema.
    b: T1-SE coronal: the high-lying parietal edema is seen as a slight decrease in signal.

    Lower series: c: T2-TSE transversal: increased signal in a colliquation necrosis in the area of the previous frontal edema. The small cystic structure of the the necroses cannot be seen in MRI. b: T1-SE coronal: Areas of necrosis located parietally are shown with decreased signal in the follow-up.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Periventricular Leucomalasia of a mature child.

    Regardless of the cause, every cerebral edema or every severe hypotonia can lead to a similar presentation.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    rare  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Multicystic medullary degeneration, Leucencephalomalasia, meningitis, generalized seizures, shock, Streptococcus agalacticae, mother mastitis  

     
     Pediatric Radiology Cases Cite this article:

    R Haase, Wolfgang Hirsch. Multicystic medullary degeneration after meningitis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021023155928  

     
     Pediatric Radiology Cases Read similar articles: mother mastitis&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Multicystic medullary degeneration after meningitis
    R Haase, Wolfgang Hirsch. Multicystic medullary degeneration after meningitis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021023155928


     

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    Multicystic medullary degeneration after meningitis
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    Multicystic medullary degeneration after meningitis  
     
    Multicystic medullary degeneration after meningitis
    R Haase, Wolfgang Hirsch. Multicystic medullary degeneration after meningitis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021023155928


     

    Which diagnosis have other collegues guessed?


    • Primary sclerosing cholangitis
      Votes: 16 (88 %)


    • Caroli syndrome
      Votes: 1 (5 %)


    • Obstructing concrement in the ductus choledochus
      Votes: 0 (0 %)


    • Hepatitis
      Votes: 0 (0 %)


    • Liver cirrhosis
      Votes: 1 (5 %)


    • Liver cirrhosis
      Votes: 0 (0 %)


    • Hepatocellular carcinoma
      Votes: 0 (0 %)


    • Hepatoblastoma
      Votes: 13 (40 %)


    • Follicular nodular hyperplasia
      Votes: 1 (3 %)


    • Hemangioma
      Votes: 0 (0 %)


    • Neuroblastoma
      Votes: 3 (5 %)


    • Ganglioneuroblastoma
      Votes: 2 (3 %)


    • Pheochromozytoma
      Votes: 16 (28 %)


    • Adrenal adenoma
      Votes: 3 (5 %)


    • Neurofibroma
      Votes: 1 (1 %)


    • Laryngomalacia
      Votes: 1 (1 %)


    • Cricoid cartilage stenosis
      Votes: 1 (1 %)


    • Larynxcyst
      Votes: 4 (5 %)


    • subglottic valve
      Votes: 2 (2 %)


    • Larynxpapillomatosis
      Votes: 0 (0 %)


    • Hemangioma
      Votes: 12 (15 %)


    • Cholecystitis in Cholecystolithiasis
      Votes: 12 (13 %)


    • Infected choleodochus cyst
      Votes: 1 (1 %)


    • Infected intestinal duplicature
      Votes: 1 (1 %)


    • Ovarian cyst
      Votes: 1 (1 %)


    • Wet lung
      Votes: 0 (0 %)


    • Pulmonary edema
      Votes: 3 (2 %)


    • ARDS
      Votes: 5 (4 %)


    • Pleural effusion
      Votes: 1 (0 %)


    • IRDS
      Votes: 4 (3 %)


    • Bronchopulmonary dysplasia
      Votes: 0 (0 %)



        Total answers: 105

     
    Multicystic medullary degeneration after meningitis
    R Haase, Wolfgang Hirsch. Multicystic medullary degeneration after meningitis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021023155928


     

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    Multicystic medullary degeneration after meningitis
    R Haase, Wolfgang Hirsch. Multicystic medullary degeneration after meningitis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021023155928


     


    Go to the top of the page   ID: 20020902155928 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Tectal Lipoma
    G Hahn. Tectal Lipoma. PedRad [serial online] vol 2, no. 9.
    URL: www.PedRad.info/?search=20020902155928


     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    G. Hahn (Dresden)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    2 Months  

     
     Pediatric Radiology CasesGender:

    N/A  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    Clinically unnoticeable 2 month old infant with perinatal adjustment difficulties. In the post-natal ultrasound in another clinic, there was an unclear structure seen infratentorally. We admitted this patient for further investigation with MR.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    N/A  

     
     Pediatric Radiology CasesRadiological findings:


    MRI 1 <- view MRI 1

    MRI 1: T2 weighted axial image with markedly decreased sulcal pattern (= pachygyria) and thin cortex. Furthermore seen is a hemorrhage into the right lateral ventricle (hypointense).



    MRI 2 <- view MRI 2

    MRI 2: T1 weighted axial image demonstrates also significant pachygyria and prominent external CSF spaces. The fluid-fluid level containing hemorrhage in the posterior horns of the right lateral ventricle is better deliniated on the T1 weighted sequence.



    MRI 3 <- view MRI 3

    MRI 3: T2 weighted axial image at the level of the basal ganglia, which appear normal.



    MRI 4 <- view MRI 4

    MRI 4: Coronal CSF suppressed T2 weighted sequence (FLAIR) also demonstrates a markedly decreased sulcal pattern.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Increased liver echogenicity; Bile ducts partially up to the periphery irregularly dilated.



    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Minimal distended gallbladder with significant wall thickening and shadowing.



    MRI 1 <- view MRI 1

    MRI 1: MRCP: No dilatation of the intra- and extrahepatic bile ducts. Slightly irregularity of the walls of the Ductus choledochus. No changes in caliber of the intrahepatic bile ducts.





