1. Central Nervous System: Brain ......... 1

GUIDELINES FOR PERFORMANCE OF ULTRASOUND
EXAMINATION IN INFANTILE BRAIN 3

TECHNIQUE OF BRAIN ULTRASOUND 3
– Coronal Images 3
– Sagittal View 6

DOPPLER AND COLOR DOPPLER IMAGING 9

CONGENITAL INTRACRANIAL ANOMALIES 9
– Encephalocele 9
– Arnold-Chiari Malformation 9
– Dandy-Walker Malformation 13
– Dysgenesis of Corpus Callosum 14
– Holoprosencephaly 15
– Hemimegalencephaly 15
– Hydranencephaly 15

BRAIN CYSTS 24
– Arachnoid Cysts 24
– Choroid Plexus Cysts 26

ANEURYSM VEIN OF GALEN 26

HYDROCEPHALUS 31

INTRACRANIAL INFECTIONS 36
– Neonatal Meningitis 37
– Brain Abscess 37
– Congenital Infections 37

INTRACRANIAL HEMORRHAGES 43
– Subependymal and Intraventricular
Hemorrhages 43
– Intracranial Hemorrhage in Full Term
Babies 52
– Subdural Hemorrhage 52
– Subarachnoid Hemorrhage 53
– Intraparenchymal Hemorrhage 53

HYPOXIC-ISCHEMIC ENCEPHALOPATH 53
– Ischemic Lesion in Premature Infants 54
– Hypoxic-ischemic Encephalopathy in
Term Babies 54
2. Central Nervous System: Spine ....... 71

ULTRASONOGRAPHY OF NEONATAL SPINE 73

NORMAL ANATOMY OF SPINE 73

SPINA BIFIDA 73
– Spina Bifida Occulta 74
– Spina Bifida Cystica 74
– Spina Bifida Aperta 79

PSOAS ABSCESS 79

NEUROGENIC TUMOR 82
3. Neonatal Hip .................................. 85

ULTRASOUND INDICATIONS OF NEONATAL HIP 87

ANATOMY OF HIP JOINT 87

TIME OF EXAMINATION 87

EXAMINATION VIEWS 87
– True Coronal View 87
– Transverse Neutral View 89
– Transverse Flexion View 89

HIP JOINT MEASUREMENTS 90
– Graf’s Technique for the Measurement of
Neonatal Hip 90
– Lateral Head Distance (LHD) Terjesen Method 90

ULTRASOUND APPEARANCE IN DISLOCATION 97
4. Chest .............................................. 99

ULTRASOUND OF THE CHEST 101
– Indications of Ultrasound Chest 101
– Ultrasound Technique 101

DIAPHRAGMATIC HERNIA 101

EVENTRATION OF DIAPHRAGM 101

MEDIASTINAL WIDENING 105

LUNG CONSOLIDATION 110

PLEURAL EFFUSION 110
5. Abdomen: Bowel and Mesentery . 113
BOWEL

ULTRASOUND OF THE BOWEL 115
– Technique 115
– Sonographic Layers of the Bowel 115

HYPERTROPHIC PYLORIC STENOSIS (HPS) 115
– Ultrasound of Patient with HPS 115

DUPLICATION CYST 117
– Duplication Cyst of Stomach 117
– Duplication Cyst of Duodenum 117

DUODENAL ATRESIA 117

BEZOAR 122

INTUSSUSCEPTION 122

LYMPHOMA 127

APPENDICITIS 129
– Ultrasound Findings 136

INTESTINAL OBSTRUCTION 137
– Small Bowel 137
– Large Bowel 138

ULTRASOUND TECHNIQUE FOR IMPERFORATE
ANUS 139

HIRSCHSPRUNG’S DISEASE 139

WORMS IN BOWELS 139

TUBERCULOSIS 139
MESENTERY

MESENTERIC CYSTS 148

MECONIUM PERITONITIS AND MECONIUM
PSEUDOCYST 148

ASCITES 151
6. Abdomen: Infiltrative
Disorders of Liver ......................... 155

NORMAL ANATOMY AND APPEARANCE 157

GENERALIZED INFILTRATION OF LIVER 157
– Acute Viral Hepatitis 157
– Chronic Persistent Hepatitis 159
– Granulomatous Hepatitis 159

CIRRHOSIS 161

BUDD-CHIARI SYNDROME 161

CONGESTIVE LIVER 166

FATTY INFILTRATION LIVER 166

LYSOSOMAL AND GLYCOGEN STORAGE DISEASES 169
– Gaucher’s Disease 169

OTHER INFILTRATIVE DISEASES 169
7. Abdomen: Focal Lesions in
Liver ............................................. 173

SIMPLE LIVER CYST 175

ECHINOCOCCAL CYST 175

LIVER ABSCESSES 179
– Amebic Liver Abscess 179
– Pyogenic Liver Abscesses 182
– Tuberculous Abscess 182

HEPATIC TRAUMA 185

BENIGN LIVER MASSES 185
– Hemangioma 185
– Hemangioendothelioma 185
– Focal Nodular Hyperplasia 187

MALIGNANT TUMORS 187
– Hepatoblastoma and Hepatocellular
Carcinoma 187
– Metastasis 189
– Lymphoma Liver 195
8. Abdomen: Gallbladder and
Common Bile Duct..................... 197
GALLBLADDER

