Ultrasonography In Infants Research Articles

A Cross Sectional Study of Early Detection of Developmental Dysplasia of Hip Joint by Ultrasonography in Infants below 90 days of Age

Hip dysplasia is an abnormality of the hip joint where the acetabular socket portion does not fully cover the ball portion of femoral head, resulting in an increased risk for joint dislocation. DDH ranges from a simple flattening of the acetabular cavity to the complete dislocation of the femoral head. If untreated, DDH can cause early hip osteoarthritis and, in the most severe forms, the presence of a limp with severe functional limitations, since walking age5.In the past, the incidence of severe forms of the disease without an early diagnosis program, was reported to be 0.13% of all newborns. Aim: To assess the usefulness of ultrasonography in early detection of Developmental Dysplasia of Hip joint in infants below 90 days of age. Material and Methods: A Cross sectional study was carried out under department of Radiology at a Tertiary rural health care centre. All neonates born in labor room and infants below 90 days of age receiving outpatient and inpatient care at tertiary rural health care centre fulfilling the inclusion criteria. Thus total 630 neonates were studied. Data were entered in EXCEL sheet and analysed using SSPS software version 20.0. Risk factors were presented and assessed by chi-square. Results: Majority 96.5% neonates had age less than 5 days. Mean age was 3.03+5.5 days, ranging between 1 Day to 86 days. On coronal- neutral HIP angle, on right mean alpha was 61.1 and beta was 61.5 and on left side mean alpha was 60.2 and beta was 62.9. Prevalence of Developmental Dysplasia of Hip joint was found to be 1.6%. Conclusion: Present study showed significance for gender, family history and gestational age. Present study concludes that USG can do early detection of DDH because Clinical presentation of DDH is little late. So for early diagnosis and treatment USG can be used as a screening test for all the newborns for DDH.

Manual Palpation versus Ultrasound to Identify the Intervertebral Space for Spinal Anesthesia in Infants.

Awake spinal anesthesia continues as an alternative to general anesthesia for infants. Standard clinical practice includes the manual palpation of surface landmarks to identify the desired intervertebral space for lumbar puncture (LP). The current study investigates the accuracy of manual palpation for identifying the intended intervertebral site for LP, using ultrasonography for confirmation and to determine the interspace where the conus medullaris ends. After informed parental consent, patients less than one year of age undergoing spinal anesthesia for lower abdominal, urologic, or lower extremity surgical procedures were included. Patients were held in the seated position and an attending pediatric anesthesiologist or pediatric anesthesiology fellow declared the vertebral interspace intended for needle insertion, palpated surface landmarks, and placed a mark at the site. A research anesthesiologist then determined the actual vertebral interspace of the marked site and the location of the conus medullaris using ultrasonography. The time to complete both techniques (manual palpation and ultrasonography) was recorded. The study cohort included 50 infants (median age of 7 months). Sixteen vertebral interspaces (32%) were inaccurately marked. One was marked two spaces higher than intended, ten were marked one space higher than intended, and five were marked one space lower than intended. In one patient, the intended vertebral interspace for the lumbar puncture overlaid the conus medullaris. The median time required was 25 seconds (IQR 14.3, 32) for palpation and 39 seconds (IQR 29, 63.8) for ultrasonography. Manual palpation of surface landmarks to determine the correct interspace for LP for spinal anesthesia in infants is inaccurate. The time required to perform spinal ultrasonography in infants for determination of the optimal site for LP is brief and may be useful in ensuring accurate identification of the correct interspace and the location of the conus medullaris.

Evaluation of sucking using ultrasonography in infants: a scoping review protocol

RESUMO Objetivo: identificar estudos relacionados à avaliação ultrassonográfica da função de sucção em lactentes. Métodos: esta pesquisa procura investigar como a literatura descreve o uso da ultrassonografia na avaliação da sucção dos lactentes. A estratégia Participantes, Conceito e Contexto foi utilizada para definir os critérios de inclusão, sendo a população avaliada de lactentes de um a 180 dias de vida; com o conceito investigado de avaliação da função de sucção; e o contexto investigado de avaliação ultrassonográfica. A estratégia de busca será realizada nas bases de dados eletrônicas MEDLINE (via PubMed), EMBASE, Web of Science e Scopus e os estudos serão selecionados com base nos critérios de inclusão e exclusão estabelecidos por dois profissionais treinados, independentemente. O protocolo de análise dos artigos irá considerar ano do estudo, delineamento do estudo, número de bebês avaliados, idade, metodologia para avaliação da sucção, metodologia de aquisição de imagens ultrassonográficas da sucção e metodologia de análise ultrassonográfica da sucção. Os dados serão apresentados por meio de diagramas, narrativas e tabelas. Considerações Finais: a ultrassonografia vem sendo descrita na literatura como um instrumento de avaliação que permite a análise dos movimentos da língua durante a sucção. Esta revisão de escopo irá permitir a descrição dos métodos de aquisição da ultrassonografia na avaliação da sucção.