    X-Ray 1 <- view X-Ray 1

    X-Ray 1: ERCP: Rarefication of the intrahepatic bile ducts with multiple stenoses of different lenght especially in the right liver lobe. Extrahepatic bile ducts are not significantly dilated, Ductus cysticus serpentinuous.




    MRI 1 <- view MRI 1

    MRI 1: T2 transverse: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe. The vena portae is considerably compressed ventrally and is pushed to the left, as is the pancreas. The gall bladder is no longer demarcated.
    The right kidney is compressed from above and thus has moved caudally. The vena cava's lumen is reduced to a slit due to compression in the region of the tumor.




    MRI 2 <- view MRI 2

    MRI 2: T2 coronal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.




    MRI 3 <- view MRI 3

    MRI 3: T1 transversal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.The right kidney is compressed from above and thus has moved caudally.




    MRI 4 <- view MRI 4

    MRI 4: T1 sagittal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 5 <- view MRI 5

    MRI 5: T1 coronar, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 6 <- view MRI 6

    MRI 6: T1 transversal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronary slice: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles (Arrow). Pronounced lateral ventricles with preserved angulation bilat. and slight asymmetry to the left.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Subependymal, cystic structures bilat. left larger than right in the nucleothalamic groove of the lateral ventricles as sequel of a subependymal cerebral hemorrhage I°.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Coronary slice: Subependymal, cystic structures bilat. left larger than right in the lateral ventricles. Multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: transversal: relatively homogenously round tumor. Not above, but rather ventromedial to the left kidney (but above the kidney hilus).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: No increased perfusion in the colored doppler ultrasound is seen. This finding is not typical for this diagnosis.




    MRI 1 <- view MRI 1

    MRI 1: T2-weighted, transversal: hyperintense, slightly inhomogenously round tumor, ventromedial to the left kidney (but above the kidney hilus) .




    MRI 2 <- view MRI 2

    MRI 2: T1-weigted without contrast media, sagittal: isointense- (centrally slightly inhomogenously hypointense). Tumor is ventromedial to the left kidney. After contrast media was given, an obvious contrast enhancement was seen (here without picture).


    MRI 1 <- view MRI 1

    MRI 1: T2-weigted transversal: subglottic hyperintense intratracheal soft tissue mass with a maximal length of ca. 10 mm craniocaudal. Also a 4 mm x 4 mm diameter. This causes the tracheal lumen to be about 10% of what it usually should be.




    MRI 2 <- view MRI 2

    MRI 2: T1-weighted after contrast media: strong homogenous contrast media absprbtion of the subglottic intratracheal soft tissue mass after dose of Gadolinium-DTPA




    Endoscopy 1 <- view Endoscopy 1

    Endoscopy 1: Bronchoscopy: subglottic, starting dorsally, compressed tumor, which seriously restricted the tracheal lumen.



     Ultrasound <- view Ultrasound

    Ultrasound 1: Widened gall bladder without emptying, thickening of the gall bladder wall with increased echogenicity. Depiction of a concrement giving an acoustic shadow at the transition to the cystic duct.





     OP-Situs <- view OP-Situs

    OP-Situs 1: Laparoscopic resected gall bladder with thickened walls and concrement.



    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Stage 1: slight reticular (slight granular) decrease in transparency of the lung, no certain difference to normal findings. (The matches are used to show size)




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Stage 2: Soft decrease in transparency with an aerobronchogram, which overlaps the heart (= always a sign of an alveolar lung reaction!)




    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Stage 3: like stage 2, but with gradual stronger decrease in transparency, as well as a blurry diaphragm and heart.




    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Stage 4: White lung: practically homogenic lung opacity.




    X-Ray 5 <- view X-Ray 5

    X-Ray 5: Synopsis of the changes in Stages I - IV.


    MRI 1 <- view MRI 1

    MRI 1: T1-transversal: Depiction of the VSD as well as the dextropositioned aortic root (arrow), the right ventricular hypertrophy is also seen.




    MRI 2 <- view MRI 2

    MRI 2: Phase-contrast image (VENC 130 cm/s) measured vertical to the stenotic pulmonary trunk. Flow accelleration in the pulmonary trunk is seen in aliasing. In adjusted VENC (300 cm/s), a flow speed of 2.4 m/s was measured.




    MRI 3 <- view MRI 3

    MRI 3: T1-sagittal: Pulmonary sling with severe compression of the trachia and carina. Broncioscopic tracheomalacia. The ventrally located vessel is the pulmonary trunk, dorsally, the left pulmonary artery can be seen.




    MRI 4 <- view MRI 4

    MRI 4: T1-Short axis slice through the ventricle. Obvious right ventricular hypertrophy (arrow)




    MRI 5 <- view MRI 5

    MRI 5: T1-transversal. Pulmonary sling (long arrow) with severe compression of the trachea (short arrow) and carina (bronchioscopic tracheomalacia). Stenosis of the pulmonary trunk (also seen in the Fallot-Tetralogy symptom of the pulmonary stenosis) - within this stenosis, the phase-contrast flow measurement was made (see 2nd image).




    MRI 6 <- view MRI 6

    MRI 6: T1-transversal : Isolated upper lobe bronchus (right, arrow). This isolated bronchus, as well as the further course of the trachea and carina defined in this case of a Type IB (See classification in the picture "Pathology 1").




