Diagnostic pediatric ultrasound

662 Pages·2016·69.767 MB·English

by  Rick R. van Rijn, Erik Beek, Alan Daneman

To access additional material or resources available with this e-book, please visit
http://www.thieme.com/bonuscontent. After completing a short form to verify your e-book
purchase, you will be provided with the instructions and access codes necessary to retrieve
any bonus content.
TPS23x31-2|11.05.15-17:20
TPS23x31-2|11.05.15-17:20
TPS23x31-2|11.05.15-17:20
Diagnostic Pediatric Ultrasound
Dr. Erik Beek, MD, PhD
Consulting Radiologist
Department of Radiology
Wilhelmina Children's Hospital
University Medical Center Utrecht
Utrecht, The Netherlands
Prof. Rick R. van Rijn, MD, PhD
Professor
Department of Radiology
Emma Children's Hospital
Academic Medical Center
Amsterdam, The Netherlands
Foreword by
Alan Daneman, BSc, MBBCh, FRANZCR, FRCPC
2,025 illustrations
Thieme
Stuttgart (cid:129) New York (cid:129) Delhi (cid:129) Rio de Janeiro
TPS23x31-2|11.05.15-17:20
LibraryofCongressCataloging-in-PublicationData Importantnote:Medicineisanever-changingscienceundergoing
Diagnosticpediatricultrasound/[editedby]ErikBeek, continualdevelopment.Researchandclinicalexperiencearecon-
RickR.vanRijn. tinuallyexpandingourknowledge,inparticularourknowledgeof
p.;cm. propertreatmentanddrugtherapy.Insofarasthisbookmentions
Includesbibliographicalreferencesandindex. any dosage or application, readers may rest assured that the
ISBN978-3-13-169731-8(hardback)– authors,editors,andpublishershavemadeeveryefforttoensure
ISBN978-3-13-169741-7(eISBN) thatsuchreferencesareinaccordancewiththestateofknowledge
I.Beek,Erik,editor.II.Rijn,RickR.van,editor. atthetimeofproductionofthebook.
[DNLM:1. Ultrasonography–methods.2. Child.3. Infant. Nevertheless,thisdoesnotinvolve,imply,orexpressanyguar-
WN208] anteeorresponsibilityonthepartofthepublishersinrespecttoany
RJ51.U45 dosageinstructionsandformsofapplicationsstatedinthebook.
618.92'007543–dc23 Everyuserisrequestedtoexaminecarefullythemanufacturers’
2015006968 leaflets accompanying each drug and to check, if necessary in
consultation with a physician or specialist, whether the dosage
schedulesmentionedthereinorthecontraindicationsstatedbythe
manufacturers differ from the statements made in the present
book.Suchexaminationisparticularlyimportantwithdrugsthat
areeitherrarelyusedorhavebeennewlyreleasedonthemarket.
Everydosagescheduleoreveryformofapplicationusedisentirely
attheuser’sownriskandresponsibility.Theauthorsandpublishers
requesteveryusertoreporttothepublishersanydiscrepanciesor
inaccuraciesnoticed.Iferrorsinthisworkarefoundafterpubli-
cation,erratawillbepostedatwww.thieme.comontheproduct
descriptionpage.
Some of the product names, patents, and registered designs
referredtointhisbookareinfactregisteredtrademarksorpro-
prietarynameseventhoughspecificreferencetothisfact isnot
always made in the text. Therefore, the appearance of a name
without designation as proprietary is not to be construed as a
©2016byGeorgThiemeVerlagKG representationbythepublisherthatitisinthepublicdomain.
ThiemePublishersStuttgart
Rüdigerstrasse14,70469Stuttgart,Germany
+49[0]7118931421,[email protected]
ThiemePublishersNewYork
333SeventhAvenue,NewYork,NY10001USA
[phone],[email protected]
ThiemePublishersDelhi
A-12,SecondFloor,Sector-2,Noida-201301
UttarPradesh,India
[phone],[email protected]
ThiemePublishersRio,ThiemePublicaçõesLtda.
EdifícioRodolphodePaoli,25ºandar
Av.NiloPeçanha,50–Sala2508
RiodeJaneiro20020-906,Brasil
[phone]/[phone]
Coverdesign:ThiemePublishingGroup
TypesettingbyThomsonDigital,India
Thisbook,includingallpartsthereof,islegallyprotectedbycopy-
PrintedinChinabyEverbestPrintingLtd 54321 right. Any use, exploitation, or commercialization outside the
narrowlimitssetbycopyrightlegislationwithoutthepublisher’s
ISBN978-3-13169-731-8 consentisillegalandliabletoprosecution.Thisappliesinparticular
tophotostatreproduction,copying,mimeographingorduplication
Alsoavailableasane-book: ofanykind,translating,preparationofmicrofilms,andelectronic
eISBN978-3-13169-741-7 dataprocessingandstorage.
|11.05.15-09:43
Contents
VideoContents................................................................................... xi
Foreword.......................................................................................... xv
Preface............................................................................................ xvii