Lenticulostriate vasculopathy in routine brain ultrasonography in infants: next step?

Lenticulostriate vasculopathy (LSV) is a relatively common fi nding in routine cranial ultrasound examination that has been associated with many infectious and non-infectious conditions. The aim of this review was to provide a better understanding of LSV ultrasound fi nding, as well as the need for further laboratory and imaging examinations in infants. The most of the published studies represented small series, with few prospective long-term studies involving the control groups. Authors have mostly found an association between LSV, especially higher-grade (although there is no universally accepted classifi cation) with congenital cytomegalovirus (CMV) infection, classifying those children as at risk for sensorineural hearing loss. In contrast, some authors pointed out that LSV could be found relatively often, and believe that isolated LSV, especially lower-grade, is not predictive for an unfavourable outcome and a long-term prognosis. Therefore, although 35 years have passed since the first publication of LSV, there is still no consensus among experts on the clinical signifi cance of isolated LSV, but caution is certainly needed given the fact that most infants with congenital CMV are asymptomatic.

Prediction of gastric fluid volume by ultrasonography in infants undergoing general anaesthesia

BackgroundPoint-of-care ultrasonography can estimate gastric contents and volume to assess the risk of pulmonary aspiration; however, its use in infants has not been well validated. We aimed to develop a predictive model for estimating gastric fluid volume using ultrasonography in infants. MethodsThis prospective observational study enrolled 200 infants (≤12 months) undergoing general anaesthesia. After anaesthetic induction, while preserving spontaneous respiration, we measured gastric antral cross-sectional area using ultrasonography in both the supine and right lateral decubitus positions. We then suctioned the gastric content and measured its volume. The primary outcome was development of a gastric fluid volume prediction model with multiple regression analysis. Agreement between the predicted volume and the suctioned volume was evaluated using a Bland–Altman plot. ResultsOverall, 192 infants were included in the final analysis. Pearson correlation analysis showed that the gastric antral cross-sectional area in the supine (P<0.001; correlation coefficient: 0.667) and right lateral decubitus (P<0.001; correlation coefficient: 0.845) positions and qualitative antral grade (P<0.001; correlation coefficient: 0.581) correlated with suctioned volume. We developed a predictive model: predicted volume (ml)=–3.7+6.5 × (right lateral decubitus cross-sectional area [cm2])–3.9 (supine cross-sectional area [cm2])+1.7 × grade (P<0.01). When comparing the predicted volume and suctioned volume, the mean bias was 0.01 ml kg−1 and the limit of agreement was –0.58 to 0.62 ml kg−1. ConclusionsGastric fluid volume can be estimated using a predictive model based on ultrasonography data in infants. Clinical trial registrationNCT03155776.

Association Between Fat Mass in Early Life and Later Fat Mass Trajectories

A rapid increase in weight in early life is associated with an increased risk for adiposity and cardiovascular diseases at age 21 years and beyond. However, data on associations of early change in measured fat mass percentage (FM%) with adiposity development are lacking. To investigate whether a rapid increase in FM% in the first months of life is associated with higher trajectories of body fat mass during the first 2 years of life. A birth cohort consisting of 401 healthy, term-born infants of the Sophia Pluto Cohort Study was analyzed. Participants were born between January 7, 2013, and October 13, 2017. Data were analyzed from February 1, 2020, to May 20, 2020. Longitudinal measurements of FM% by air-displacement plethysmography and dual-energy x-ray absorptiometry, and abdominal subcutaneous and visceral fat mass (FM) by ultrasonography in infants at ages 1, 3, 6, 9, 12, 18, and 24 months. A rapid increase in FM% was defined as a change in FM% of greater than 0.67 standard deviation scores (SDS). Associations between change in FM% SDS in the first and second 6-month period of life with body composition at age 2 years and whether a rapid increase in FM% SDS during the first 6 months leads to higher body FM and abdominal FM trajectories during the first 2 years of life. Of the 401 participants, 228 infants (57%) were male. Change in FM% SDS from age 1 to 6 months was positively associated with FM% (β, 0.044; 95% CI, 0.017-0.068), FMI (β, 0.061; 95% CI, 0.032-0.091), and abdominal subcutaneous FM (β, 0.064; 95% CI, 0.036-0.092) at age 2 years, but not with visceral FM. In contrast, no associations were found within the 6- to 12-month period. Infants with a rapid increase in FM% of greater than 0.67 SDS in the first 6 months of life had higher trajectories of FM%, FM index, and subcutaneous FM during the first 2 years of life (all P≤.001), but visceral FM index was not significantly different compared with infants without a rapid increase (P = .12). In this study, only the change in FM% in the first 6 months of life was associated with more adiposity at age 2 years. Infants with a rapid increase in FM% had higher trajectories of FM% and FM index during the first 2 years of life. These findings appear to support a critical window for adiposity programming in early life.