    Pathology 1 <- view Pathology 1

    Pathology 1: Sling-Classification of chages of the tracheobroncial system in pulmonary slings in Types IA through IIB


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: upper series: Beginning findings on the first day of treatment: a: parasagittal slice: punctuated hyperechogenicities in the marrow (5 MHz). b & c: Part (12 MHz) coronal (b) and sagittal (c): confluent hyperechogenicities (Marrow edema)

    Lower series: Follow-up examination on the 14th day of treatment: d: parasagittal slice: in the close-up with a sector transducer there are no echogenicity increases seen (5 MHz); e & f: (12 MHz) coronal (e) and sagittal (f): obvious multicystic cerebral parenchymal degeneration.




    MRI 1 <- view MRI 1

    MRI 1: Upper series: Beginning findings on the first day of treatment: a: T2-TSE transversal: frontal and parietal marrow edema.
    b: T1-SE coronal: the high-lying parietal edema is seen as a slight decrease in signal.

    Lower series: c: T2-TSE transversal: increased signal in a colliquation necrosis in the area of the previous frontal edema. The small cystic structure of the the necroses cannot be seen in MRI. b: T1-SE coronal: Areas of necrosis located parietally are shown with decreased signal in the follow-up.


    MRI 1 <- view MRI 1

    MRI 1 : Fat isointense mass of about 1 cm in size, originating from the right inferior colliculus (T2-TSE). Impressive chemical-shift artefacts (black line on the lipoma).




    MRI 2 <- view MRI 2

    MRI 2 : Fat isointense mass of about 1 cm in size, originating from the right inferior colliculus (T1-SE tra). Impressive chemical-shift artefacts (black line on the lipoma).




    MRI 3 <- view MRI 3

    MRI 3: Fat isointense mass of about 1 cm in size, originating from the right inferior colliculus (T1-SE sag). Impressive chemical-shift artefacts (black line on the lipoma).




    MRI 4 <- view MRI 4

    MRI 4: Fat isointense mass of about 1 cm in size, originating from the right inferior colliculus (T1 SE cor). Impressive chemical-shift artefacts (black line on the lipoma).




    MRI 5 <- view MRI 5

    MRI 5:Fat isointense mass of about 1 cm in size, originating from the right inferior colliculus (T1-SE-FS). The absent signal after fat supression proves the lipomatous character of the mass.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    none  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Chance findings without therapeutic relevance. No follow-up necessary. Avoid surgery at all costs.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Tectal Lipoma, brain tumor, Lipoma  

     
     Pediatric Radiology Cases Cite this article:

    G Hahn. Tectal Lipoma. PedRad [serial online] vol 2, no. 9.
    URL: www.PedRad.info/?search=20020902155928  

     
     Pediatric Radiology Cases Read similar articles: Lipoma&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Tectal Lipoma
    G Hahn. Tectal Lipoma. PedRad [serial online] vol 2, no. 9.
    URL: www.PedRad.info/?search=20020902155928


     

    Search similar cases in:
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    Tectal Lipoma
    Other cases by these authors:

    Search Johannes Gossner in Medline Johannes Gossner (2)   
    Search J. Larsen in Medline J. Larsen (1)   
    Search A. Nordwig in Medline A. Nordwig (20)   
    Search N. Lorenz in Medline N. Lorenz (1)   
    Search B. Biereder in Medline B. Biereder (1)   
    Search T. Haufe in Medline T. Haufe (4)   
    Search M. Kabus in Medline M. Kabus (1)   
    Search G. Hahn in Medline G. Hahn (38)   
    Search D. Weber in Medline D. Weber (20)   
    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   
    Search Ina Sorge in Medline Ina Sorge (24)   
    Search A. Nordwig in Medline A. Nordwig (20)   
    Search A. Jassoy in Medline A. Jassoy (6)   
    Search J. Waldschmidt in Medline J. Waldschmidt (1)   
    Search W. Lässig in Medline W. Lässig (2)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search V. Hofmann in Medline V. Hofmann (17)   
    Search M. Paetzel in Medline M. Paetzel (26)   
    Search N. Abolmaali in Medline N. Abolmaali (18)   
    Search R. Haase in Medline R. Haase (17)   
    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   
    Search G. Hahn in Medline G. Hahn (38)   

    Tectal Lipoma  
     
    Tectal Lipoma
    G Hahn. Tectal Lipoma. PedRad [serial online] vol 2, no. 9.
    URL: www.PedRad.info/?search=20020902155928


     

    Which diagnosis have other collegues guessed?


    • Primary sclerosing cholangitis
      Votes: 16 (88 %)


    • Caroli syndrome
      Votes: 1 (5 %)


    • Obstructing concrement in the ductus choledochus
      Votes: 0 (0 %)


    • Hepatitis
      Votes: 0 (0 %)


    • Liver cirrhosis
      Votes: 1 (5 %)


    • Liver cirrhosis
      Votes: 0 (0 %)


    • Hepatocellular carcinoma
      Votes: 0 (0 %)


    • Hepatoblastoma
      Votes: 13 (40 %)


    • Follicular nodular hyperplasia
      Votes: 1 (3 %)


    • Hemangioma
      Votes: 0 (0 %)


    • Neuroblastoma
      Votes: 3 (5 %)


    • Ganglioneuroblastoma
      Votes: 2 (3 %)


    • Pheochromozytoma
      Votes: 16 (28 %)


    • Adrenal adenoma
      Votes: 3 (5 %)


    • Neurofibroma
      Votes: 1 (1 %)


    • Laryngomalacia
      Votes: 1 (1 %)


