Radiology Notes

My notes during radiology residency, fellowship, and beyond…

Archive for September 9th, 2008

Hirschsprung’s Disease, BE findings

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  • Transition zone (often subtle during first week of life)
  • Abnormal, irregular contractions of aganglionic segment (rare)
  • Thickening and nodularity of colonic mucosa proximal to transition zone; cobblestone (rare)
  • Delayed evacuation of barium
  • Mixed barium-stool pattern on delayed radiographs
  • Distended bowel loops on plain radiographs that almost fill after contrast enema
  • Question mark–shaped colon in total colonic aganglionosis

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Written by lmwong

September 9, 2008 at 6:56 pm

Posted in abdomen, gi, pediatrics

Neuroblastoma

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  • most common extracranial solid tumor in kids
  • from neural crest tissue, sympathetic nervous system
  • 50% fatal; 2/3 have mets at diagnosis
  • ages 2-4 yo, 90% diagnosed at 5 yo; younger diagnosed, better outcome
  • 65% abdominal, 2/3 of which are adrenal; remainder in neck
  • fever, malaise, bone pain, racoon eyes (periordbital ecchymosis and proptosis), blueberry muffin baby (skin mets)
  • associated syndromes: myoclonic encephalopathy of infancy (MEI), watery diarrhea, heterochromia and Horner’s syndrome
  • mets to lymph nodes, liver, bone, cns, skin (blueberry muffin)
  • prognosis: age, state, histology, site of primary
  • NM MIBG: increased uptake in tissue, photpenia in bone mets, hot on bone scan
  • X-ray: calcifications, moth-eaten bony mets
  • CT: calcification, necrosis, LAD, mets, IVC thrombus, encases mesenteric vessels

Staging

1: tumor localized, resected
2A: tumor localized, non-resectable
2B: tumor unilateral, ipsilateral nodes
3: tumor crosses midline, +/- nodes
4: tumor crosses midline, + nodes, distant mets
4S: mets to skin, liver, bone marrow

Written by lmwong

September 9, 2008 at 1:24 pm

Posted in abdomen, gi, pediatrics, tumor