Contrast‐Enhanced Colosonography for the Evaluation of Children With an Imperforate Anus

This case series describes a novel method for showing the preoperative anatomy of children with anorectal malformations using ultrasound contrast, which we have termed “contrast‐enhanced colosonography (ceCS).” Six patients with anorectal malformations without a perineal fistula were studied both by fluoroscopic distal colostography and ceCS, and their results were confirmed surgically. Contrast‐enhanced CS precisely showed the complex anatomic relationships in all cases. Compared to traditional fluoroscopic studies, ceCS has the benefit of no associated ionizing radiation and thus is safer for children.     

Role of Sonography for Evaluation of Gastrointestinal Foreign Bodies

Foreign body ingestion is frequently encountered in children. The locations of the foreign bodies and the period during which they have been present in the thorax and abdomen are important for determining the method and timing of treatment. Although plain radiography and computed tomography are primarily used for assessment of foreign bodies, sonography without radiation is also useful for diagnosis of foreign bodies. This report describes 5 cases of foreign bodies in the digestive tract and the usefulness of sonography for real‐time evaluation of foreign bodies with high spatial resolution. Physicians can use sonography along with radiography and computed tomography in cases involving foreign bodies.     

Sonography of the pediatric thyroid: A pictorial essay

The purpose of this article is to review the various pediatric thyroid diseases using sonographic images. These diseases included congenital hypothyroidism (dysgenesis [aplasia; ectopy; hypoplasia], dyshormonogenesis, transient hypothyroidism), thyroglossal duct cyst, Graves' disease, Hashimoto's thyroiditis, suppurative thyroiditis, nodular hyperplasia (goiter) and thyroid mass. Thyroid sonogram is the primary method used for thyroid disease and can be used for guiding of fine needle aspiration to obtain a more accurate diagnosis for suspected thyroid lesions. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound 2009     

Sonography of Abdominal Pain in Children

Abdominal pain is very common in the pediatric population (<18 years of age). Sonography is a safe modality that can often differentiate the frequently encountered causes of abdominal pain in children. This pictorial essay will discuss the sonographic findings of acute appendicitis, including the imaging appearance of a perforated appendicitis. It will also present the sonographic features of the relatively common mimics of appendicitis, such as mesenteric adenitis/gastroenteritis, intussusception, Meckel diverticulum, and ovarian torsion.     

Three‐Dimensional Sonography in the Evaluation of Primary Hyperparathyroidism

Three‐dimensional sonography is useful in the preoperative evaluation of patients with primary hyperparathyroidism. In this pictorial essay, we review the characteristic spectrum of grayscale and Doppler appearances of parathyroid glands on 2‐dimensional sonography and demonstrate the additional benefits of 3‐dimensional scanning.     

Sonography for diagnosis of cervical ribs in children.

OBJECTIVE: The purpose of this series was to describe the use of sonography for diagnosis of cervical ribs in children. METHODS: Two children had hard nonmobile supraclavicular masses that were of clinical concern for malignancy. Both children were first evaluated by sonography. RESULTS: Sonography showed each mass to be a tubular bony structure with a cartilaginous end. They were thought to represent cervical ribs. This anatomic variant was subsequently confirmed with radiography in 1 case and computed tomography in the other. CONCLUSIONS: Musculoskeletal sonography may offer a reliable method for diagnosing cervical ribs without the need for ionizing radiation.     

A Potential Pitfall of Using Focused Assessment With Sonography for Trauma in Pediatric Trauma

Prospective studies have shown sensitivities of 73% to 88% and specificities of 98% to 100% for using the focused assessment with sonography for trauma (FAST) examination to identify free fluid in adult trauma patients. However, the efficacy of FAST examinations for pediatric trauma patients has not been well defined, and studies looking at diagnostic performance have had varied results. We describe 3 cases of the potential pitfalls of the pediatric FAST examination in pediatric trauma patients using an advanced‐processing ultrasound machine. We hypothesize several etiologies for these false‐positive findings in the setting of advanced image‐processing capabilities of point‐of‐care ultrasound. We also discuss the reevaluation of clinical algorithms and interpretation practices when using the FAST examination in pediatric trauma.