    • Cricoid cartilage stenosis
      Votes: 1 (1 %)


    • Larynxcyst
      Votes: 4 (5 %)


    • subglottic valve
      Votes: 2 (2 %)


    • Larynxpapillomatosis
      Votes: 0 (0 %)


    • Hemangioma
      Votes: 12 (15 %)


    • Cholecystitis in Cholecystolithiasis
      Votes: 12 (13 %)


    • Infected choleodochus cyst
      Votes: 1 (1 %)


    • Infected intestinal duplicature
      Votes: 1 (1 %)


    • Ovarian cyst
      Votes: 1 (1 %)


    • Wet lung
      Votes: 0 (0 %)


    • Pulmonary edema
      Votes: 3 (2 %)


    • ARDS
      Votes: 5 (4 %)


    • Pleural effusion
      Votes: 1 (0 %)


    • IRDS
      Votes: 4 (3 %)


    • Bronchopulmonary dysplasia
      Votes: 0 (0 %)



        Total answers: 105

     
    Tectal Lipoma
    G Hahn. Tectal Lipoma. PedRad [serial online] vol 2, no. 9.
    URL: www.PedRad.info/?search=20020902155928


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Tectal Lipoma
    G Hahn. Tectal Lipoma. PedRad [serial online] vol 2, no. 9.
    URL: www.PedRad.info/?search=20020902155928


     


    Go to the top of the page   ID: 20020531205559 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Echinococcus granulosus cyst in the liver
    M Uhl. Echinococcus granulosus cyst in the liver. PedRad [serial online] vol 2, no. 5.
    URL: www.PedRad.info/?search=20020531205559


     
     Pediatric Radiology CasesImages to this case: There are CT-images available for this case. [ CT ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    M. Uhl (Freiburg)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    14 Years  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    14 year-old girl from Kurdistan with serologically proven echinococcus granulosus illness.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Synonym: Echinococcus cysticus unilocularis. (Canine tapeworm), End host: dog, fox, wolf.

    Larvae enter the liver via the portal vein, slowly displacing growth (ca 5 cm growth per year). Daughter cysts are frequently seen.

     

     
     Pediatric Radiology CasesRadiological findings:


    MRI 1 <- view MRI 1

    MRI 1: T2 weighted axial image with markedly decreased sulcal pattern (= pachygyria) and thin cortex. Furthermore seen is a hemorrhage into the right lateral ventricle (hypointense).



    MRI 2 <- view MRI 2

    MRI 2: T1 weighted axial image demonstrates also significant pachygyria and prominent external CSF spaces. The fluid-fluid level containing hemorrhage in the posterior horns of the right lateral ventricle is better deliniated on the T1 weighted sequence.



    MRI 3 <- view MRI 3

    MRI 3: T2 weighted axial image at the level of the basal ganglia, which appear normal.



    MRI 4 <- view MRI 4

    MRI 4: Coronal CSF suppressed T2 weighted sequence (FLAIR) also demonstrates a markedly decreased sulcal pattern.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Increased liver echogenicity; Bile ducts partially up to the periphery irregularly dilated.



    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Minimal distended gallbladder with significant wall thickening and shadowing.



    MRI 1 <- view MRI 1

    MRI 1: MRCP: No dilatation of the intra- and extrahepatic bile ducts. Slightly irregularity of the walls of the Ductus choledochus. No changes in caliber of the intrahepatic bile ducts.





    X-Ray 1 <- view X-Ray 1

    X-Ray 1: ERCP: Rarefication of the intrahepatic bile ducts with multiple stenoses of different lenght especially in the right liver lobe. Extrahepatic bile ducts are not significantly dilated, Ductus cysticus serpentinuous.




    MRI 1 <- view MRI 1

    MRI 1: T2 transverse: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe. The vena portae is considerably compressed ventrally and is pushed to the left, as is the pancreas. The gall bladder is no longer demarcated.
    The right kidney is compressed from above and thus has moved caudally. The vena cava's lumen is reduced to a slit due to compression in the region of the tumor.




    MRI 2 <- view MRI 2

    MRI 2: T2 coronal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.




    MRI 3 <- view MRI 3

    MRI 3: T1 transversal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.The right kidney is compressed from above and thus has moved caudally.




    MRI 4 <- view MRI 4

    MRI 4: T1 sagittal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 5 <- view MRI 5

    MRI 5: T1 coronar, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 6 <- view MRI 6

    MRI 6: T1 transversal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronary slice: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles (Arrow). Pronounced lateral ventricles with preserved angulation bilat. and slight asymmetry to the left.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Subependymal, cystic structures bilat. left larger than right in the nucleothalamic groove of the lateral ventricles as sequel of a subependymal cerebral hemorrhage I°.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Coronary slice: Subependymal, cystic structures bilat. left larger than right in the lateral ventricles. Multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: transversal: relatively homogenously round tumor. Not above, but rather ventromedial to the left kidney (but above the kidney hilus).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: No increased perfusion in the colored doppler ultrasound is seen. This finding is not typical for this diagnosis.




    MRI 1 <- view MRI 1

    MRI 1: T2-weighted, transversal: hyperintense, slightly inhomogenously round tumor, ventromedial to the left kidney (but above the kidney hilus) .




    MRI 2 <- view MRI 2

    MRI 2: T1-weigted without contrast media, sagittal: isointense- (centrally slightly inhomogenously hypointense). Tumor is ventromedial to the left kidney. After contrast media was given, an obvious contrast enhancement was seen (here without picture).