Filum terminale lipoma revealed by screening spinal ultrasonography in infants with simple sacral dimple.

Spine ultrasound (US) examinations are widely performed in neonates and infants with sacral dimple to exclude associated congenital malformations. Increased utilization of, and improvements in, sonographic technology has resulted in the frequent identification of echogenic filum terminale (FT) containing fat below the conus medullaris, termed FT lipoma or fatty FT. We examined the value of screening US, especially for diagnosis of FT lipoma, in infants with "simple sacral dimple." This study was a retrospective review of spinal US and magnetic resonance imaging (MRI) findings performed in our hospital on full-term and preterm infants with simple sacral dimple. We reviewed the clinical records and spinal sonographic scans of 337 patients, and the MRI scans of 40 patients with simple sacral dimple. We evaluated the thickness and echogenicity of FT on US, and the presence of fat in the FT was determined by MRI. In total, 50 of the 337 patients showed strong echogenic FT on US. Correlation with MRI data was possible in 40 of the 50 patients with strong echogenic FT. MRI scans of all 40 of these patients revealed the presence of fat in the FT. The maximum thickness in the strong echogenic area of the FT lipomas of these 40 patients was 1.7 ± 0.4mm (range 1.2-2.5mm), and the minimum thickness was 1.1 ± 0.2mm (range 0.8-1.4mm). Among the 40 infants, 13 (32%) had maximum FT thickness > 2mm (mean thickness 2.2 ± 0.2mm; range 2-2.5mm) and 27 (68%) had echogenic FT < 2mm thick (mean thickness 1.5 ± 0.2mm; range 1-1.9mm). The length of the echogenic segment on US was about 1.9-5.1cm (mean length 3.4 ± 1.1cm). All 40 patients showed FT lipoma without any associated abnormalities, such as cord tethering or low-lying conus. Among the total population of 337 patients, 30 (8.9%) showed borderline low-lying conus medullaris located at the L2-3 disc space or midpoint of the L3 vertebra. All 30 of these patients had borderline low-lying conus without other associated abnormalities. Filar cyst was noted in 36 of 337 patients (10.6%), without other associated abnormalities. No patient underwent surgery associated with a risk of neurological problems within a follow-up period of 10-37months. Although screening US in infants with simple sacral dimple yielded benign imaging findings, the presence of FT lipoma was common in these infants. Therefore, it is necessary to carefully observe changes in echogenicity during measurement of FT thickness on US. All FT lipomas were low risk and had no associated abnormalities, such as cord tethering or low-lying conus.

Development and Characterization of Medical Phantoms for Ultrasound Imaging Based on Customizable and Mouldable Polyvinyl Alcohol Cryogel–Based Materials and 3-D Printing: Application to High-Frequency Cranial Ultrasonography in Infants

This work presents an affordable and easily customizable methodology for phantom manufacturing, which can be used to mimic different anatomic organs and structures. This methodology is based on the use of polyvinyl alcohol–based cryogels as a physical substitute for biologic soft tissues and of 3-D printed polymers for hard tissues, moulding and supporting elements. Thin and durable soft-tissue mimicking layers and multilayer arrangements can be obtained using these materials. Special attention was paid to the acoustic properties (sound speed, attenuation coefficient and mechanical impedance) of the materials developed to simulate soft tissues. These properties were characterized as a function of the additives concentration (propylene-glycol and alumina particles). The polyvinyl alcohol formulation proposed in this work is stable over several freeze-thaw cycles, allowing the manufacturing of multilayer materials with controlled properties. The manufacturing methodology presented was applied to the development of a phantom for high-frequency cranial ultrasonography in infants. This phantom was able to reproduce the main characteristics of the ultrasound images obtained in neonates through the anterior fontanel, down to 8-mm depth.

