J Radiol
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This article reviews the major indications for chest sonography in children. Sonography should be performed after chest radiographs have been obtained in order to assess the need for further imaging with CT and/or MRI. Sonography allows accurate assessment of the pleural compartment especially for evaluation of pleural effusions, the diaphragm, peripheral lung lesions and anterior, middle and postero-inferior mediastinal lesions. ⋯ This technique allows tissue characterization and it is superior to other modalities in characterization of fluid. Sonography may be used to guide aspirations and biopsies. Sonography of the chest is the modality of choice in children because of its lack of ionizing radiation and ease to perform.
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Over the last twenty years, ultrasound has progressively become the primary modality used to assess the acute pediatric abdomen. The lack of radiation exposure and the high diagnostic efficacy of US have contributed to broaden the use of US. During his career, any radiologist may be involved in the evaluation of an acute abdomen in a child. ⋯ For experienced radiologists the accuracy in detecting appendicitis and intussusception are respectively close to 95% and 100%. In this chapter, we will also discuss the differential diagnoses of the most frequent causes of acute pediatric abdomen and the technical limitations of US. The learning objectives will be
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Case Reports
[Cross-sectional imaging of post endocarditis paravalvular myocardial abscesses of native mitral valves: 4 cases].
Four cases of submitral myocardial abscess imaged by CT or MRI following endocarditis are described. All cases occurred in fragile patients (diabetes mellitus, dialysis, severe cardiovascular diseases). An iatrogenic source was noted in one patient. ⋯ If subvalvular aortic abscesses are usually described, submitral myocardial abscesses are infrequent. In addition to transesophageal echocardiography, a technique superior to transthoracic echocardiography, CT and MRI may incidentally suggest the correct diagnosis. Both techniques provide useful morphological evaluation, information that can be used to optimize the timing for surgical repair.
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Conventional radiography plays a key-role in the assessment of symptomatic hips. A well-performed radiographic examination (comparative A-P views with straight or ascending X-Ray beam, off-lateral view of Lequesne) enables to recognise most bone (fractures, transient osteoporosis, epiphyseal osteonecrosis) and articular lesions (osteoarthritis). In some situations (incoherent radio-clinical findings, need of a confident diagnosis), joint aspiration or additional imaging procedures are needed. ⋯ Bone scintigraphy is obtained to confidently exclude bone or articular disorders or in case of suspected disseminated bone disease. The majority of bone, articular and abarticular lesions can be diagnosed by using MRI. It should be obtained when results are likely to influence the final outcome of the disease.
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The authors report results of a retrospective study evaluating the efficacy of US-guided alcohol ablation of the celiac plexus in 26 patients with chronic cancer-related abdominal pain. They review the interest of this imaging technique for guidance. ⋯ Celiac plexus ablation is considered to be one of the most effective treatments for chronic cancer-related abdominal pain, often used as an adjuvant treatment in the pain management strategy. US guidance is advantageous because it is simple and accurate and enables quick needle placement.