    MRI 1 <- view MRI 1

    MRI 1: T2-weigted transversal: subglottic hyperintense intratracheal soft tissue mass with a maximal length of ca. 10 mm craniocaudal. Also a 4 mm x 4 mm diameter. This causes the tracheal lumen to be about 10% of what it usually should be.




    MRI 2 <- view MRI 2

    MRI 2: T1-weighted after contrast media: strong homogenous contrast media absprbtion of the subglottic intratracheal soft tissue mass after dose of Gadolinium-DTPA




    Endoscopy 1 <- view Endoscopy 1

    Endoscopy 1: Bronchoscopy: subglottic, starting dorsally, compressed tumor, which seriously restricted the tracheal lumen.



     Ultrasound <- view Ultrasound

    Ultrasound 1: Widened gall bladder without emptying, thickening of the gall bladder wall with increased echogenicity. Depiction of a concrement giving an acoustic shadow at the transition to the cystic duct.





     OP-Situs <- view OP-Situs

    OP-Situs 1: Laparoscopic resected gall bladder with thickened walls and concrement.



    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Stage 1: slight reticular (slight granular) decrease in transparency of the lung, no certain difference to normal findings. (The matches are used to show size)




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Stage 2: Soft decrease in transparency with an aerobronchogram, which overlaps the heart (= always a sign of an alveolar lung reaction!)




    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Stage 3: like stage 2, but with gradual stronger decrease in transparency, as well as a blurry diaphragm and heart.




    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Stage 4: White lung: practically homogenic lung opacity.




    X-Ray 5 <- view X-Ray 5

    X-Ray 5: Synopsis of the changes in Stages I - IV.


    MRI 1 <- view MRI 1

    MRI 1: T1-transversal: Depiction of the VSD as well as the dextropositioned aortic root (arrow), the right ventricular hypertrophy is also seen.




    MRI 2 <- view MRI 2

    MRI 2: Phase-contrast image (VENC 130 cm/s) measured vertical to the stenotic pulmonary trunk. Flow accelleration in the pulmonary trunk is seen in aliasing. In adjusted VENC (300 cm/s), a flow speed of 2.4 m/s was measured.




    MRI 3 <- view MRI 3

    MRI 3: T1-sagittal: Pulmonary sling with severe compression of the trachia and carina. Broncioscopic tracheomalacia. The ventrally located vessel is the pulmonary trunk, dorsally, the left pulmonary artery can be seen.




    MRI 4 <- view MRI 4

    MRI 4: T1-Short axis slice through the ventricle. Obvious right ventricular hypertrophy (arrow)




    MRI 5 <- view MRI 5

    MRI 5: T1-transversal. Pulmonary sling (long arrow) with severe compression of the trachea (short arrow) and carina (bronchioscopic tracheomalacia). Stenosis of the pulmonary trunk (also seen in the Fallot-Tetralogy symptom of the pulmonary stenosis) - within this stenosis, the phase-contrast flow measurement was made (see 2nd image).




    MRI 6 <- view MRI 6

    MRI 6: T1-transversal : Isolated upper lobe bronchus (right, arrow). This isolated bronchus, as well as the further course of the trachea and carina defined in this case of a Type IB (See classification in the picture "Pathology 1").




    Pathology 1 <- view Pathology 1

    Pathology 1: Sling-Classification of chages of the tracheobroncial system in pulmonary slings in Types IA through IIB


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: upper series: Beginning findings on the first day of treatment: a: parasagittal slice: punctuated hyperechogenicities in the marrow (5 MHz). b & c: Part (12 MHz) coronal (b) and sagittal (c): confluent hyperechogenicities (Marrow edema)

    Lower series: Follow-up examination on the 14th day of treatment: d: parasagittal slice: in the close-up with a sector transducer there are no echogenicity increases seen (5 MHz); e & f: (12 MHz) coronal (e) and sagittal (f): obvious multicystic cerebral parenchymal degeneration.




    MRI 1 <- view MRI 1

    MRI 1: Upper series: Beginning findings on the first day of treatment: a: T2-TSE transversal: frontal and parietal marrow edema.
    b: T1-SE coronal: the high-lying parietal edema is seen as a slight decrease in signal.

    Lower series: c: T2-TSE transversal: increased signal in a colliquation necrosis in the area of the previous frontal edema. The small cystic structure of the the necroses cannot be seen in MRI. b: T1-SE coronal: Areas of necrosis located parietally are shown with decreased signal in the follow-up.


    MRI 1 <- view MRI 1

    MRI 1 : Fat isointense mass of about 1 cm in size, originating from the right inferior colliculus (T2-TSE). Impressive chemical-shift artefacts (black line on the lipoma).




    MRI 2 <- view MRI 2

    MRI 2 : Fat isointense mass of about 1 cm in size, originating from the right inferior colliculus (T1-SE tra). Impressive chemical-shift artefacts (black line on the lipoma).




    MRI 3 <- view MRI 3

    MRI 3: Fat isointense mass of about 1 cm in size, originating from the right inferior colliculus (T1-SE sag). Impressive chemical-shift artefacts (black line on the lipoma).




    MRI 4 <- view MRI 4

    MRI 4: Fat isointense mass of about 1 cm in size, originating from the right inferior colliculus (T1 SE cor). Impressive chemical-shift artefacts (black line on the lipoma).




    MRI 5 <- view MRI 5

    MRI 5:Fat isointense mass of about 1 cm in size, originating from the right inferior colliculus (T1-SE-FS). The absent signal after fat supression proves the lipomatous character of the mass.