A Study of Lung Ultrasonography in Infants with Acute Lower Respiratory Tract Infection as a Quick and Safe Alternative Tool in a Group of Egyptian Infants

Background: Acute lower respiratory infections (ALRI), such as pneumonia and bronchiolitis, are the leading cause of morbidity and mortality in children under five years of age. Aim of the Work: To study ultrasonography findings in infants with acute lower respiratory tract infection and to test its sensitivity and specificity in comparison to clinical and conventional x- ray for diagnosis of childhood acute lower respiratory tract infection. Patients and Methods: The present cross sectional study was conducted on sixty patients were chosen according to inclusion criteria (fever with signs of respiratory distress) to compare chest ultrasonography to chest x-ray in diagnosis of children with acute lower respiratory tract infection. Results: In our study, diagnostic Accuracy of ultrasound was 93.45%, while diagnostic Accuracy of chest X- ray was 81% in patients’ group. Sensitivity of ultrasound in cases of Bronchiolitis was 87.5% in comparison to chest X-ray was 78.1%, sensitivity of ultrasound in cases of pneumonia was 84.2% in comparison to chest X- ray was 52.6%. According to specificity, there is no difference in specificity between all patients’ groupConclusion: In view of our study it can be concluded that, chest US offers an important contribution to the diagnostic procedures of acute lower respiratory tract infection in children, as Bronchiolitis, pneumonia and pleural effusion with higher sensitivity, specificity and positive predictive index comparable to chest X-ray.

Effect of Single Intravitreal Bevacizumab on Ophthalmic and Middle Cerebral Arterial Blood Flow in Retinopathy of Prematurity

Purpose: To evaluate the effect of a single intravitreal bevacizumab (IVB) injection on blood flow parameters in the ophthalmic artery (OA) and middle cerebral artery (MCA) in infants with retinopathy of prematurity (ROP). Materials and Methods: This prospective and interventional study included 15 infants with ROP who were treated with IVB. Peak systolic velocity (PSV), end-diastolic velocity, mean velocity (MV) and resistivity index were measured using pulse wave Doppler ultrasonography (Philips En Visor C, Amsterdam, The Netherlands) in the OA and MCA, before IVB injection and 1 day, 1 week and 1 month after IVB injection. Results: Measurements of PSV-OA, MV-OA and PSV-MCA showed significant changes after IVB treatment (p = 0.01, p = 0.02, p = 0.02, respectively). The PSV-OA measurements at 1 week and 1 month were significantly lower than the baseline PSV-OA measurement (p = 0.03 and p = 0.01, respectively). The MV-OA measurement was significantly lower at 1 month following IVB as compared to the baseline MV-OA measurement (p = 0.03). The PSV-MCA showed a significant decline 1 day after IVB injection (p = 0.03). Conclusions: The study demonstrated that IVB causes significant alterations in blood flow parameters in the OA and MCA predicted by Doppler ultrasonography in infants with ROP.

Intraoperative trans-fontanellar cerebral ultrasonography in infants during cardiac surgery under cardiopulmonary bypass: an observational study.

This study was performed to evaluate the feasibility of intraoperative point-of-care trans-fontanellar cerebral ultrasonography (TFCU) to obtain blood flow velocity (BFV) reference values at the internal carotid arteries (ICAs) and peri-callosal part of the anterior cerebral artery (pACA) during pediatric cardiac surgery under cardiopulmonary bypass (CPB). TFCU was performed at three time points (after induction of anesthesia, during CPB, after CPB) in 35 infants. BFV was measured at both ICAs and pACA through the anterior fontanelle with an ultrasound sector probe. We divided patients into Group S (<5kg, n=16) and Group L (≥5kg, n=19) for comparisons according to weight. We also analyzed BFV in low cerebral regional oxygen saturation (rSO2) data. All measurements of the BFV at both the ICAs and the pACA were possible. BFVs at the ICAs were lower in Group S than in Group L at all three time points. BFVs at the pACA were similar in both groups except higher value in Group L after CPB. When the rSO2 was <50, most BFVs (14 of 15 measurements) were lower than the median BFV value during CPB. However, a low rSO2 did not always reflect low BFV before and after CPB. Point-of-care TFCU can determine BFV at the ICAs and pACA during pediatric cardiac surgery. BFV differs according to the patient's size and CPB application. TFCU can be a practical cerebral blood flow monitoring method when rSO2 changes without any specific reason in infants.ClinicalTrials.gov NCT01996020.

