Dimensions of the growing trachea related to body height. Length, anteroposterior and transverse diameters, cross-sectional area, and volume in subjects younger than 20 years of age

Using computed tomography, we measured the tracheas of 100 subjects younger than 20 yr of age. The 10 youngest were sleeping. The other 90 were awake, and most were measured near total lung capacity. Tracheal length, mean anteroposterior diameter, mean transverse diameter, mean cross-sectional area, and contained volume were plotted against body height for all 100 subjects. The relationships of these dimensions to body height were derived for the 90 subjects examined awake. The resulting regressions had r values of 0.88 to 0.92. The exponents for height were 1.22 to 1.37 for the linear dimensions, 2.58 for area, and 3.80 for volume. We found no differences between the sexes. Variability in diameters and area along individual tracheas was small, especially after early childhood. Such variability as occurred tended to preserve shape slightly more than size. This constancy allows accurate prediction of tracheal area from either tracheal diameter.     

Trends in pediatric radiology in the United States

Long-term trends in pediatric radiology in the United States – in the radiologic care of children, in research, in education and career development, in the Society for Pediatric Radiology, and in the field as a whole – were listed in 1995. The present article attempts to bring those trends up to date for the year 2000 and also describes trends not identified in the earlier report. Received: 6 June 2000/Accepted: 14 August 2000     

Neonatal intestinal opacification secondary to transplacental passage of urographic contrast medium.

Neonatal intestinal opacification in five infants (one set each of triplets and twins) after maternal excretory urography is described, and mechanisms leading to this phenomenon are discussed. Transplacental passage of urographic contrast medium with subsequent excretion by the fetal kidneys and possibly liver and small bowel seems to explain the radiographic appearance. Although the contrast medium probably does not harm the fetus, it should be distinguished from other more sinister causes of colonic opacification in the neonate.     

Ascites during the first week of life (author's transl)]

Retrospective analysis of 22 cases with neonatal ascites showed the most common cause to be anomalies of the urogenital system (urethral valve, hydronephrosis, rupture of bladder, rupture of ovarian cyst). Next came malformations of the gastro-intestinal tract and of the liver and congenital infections (toxoplasmosis, cytomegaly). In 4 cases the cause was not found. More than one half of the cases permitted a definitive radiologic diagnosis, mainly in malformations requiring surgery. We suggest a standardized procedure of investigation of all cases with neonatal ascites. If this procedure does not result in a positive diagnosis and if the ascites fluid does not contain blood or bile, we fell that laparotomy is not indicated.     

Interpretation of chest radiographs in infants with cough and fever

An understanding of the appearance of the infant chest radiograph requires an understanding of the anatomy and the physiologic, immunologic, and pathologic processes in the infant's chest. The authors describe the features of the infant chest that most influence the appearance of the chest radiograph in infants with cough and fever. They discuss why confusion sometimes occurs when radiology residents and general radiologists familiar with adult chest radiographs first evaluate the infant chest radiograph. The radiographic appearance of acute inflammation does not look the same in infants as it does in older children and adults. The hallmark of inflammatory lung disease in the infant chest is air trapping on the chest radiograph.     

Effects of therapeutic irradiation delivered in early childhood upon subsequent lung function.

To determine the long-term effects of therapeutic pulmonary irradiation and treatment with actinomycin D during a period of lung growth, 12 patients treated for Wilms' tumor metastatic to the lung and 8 patients treated for Wilms' tumor with no evidence of pulmonary metastases were studied 7 to 14 years after their initial tumor therapy. All patients had received irradiation to the tumor bed and treatment with actinomycin D. Group 1 had received a single course of bilateral pulmonary irradiation; group 2 had received additional pulmonary irradiation and/or thoracic surgery; group 3 had received no therapeutic irradiation directed primarily to the chest. Total lung capacity (TLC) averaged 71% of predicted value in group 1, 58% in group 2, and 94% in group 3. Diffusing capacity in groups 1 and 2 was reduced to the same extent as lung volume. Quasi-static pressure-volume relationships, studied in three of six patients in group 1, were within the normal range when lung volume was expressed as percentage of observed TLC. Airway resistance, evaluated by spirometry, maximum expiratory flow-volume curves, and resistance of the total respiratory system, was normal or reduced. The data support the hypothesis that therapeutic irradiation during a period of lung growth primarily affects the lung parenchyma and produces a decrease in subsequent size of both the lung and chest wall. No effect of actinomycin D alone upon the lung could be demonstrated.