    CT 1 <- view CT 1

    CT 1: Intrahepatic, hypodense mass, in our case no typical septae recognizable. Air levels within the cysts.

    Because this image was ordered by our surgical team, there are no images from an ultrasound examination before surgery.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    N/A  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    N/A  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Echinococcus, granulosus, cyst, liver, Echinococcus granulosus, liver cyst, Echinococcus cysticus unilocularis, canine tapeworm  

     
     Pediatric Radiology Cases Cite this article:

    M Uhl. Echinococcus granulosus cyst in the liver. PedRad [serial online] vol 2, no. 5.
    URL: www.PedRad.info/?search=20020531205559  

     
     Pediatric Radiology Cases Read similar articles: canine tapeworm&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are CT-images available for this case. [ CT ] View all modalities [ All ]   
     
    Echinococcus granulosus cyst in the liver
    M Uhl. Echinococcus granulosus cyst in the liver. PedRad [serial online] vol 2, no. 5.
    URL: www.PedRad.info/?search=20020531205559


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Echinococcus granulosus cyst in the liver
    Other cases by these authors:

    Search Johannes Gossner in Medline Johannes Gossner (2)   
    Search J. Larsen in Medline J. Larsen (1)   
    Search A. Nordwig in Medline A. Nordwig (20)   
    Search N. Lorenz in Medline N. Lorenz (1)   
    Search B. Biereder in Medline B. Biereder (1)   
    Search T. Haufe in Medline T. Haufe (4)   
    Search M. Kabus in Medline M. Kabus (1)   
    Search G. Hahn in Medline G. Hahn (38)   
    Search D. Weber in Medline D. Weber (20)   
    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   
    Search Ina Sorge in Medline Ina Sorge (24)   
    Search A. Nordwig in Medline A. Nordwig (20)   
    Search A. Jassoy in Medline A. Jassoy (6)   
    Search J. Waldschmidt in Medline J. Waldschmidt (1)   
    Search W. Lässig in Medline W. Lässig (2)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search V. Hofmann in Medline V. Hofmann (17)   
    Search M. Paetzel in Medline M. Paetzel (26)   
    Search N. Abolmaali in Medline N. Abolmaali (18)   
    Search R. Haase in Medline R. Haase (17)   
    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   
    Search G. Hahn in Medline G. Hahn (38)   
    Search M. Uhl in Medline M. Uhl (21)   

    Echinococcus granulosus cyst in the liver  
     
    Echinococcus granulosus cyst in the liver
    M Uhl. Echinococcus granulosus cyst in the liver. PedRad [serial online] vol 2, no. 5.
    URL: www.PedRad.info/?search=20020531205559


     

    Which diagnosis have other collegues guessed?


    • Primary sclerosing cholangitis
      Votes: 16 (88 %)


    • Caroli syndrome
      Votes: 1 (5 %)


    • Obstructing concrement in the ductus choledochus
      Votes: 0 (0 %)


    • Hepatitis
      Votes: 0 (0 %)


    • Liver cirrhosis
      Votes: 1 (5 %)


    • Liver cirrhosis
      Votes: 0 (0 %)


    • Hepatocellular carcinoma
      Votes: 0 (0 %)


    • Hepatoblastoma
      Votes: 13 (40 %)


    • Follicular nodular hyperplasia
      Votes: 1 (3 %)


    • Hemangioma
      Votes: 0 (0 %)


    • Neuroblastoma
      Votes: 3 (5 %)


    • Ganglioneuroblastoma
      Votes: 2 (3 %)


    • Pheochromozytoma
      Votes: 16 (28 %)


    • Adrenal adenoma
      Votes: 3 (5 %)


    • Neurofibroma
      Votes: 1 (1 %)


    • Laryngomalacia
      Votes: 1 (1 %)


    • Cricoid cartilage stenosis
      Votes: 1 (1 %)


    • Larynxcyst
      Votes: 4 (5 %)


    • subglottic valve
      Votes: 2 (2 %)


    • Larynxpapillomatosis
      Votes: 0 (0 %)


    • Hemangioma
      Votes: 12 (15 %)


    • Cholecystitis in Cholecystolithiasis
      Votes: 12 (13 %)


    • Infected choleodochus cyst
      Votes: 1 (1 %)


    • Infected intestinal duplicature
      Votes: 1 (1 %)


    • Ovarian cyst
      Votes: 1 (1 %)


    • Wet lung
      Votes: 0 (0 %)


    • Pulmonary edema
      Votes: 3 (2 %)


    • ARDS
      Votes: 5 (4 %)


    • Pleural effusion
      Votes: 1 (0 %)


    • IRDS
      Votes: 4 (3 %)


    • Bronchopulmonary dysplasia
      Votes: 0 (0 %)



        Total answers: 105

     
    Echinococcus granulosus cyst in the liver
    M Uhl. Echinococcus granulosus cyst in the liver. PedRad [serial online] vol 2, no. 5.
    URL: www.PedRad.info/?search=20020531205559


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Echinococcus granulosus cyst in the liver
    M Uhl. Echinococcus granulosus cyst in the liver. PedRad [serial online] vol 2, no. 5.
    URL: www.PedRad.info/?search=20020531205559


     


    Go to the top of the page   ID: 20020503085551 Original case in english  More links about this topic on Pubmed (PubMed Reader)
    Add this case to your RSS feeder: Subscribe to RSS feed Add to Yahoo Add to Google Add to AOL Add to Furl Subscribe to Feed Burner feed

    Bookmark and Share


    Discussion
     
    Subependymal cyst after 1. degree cerebral hemorrhage
    U Wachter. Subependymal cyst after 1. degree cerebral hemorrhage. PedRad [serial online] vol 2, no. 5.
    URL: www.PedRad.info/?search=20020503085551


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    U. Wachter (Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    Newborn  

     
     Pediatric Radiology CasesGender:

    N/A  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    Clinically unnoticeable newborn; in the screening examination performed on the 3rd day of life, the following ultrasound finding was seen.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    The germinal matrix proliferates at a maximum between the 24th and 32nd week of pregnancy, and is located at the walls of the lateral ventricles, behind the foramen of monroi and lateral to the choroid plexus between the caudate nucleus and thalamus.