Intestinal ultrasonography in infants with moderate or severe hypoxic-ischemic encephalopathy receiving hypothermia.

Infants with hypoxic-ischemic encephalopathy (HIE) may develop multiorgan dysfunction, but assessment of intestinal involvement is imprecise and based on nonspecific clinical signs that may occur several days later. Ultrasound imaging has been described as a helpful tool in assessing intestinal involvement in many gastrointestinal disorders. Describe abdominal ultrasonography findings in infants receiving therapeutic hypothermia and investigate its association with the severity of the hypoxic-ischemic insult and death. Studies were performed within the first 36h of life to assess intestinal appearance (normal bowel, bowel wall echogenicity and thickness, and sloughed mucosa), free fluid, peristalsis and intramural perfusion. These findings were compared between infants with moderate and severe encephalopathy. Ultrasound findings were also categorized in three major groups and compared with markers of severity of the hypoxic-ischemic insult and with mortality. Nineteen infants with moderate and 9 with severe HIE at admission were studied (17.7 ± 9.5h of life). Major ultrasonography findings were increased bowel wall echogenicity (78%), free fluid (75%), decreased or absent peristalsis (50%) and sloughing of the intestinal mucosa (21%). Abnormal intestinal findings such as increased bowel wall echogenicity in all quadrants and presence of sloughed mucosa were associated with more severe hypoxic-ischemic insult. All 12 patients with normal bowel appearance or increased bowel wall echogenicity restricted to only one quadrant survived, whereas 7/15 (47%) patients with increased bowel wall echogenicity in all four quadrants died during hospitalization. The presence of sloughed mucosa was associated with increased mortality (P < 0.001). In infants receiving therapeutic hypothermia, a high prevalence of intestinal involvement was noted by using ultrasonographic assessment. An association between intestinal findings and severity of hypoxic-ischemic insult was observed. The presence of sloughed mucosa is a potential ultrasonographic sign of severity.

Meaning of ureter dilatation during ultrasonography in infants for evaluating vesicoureteral reflux

PurposeTo investigate the meaning of ureter dilatation during ultrasonography (US) in infants for evaluating vesicoureteral reflux (VUR). Materials and methodsWe retrospectively reviewed abdominal US images of infants who were diagnosed with urinary tract infection (UTI group) or only hydronephrosis without UTI (control group). Hydronephrosis (graded 0–4) and ureter dilatation (present or absent) were evaluated on each side with US. Voiding cystourethrography (VCUG) within 3 months time interval with US was also reviewed and VUR was graded (0–5) on each side. Hydronephrosis, ureter dilatation, and VUR were then compared between the two groups. ResultsFour hundred and three infants (142 in the UTI group and 261 in the control group) were included and VCUG was performed in 129 infants (68 in UTI and 61 in control groups). VUR grades were not different between the two groups (p=0.252). Hydronephrosis grade was not related to VUR in either group (p>0.05). However, ureter dilatation had a significant relationship with VUR in the UTI group (p=0.015), even among patients with a high-grade VUR (p=0.005). Whereas, ureter dilatation was not associated with VUR in the control group (p=0.744). The relationship between ureter dilatation and VUR was different between the two groups for both all grades (p=0.014) and high-grade (p=0.004) VUR. Ureter dilatation had 66.7% sensitivity, 80.3% specificity, and 79.4% accuracy for evaluating high-grade VUR in the UTI group. ConclusionUreter dilatation on US can be a helpful finding for detecting VUR in infants with UTI, but not infants without UTI.

Serial Cranial US for Detection of Cerebral Sinovenous Thrombosis in Preterm Infants

