Radiology Notes

My notes during radiology residency, fellowship, and beyond…

Archive for the ‘congenital’ Category

Congenital Diaphragmatic Hernia

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  • MC is Bochdalek hernia
  • MC left side
  • diagnosed at prenatal US, follow with MRI
  • up to 50% mortality
  • 50% have CHD
  • most have malrotation

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Written by lmwong

January 30, 2010 at 9:47 am

Right Aortic Arch

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Type 1 = Mirror Image
  • ~congenital heart abnormalities
  • arch descends on right
  • trachea

Type 2 = Aberrant Left Subclavian Artery

  • retroesophageal compression
  • dilateral subclavian artery = Kommerell diverticulum

Written by lmwong

January 24, 2010 at 3:57 pm

Double Aortic Arch

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  • persistent right and left 4th aortic arches
  • anterior compression of trachea
  • posterior compression of esophagus
  • determine dominant arch for surgical planning

Written by lmwong

January 24, 2010 at 3:12 pm

Congenital Hip Dysplasia

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  • US
    • superolateral displacement of hip relative to acetabulum
    • axial and coronal views
    • measure alpha angle, normal is >60 degress
    • stress maneuvers: abnormal posterior and superior subluxation
  • risk factors
    • family history
    • breech presentation
    • torticollis
    • foot and knee deformity
    • neuromuscular disease (myelodysplasia and arthrogryposis
  • F>M, L>R
  • screening exam at 4-6 weeks

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Written by lmwong

January 17, 2010 at 8:28 am

Pulmonary Sequestration

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  • pulmonary tissue without normal connection to bronchial tree
  • anomalous arterial blood supply, from aorta; must document for surgery
  • recurrent PNA
  • solid to multiloculated cystic masses
  • MC in LLL
  • Intralobar
    • more common
    • no extra pleural covering
    • left side; 2/3 posterobasal segment LLL, adjacent to diaphragm
    • arterial supply from thoracic aorta
    • older children and adults
  • Extralobar
    • extra pleural covering
    • associated anomalies
    • arterial supply from abdominal aorta
    • infancy
    • presents as mass lesion

Written by lmwong

January 16, 2010 at 10:27 am

Aberrant right subclavian artery

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  • most common vessel branching anomaly, 1% of population
  • left arch (always opposite of aberrant vessel)
  • POSTERIOR extrinsic filling defect in esophagus (vs ANTERIOR = double arch)
  • right aberrant vessel last branch of arch, the right carotid will be first branch

Written by lmwong

January 9, 2010 at 12:57 am

Coarctation of the Aorta

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  • congenital narrowing in the aorta, juxtaductal (proximal or distal to ductus arteriosis), with pressure gradient
    • proximal: blood shunts through PDA until it closes giving CHF and L to R shunt through VSD
    • distal: LVH, “3 figure” contour aortic knob, rib notching
  • associated with bicuspid aortic valve, VSD, PDA, Berry aneurysms, Turner’s syndrome
  • surgical placement of an aortic patch, ballooning for restenosis
  • MRI for followup
  • pseudocoarctation = kinking in aorta without pressure gradient

http://www.bcm.edu/radiology/cases/pediatric/text/4b1A.htm

Written by lmwong

June 5, 2008 at 3:29 pm