    The vessels are lined with a one-layered endothelium and are particularly vunerable to hypoxic-ischemic insults (high metabolism, large mitochondrial numbers) as well as to blood pressure changes.  

     
     Pediatric Radiology CasesRadiological findings:


    MRI 1 <- view MRI 1

    MRI 1: T2 weighted axial image with markedly decreased sulcal pattern (= pachygyria) and thin cortex. Furthermore seen is a hemorrhage into the right lateral ventricle (hypointense).



    MRI 2 <- view MRI 2

    MRI 2: T1 weighted axial image demonstrates also significant pachygyria and prominent external CSF spaces. The fluid-fluid level containing hemorrhage in the posterior horns of the right lateral ventricle is better deliniated on the T1 weighted sequence.



    MRI 3 <- view MRI 3

    MRI 3: T2 weighted axial image at the level of the basal ganglia, which appear normal.



    MRI 4 <- view MRI 4

    MRI 4: Coronal CSF suppressed T2 weighted sequence (FLAIR) also demonstrates a markedly decreased sulcal pattern.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Ductus choledochus above mildly dilated Vena portae with changing caliber. Increased echogenicity of the wall of the Ductus choledochus.



    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Increased liver echogenicity; Bile ducts partially up to the periphery irregularly dilated.



    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Minimal distended gallbladder with significant wall thickening and shadowing.



    MRI 1 <- view MRI 1

    MRI 1: MRCP: No dilatation of the intra- and extrahepatic bile ducts. Slightly irregularity of the walls of the Ductus choledochus. No changes in caliber of the intrahepatic bile ducts.





    X-Ray 1 <- view X-Ray 1

    X-Ray 1: ERCP: Rarefication of the intrahepatic bile ducts with multiple stenoses of different lenght especially in the right liver lobe. Extrahepatic bile ducts are not significantly dilated, Ductus cysticus serpentinuous.




    MRI 1 <- view MRI 1

    MRI 1: T2 transverse: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe. The vena portae is considerably compressed ventrally and is pushed to the left, as is the pancreas. The gall bladder is no longer demarcated.
    The right kidney is compressed from above and thus has moved caudally. The vena cava's lumen is reduced to a slit due to compression in the region of the tumor.




    MRI 2 <- view MRI 2

    MRI 2: T2 coronal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.




    MRI 3 <- view MRI 3

    MRI 3: T1 transversal: Inhomogenic, partly focally hyperintense and partly hypointense, mass of ca. 9 x 7 x 12 cm in size in the right and left hepatic lobe.The right kidney is compressed from above and thus has moved caudally.




    MRI 4 <- view MRI 4

    MRI 4: T1 sagittal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 5 <- view MRI 5

    MRI 5: T1 coronar, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    MRI 6 <- view MRI 6

    MRI 6: T1 transversal, contrast media, fat saturation: After contrast media application, inhomogenic enhancement of the intrahepatic mass, which in the T1-sequence allows delimination of focally hyperintense masses of only a few millimeters.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronary slice: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles (Arrow). Pronounced lateral ventricles with preserved angulation bilat. and slight asymmetry to the left.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Subependymal, cystic structures bilat. left larger than right in the nucleothalamic groove of the lateral ventricles as sequel of a subependymal cerebral hemorrhage I°.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Coronary slice: Subependymal, cystic structures bilat. left larger than right in the lateral ventricles. Multiple punctated echogenity increasings bilat. lateral of the lateral ventricles.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: transversal: relatively homogenously round tumor. Not above, but rather ventromedial to the left kidney (but above the kidney hilus).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: No increased perfusion in the colored doppler ultrasound is seen. This finding is not typical for this diagnosis.




    MRI 1 <- view MRI 1

    MRI 1: T2-weighted, transversal: hyperintense, slightly inhomogenously round tumor, ventromedial to the left kidney (but above the kidney hilus) .




    MRI 2 <- view MRI 2

    MRI 2: T1-weigted without contrast media, sagittal: isointense- (centrally slightly inhomogenously hypointense). Tumor is ventromedial to the left kidney. After contrast media was given, an obvious contrast enhancement was seen (here without picture).


    MRI 1 <- view MRI 1

    MRI 1: T2-weigted transversal: subglottic hyperintense intratracheal soft tissue mass with a maximal length of ca. 10 mm craniocaudal. Also a 4 mm x 4 mm diameter. This causes the tracheal lumen to be about 10% of what it usually should be.




    MRI 2 <- view MRI 2

    MRI 2: T1-weighted after contrast media: strong homogenous contrast media absprbtion of the subglottic intratracheal soft tissue mass after dose of Gadolinium-DTPA




    Endoscopy 1 <- view Endoscopy 1

    Endoscopy 1: Bronchoscopy: subglottic, starting dorsally, compressed tumor, which seriously restricted the tracheal lumen.