Purpose To report the incidence of cerebral sinovenous thrombosis (CSVT) in a prospective cohort of preterm infants with a gestational age of less than 29 weeks. Materials and Methods The local medical ethics review board approved this study, and written parental consent was obtained. Preterm infants with a gestational age of less than 29 weeks who were admitted to the neonatal intensive care unit were prospectively studied with cranial ultrasonography (US). The scanning protocol included visualization with color Doppler imaging of the superior sagittal sinus and transverse sinuses through the anterior (8.5-MHz probe) and mastoid (13-MHz probe) fontanelles. When feasible, magnetic resonance imaging was performed to confirm cranial US-diagnosed CSVT. The differences between preterm infants with and those without CSVT were analyzed by using Mann-Whitney tests for continuous variables and Fisher exact tests for categorical data. Results Cranial US was used to document CSVT in 11 of 249 preterm infants with a gestational age of less than 29 weeks. Transverse sinuses were most frequently affected (in all 11 patients with CSVT). All infants with CSVT were asymptomatic. Postnatal age at diagnosis ranged from 5 to 34 days. The mean gestational age was significantly lower in infants with CSVT (25.9 weeks vs 26.8 weeks, P = .038). Of the risk factors studied, only duration of mechanical ventilation was associated with CSVT; it was significantly longer in the CSVT group. Conclusion Systematic serial cranial US of infants with a gestational age of less than 29 weeks showed a remarkably high incidence of CSVT of 4.4%. Cranial US including color Doppler imaging with scans obtained through the mastoid fontanelle can depict CSVT at an early stage. Treatment of this possibly important condition needs attention. © RSNA, 2013

Serial Cranial US for Detection of Cerebral Sinovenous Thrombosis in Preterm Infants

To report the incidence of cerebral sinovenous thrombosis (CSVT) in a prospective cohort of preterm infants with a gestational age of less than 29 weeks. The local medical ethics review board approved this study, and written parental consent was obtained. Preterm infants with a gestational age of less than 29 weeks who were admitted to the neonatal intensive care unit were prospectively studied with cranial ultrasonography (US). The scanning protocol included visualization with color Doppler imaging of the superior sagittal sinus and transverse sinuses through the anterior (8.5-MHz probe) and mastoid (13-MHz probe) fontanelles. When feasible, magnetic resonance imaging was performed to confirm cranial US-diagnosed CSVT. The differences between preterm infants with and those without CSVT were analyzed by using Mann-Whitney tests for continuous variables and Fisher exact tests for categorical data. Cranial US was used to document CSVT in 11 of 249 preterm infants with a gestational age of less than 29 weeks. Transverse sinuses were most frequently affected (in all 11 patients with CSVT). All infants with CSVT were asymptomatic. Postnatal age at diagnosis ranged from 5 to 34 days. The mean gestational age was significantly lower in infants with CSVT (25.9 weeks vs 26.8 weeks, P = .038). Of the risk factors studied, only duration of mechanical ventilation was associated with CSVT; it was significantly longer in the CSVT group. Systematic serial cranial US of infants with a gestational age of less than 29 weeks showed a remarkably high incidence of CSVT of 4.4%. Cranial US including color Doppler imaging with scans obtained through the mastoid fontanelle can depict CSVT at an early stage. Treatment of this possibly important condition needs attention.

Technique for shoulder ultrasonography in infants with congenital brachial plexus palsy

Technique for shoulder ultrasonography in infants with congenital brachial plexus palsy

Technique for shoulder ultrasonography in infants with congenital brachial plexus palsy

BACKGROUND Glenohumeral instability is a known complication of congenital brachial plexus palsy. In certain cases, muscle imbalance leads to posterior displacement of the head of the humerus on the cartilaginous glenoid, resulting in glenoid dysplasia and varying degrees of joint subluxation. Studies using ultrasonography have demonstrated that these anatomical changes occur in the early months of life and can be reversed with prompt treatment. However, the technical challenge of obtaining standard ultrasonography in a child a few weeks old is considerable. The subject is small, mobile and unable to sit unsupported. The shoulder that is being examined must be fully exposed with the upper limb free to move in order to obtain dynamic imaging. We had previously tried several methods of supporting the baby in order to facilitate the examination to no avail until it occurred to us to use a simple proprietary seating aid.

Solid Ectopic Cervical Thymus in Neonates With Thyroid Agenesis

We report a series of ectopic thymus glands as detected by sonography in infants with thyroid agenesis. The patients were children who underwent nuclear medicine and sonography for congenital hypothyroidism. Of the 12 patients with a diagnosis of thyroid agenesis over a 5-year period, 4 (33%) were shown to have ectopic thymic tissue. Although a cervical ectopic thymus has been previously reported, there is very little discussion of it occurring in conjunction with thyroid agenesis. This case series highlights the importance of recognition of ectopic thymic tissue when examining for thyroid tissue in the setting of congenital hypothyroidism.

Transcranial Doppler ultrasonography in infants with sickle cell disease-Is earlier identification of children at risk of stroke possible?

Transcranial Doppler ultrasonography in infants with sickle cell disease-Is earlier identification of children at risk of stroke possible?

Isolated filar cyst on lumbar spine sonography in infants: a case-control study

Isolated filar cyst on lumbar spine sonography in infants: a case-control study