ANATOMY 199

TECHNIQUE 199

BILIARY SLUDGE 200

CHOLELITHIASIS 201

ACUTE CALCULUS CHOLECYSTITIS 201

ACUTE ACALCULUS CHOLECYSTITIS 201

CHOLESTEROLOSIS OF GALLBLADDER 205

GALLBLADDER TUMORS 209
COMMON BILE DUCT

CHOLESTASIS IN NEWBORN 211
– Neonatal Hepatitis 212
– Biliary Atresia 213

CHOLEDOCHAL CYST 213

BILIARY ASCARIS 218
9. Abdomen: Pancreas and Spleen ... 221
PANCREAS

NORMAL PANCREAS AND ANATOMY 223

ACUTE PANCREATITIS 223

CHRONIC PANCREATITIS 228

PANCREATIC TRAUMA 230
SPLEEN

NORMAL SPLEEN AND ANATOMY 231

POLYSPLENIA 234

WANDERING SPLEEN 234

SPLENIC CYST 235

SPLENIC ABSCESS 235

SPLENIC TRAUMA 239

STORAGE DISEASES 239

MALIGNANT MASSES 241
10. Abdomen: Urinary Tract ............... 243
RENAL ANATOMY AND APPEARANCE
RENAL ANOMALIES

RENAL HYPOPLASIA 246

SIMPLE ECTOPIA 246

CROSSED RENAL ECTOPIA 246

HORSESHOE KIDNEYS 246

DUPLICATION ANOMALIES 250

PUJ OBSTRUCTION 251

URETEROVESICAL JUNCTION OBSTRUCTION 251

CONGENITAL HYDRONEPHROSIS 254

VESICOURETERIC REFLUX 256

POSTERIOR URETHRAL VALVE 259
RENAL CYSTIC DISEASE

SIMPLE CYST 264

POLYCYSTIC DISEASE 264

AUTOSOMAL DOMINANT POLYCYSTIC DISEASE 267

MEDULLARY SPONGE KIDNEY 267

MULTICYSTIC DYSPLASTIC KIDNEY 268
RENAL INFECTIONS

ACUTE PYELONEPHRITIS 270

RENAL ABSCESS 272

PYONEPHROSIS 272

CHRONIC PYELONEPHRITIS 275

TUBERCULOSIS KIDNEYS 276
RENAL PARENCHYMAL DISEASE

ACUTE GLOMERULONEPHRITIS 278
NEPHROLITHIASIS

NORMAL VARIANTS IN NEONATAL KIDNEYS 280

NEPHROCALCINOSIS 280

UROLITHIASIS 280
RENAL TUMORS

RENAL LYMPHOMA 292

BENIGN MASSES KIDNEYS AND ANGIOMYOLIPOMA 294
URINARY BLADDER

URACHUS 295

BLADDER DIVERTICULA 296

BLADDER INFECTION 296

NEUROGENIC BLADDER 298

ADENOMYOMATOSIS OF BLADDER 298

BLADDER NEOPLASM 299

BLADDER CLOT 299
11. Abdomen: Retroperitoneum ........ 301
ADRENAL GLANDS

NORMAL ANATOMY AND APPEARANCE 303
xii Atlas of Pediatric Ultrasound

ADRENAL HEMORRHAGE 303

ADRENAL CYST 304

ADRENAL ABSCESS 304
RETROPERITONEAL MASS

NEUROBLASTOMA 307

RETROPERITONEAL CYST 312
RETROPERITONEAL LYMPH NODES
12. Female Pelvis ............................... 317
THE OVARY

TECHNIQUE AND ANATOMY 319
NEONATAL PATHOLOGY

HERNIATED OVARY IN INGUINAL CANAL 319

NEONATAL OVARIAN CYST 320
POST-MENARCHE PATHOLOGY

FUNCTIONAL CYSTS 320

CYSTADENOMAS 321

HEMORRHAGIC CYSTS 321

ENDOMETRIOSIS 322
NEOPLASMS

GERM CELL TUMORS 325

DERMOID CYSTS 325

DYSGERMINOMA 330
TORSION

TORSION OF OVARY 331

TORSION OF OVARIAN CYST 334

POLYCYSTIC OVARIES 335
THE UTERUS

NEONATAL UTERUS 335

POST-MENARCHE UTERUS 337

CONGENITAL VAGINAL OBSTRUCTION 337
POST-MENARCHE

IMPERFORATED HYMEN 338

CONGENITAL ANOMALIES 338

SEPTATE UTERUS 343
MISCELLANEOUS

FIBROID UTERUS 345

LYMPHOMA 345
13. Scrotum and Testis ....................... 349

ANATOMY 351

TECHNIQUE 351

HYDROCELE 352

SCROTAL CYSTS 355

EPIDIDYMO-ORCHITIS 355
– Chronic Epididymitis 356

TORSION TESTIS 356

VARICOCELE 361

CRYPTORCHIDISM 362

TESTICULAR MICROLITHIASIS 362

TESTICULAR TRAUMA 365

TESTICULAR TUMORS 365

ADRENAL REST 370

EXTRATESTICULAR MASSES 370
14. Neck............................................. 377
THYROID GLAND

ANATOMY 379

TECHNIQUE 379

DIFFUSE THYROID DISEASE 379

FOCAL THYROID NODULES 382
LYMPH NODES

ANATOMY 384

NEOPLASTIC NECK LYMPHADENOPATHY 389
OTHER NECK MASSES

CYSTIC HYGROMA 389

THYROGLOSSAL DUCT CYST 392

HEMANGIOMA 392

MALIGNANT TUMORS 394
Contents xiii
Index ................................................................................................................................... 397