     Ultrasound <- view Ultrasound

    Ultrasound 1: Widened gall bladder without emptying, thickening of the gall bladder wall with increased echogenicity. Depiction of a concrement giving an acoustic shadow at the transition to the cystic duct.





     OP-Situs <- view OP-Situs

    OP-Situs 1: Laparoscopic resected gall bladder with thickened walls and concrement.



    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Stage 1: slight reticular (slight granular) decrease in transparency of the lung, no certain difference to normal findings. (The matches are used to show size)




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Stage 2: Soft decrease in transparency with an aerobronchogram, which overlaps the heart (= always a sign of an alveolar lung reaction!)




    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Stage 3: like stage 2, but with gradual stronger decrease in transparency, as well as a blurry diaphragm and heart.




    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Stage 4: White lung: practically homogenic lung opacity.




    X-Ray 5 <- view X-Ray 5

    X-Ray 5: Synopsis of the changes in Stages I - IV.


    MRI 1 <- view MRI 1

    MRI 1: T1-transversal: Depiction of the VSD as well as the dextropositioned aortic root (arrow), the right ventricular hypertrophy is also seen.




    MRI 2 <- view MRI 2

    MRI 2: Phase-contrast image (VENC 130 cm/s) measured vertical to the stenotic pulmonary trunk. Flow accelleration in the pulmonary trunk is seen in aliasing. In adjusted VENC (300 cm/s), a flow speed of 2.4 m/s was measured.




    MRI 3 <- view MRI 3

    MRI 3: T1-sagittal: Pulmonary sling with severe compression of the trachia and carina. Broncioscopic tracheomalacia. The ventrally located vessel is the pulmonary trunk, dorsally, the left pulmonary artery can be seen.




    MRI 4 <- view MRI 4

    MRI 4: T1-Short axis slice through the ventricle. Obvious right ventricular hypertrophy (arrow)




    MRI 5 <- view MRI 5

    MRI 5: T1-transversal. Pulmonary sling (long arrow) with severe compression of the trachea (short arrow) and carina (bronchioscopic tracheomalacia). Stenosis of the pulmonary trunk (also seen in the Fallot-Tetralogy symptom of the pulmonary stenosis) - within this stenosis, the phase-contrast flow measurement was made (see 2nd image).




    MRI 6 <- view MRI 6

    MRI 6: T1-transversal : Isolated upper lobe bronchus (right, arrow). This isolated bronchus, as well as the further course of the trachea and carina defined in this case of a Type IB (See classification in the picture "Pathology 1").




    Pathology 1 <- view Pathology 1

    Pathology 1: Sling-Classification of chages of the tracheobroncial system in pulmonary slings in Types IA through IIB


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: upper series: Beginning findings on the first day of treatment: a: parasagittal slice: punctuated hyperechogenicities in the marrow (5 MHz). b & c: Part (12 MHz) coronal (b) and sagittal (c): confluent hyperechogenicities (Marrow edema)

    Lower series: Follow-up examination on the 14th day of treatment: d: parasagittal slice: in the close-up with a sector transducer there are no echogenicity increases seen (5 MHz); e & f: (12 MHz) coronal (e) and sagittal (f): obvious multicystic cerebral parenchymal degeneration.




    MRI 1 <- view MRI 1

    MRI 1: Upper series: Beginning findings on the first day of treatment: a: T2-TSE transversal: frontal and parietal marrow edema.
    b: T1-SE coronal: the high-lying parietal edema is seen as a slight decrease in signal.

    Lower series: c: T2-TSE transversal: increased signal in a colliquation necrosis in the area of the previous frontal edema. The small cystic structure of the the necroses cannot be seen in MRI. b: T1-SE coronal: Areas of necrosis located parietally are shown with decreased signal in the follow-up.


    MRI 1 <- view MRI 1

    MRI 1 : Fat isointense mass of about 1 cm in size, originating from the right inferior colliculus (T2-TSE). Impressive chemical-shift artefacts (black line on the lipoma).




    MRI 2 <- view MRI 2

    MRI 2 : Fat isointense mass of about 1 cm in size, originating from the right inferior colliculus (T1-SE tra). Impressive chemical-shift artefacts (black line on the lipoma).




    MRI 3 <- view MRI 3

    MRI 3: Fat isointense mass of about 1 cm in size, originating from the right inferior colliculus (T1-SE sag). Impressive chemical-shift artefacts (black line on the lipoma).




    MRI 4 <- view MRI 4

    MRI 4: Fat isointense mass of about 1 cm in size, originating from the right inferior colliculus (T1 SE cor). Impressive chemical-shift artefacts (black line on the lipoma).




    MRI 5 <- view MRI 5

    MRI 5:Fat isointense mass of about 1 cm in size, originating from the right inferior colliculus (T1-SE-FS). The absent signal after fat supression proves the lipomatous character of the mass.


    CT 1 <- view CT 1

    CT 1: Intrahepatic, hypodense mass, in our case no typical septae recognizable. Air levels within the cysts.

    Because this image was ordered by our surgical team, there are no images from an ultrasound examination before surgery.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Parasaggital: cystic lesion in the area of the nucleothalamic fissure.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Coronal: cystic lesion in the area of the nucleothalamic fissure, left.


     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    N/A  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Since a cyst is shown, it is one that has formed untrauterine. Now it is colliquation, which was a subependymal cerebral hemorrhage on the left side (Type I).  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A