Contributors...................................................................................... xix
Abbreviations..................................................................................... xxi
1 ExaminingtheChildandCreatingaChild-FriendlyEnvironment ........................... 2
AnneSmets
1.1 Child-FriendlyStaff........................ 2 1.6 Examination.............................. 4
1.2 Appointment............................. 2 1.7 HowtoScan:TipsandTricks .............. 5
1.3 AppointmentLetter....................... 2 1.8 PrivateRoom............................. 6
1.4 WaitingArea ............................. 2 1.9 CommunicatingtheResults ............... 6
1.5 ExaminationRoom........................ 3 RecommendedReadings................... 7
2 PhysicsandArtifacts............................................................................. 10
RobPeters
2.1 BasicPrinciplesofUltrasound.............. 10 2.4 Resolution ............................... 16
2.1.1 UltrasonicWaves........................... 10 2.4.1 AxialResolution ........................... 16
2.1.2 WavePropagationinHomogeneousMedia..... 10 2.4.2 LateralResolution.......................... 16
2.1.3 WavePropagationinInhomogeneousMedia... 10 2.4.3 ElevationalResolution...................... 17
2.1.4 DopplerEcho.............................. 12
2.5 ArtifactsinSonography................... 17
2.2 EchoscopicImageConstruction............ 13
2.5.1 Artifactsin2DUltrasound................... 17
2.2.1 AmplitudeMode........................... 13 2.5.2 ArtifactsinDopplerUltrasound.............. 18
2.2.2 BrightnessMode........................... 13
2.2.3 MotionMode.............................. 14 2.6 AdvancesinEchoscopicImageConstruction 19
2.2.4 ColorDoppler.............................. 14
2.2.5 PowerDoppler............................. 15 2.6.1 CompoundImaging........................ 19
2.6.2 HarmonicImaging......................... 19
2.3 Transducers .............................. 15 2.6.3 Elastography.............................. 19
2.3.1 TypesofTransducers........................ 15 2.7 BiologicalEffectsandSafety............... 20
3 NeonatalCranialUltrasonography ............................................................. 22
GerdaMeijler,LindadeVries,andHandanGüleryüz
3.1 UltrasoundAnatomyoftheNeonatalBrain. 22 3.3 TimingofExaminations................... 31
3.4 Measurements ........................... 36
3.2 MaturationalChangesandDistinction
betweenPhysiologicandPathologic
3.4.1 VentricularMeasurements.................. 36
EchogenicAreasintheNeonatalBrain...... 26
3.4.2 MeasurementsofCerebralStructures......... 38
3.2.1 WhiteMatter.............................. 26
3.5 PretermInfants:Pathology................ 39
3.2.2 DeepGrayMatter .......................... 31
v
|11.05.15-09:43
Contents
3.5.1 GerminalMatrix–IntraventricularHemorrhage 39 3.6.1 Pathology ................................. 70
3.5.2 Post-hemorrhagicVentricularDilatation ...... 52 3.6.2 CongenitalAbnormalities.................... 78
3.5.3 WhiteMatterInjury........................ 60 RecommendedReadings.................... 94
3.5.4 FocalInfarction............................ 64
3.6 TermInfants ............................. 70
4 Spine............................................................................................... 98
SamuelStafraceandErikBeek
4.1 Embryology.............................. 98 4.4 Pathology ................................ 103
4.1.1 AscensusMedullaris........................ 99 4.4.1 Non–Skin-CoveredBackMasses:OpenLesions.. 103
4.4.2 Skin-CoveredBackMasses:ClosedLesions..... 104
4.2 TechniqueofSpinalUltrasound............ 99 4.4.3 Occult/ClosedLesionswithoutaMass ......... 107
4.4.4 SacralDimple.............................. 113
4.3 NormalSonographicAnatomy............. 100 RecommendedReadings.................... 113
4.3.1 NormalVariants ........................... 102
5 Neck................................................................................................ 116
ErikBeek
5.1 NormalAnatomyandVariants............. 116 5.2.4 Pilomatrixoma............................. 127
5.2.5 SolidTumors............................... 127
5.2 Pathology................................ 119 5.2.6 ThyroidGland.............................. 137
5.2.7 SalivaryGlands............................. 138
5.2.1 VesselsoftheNeck......................... 119 5.2.8 Thymus................................... 143
5.2.2 CysticLesions ............................. 120 5.2.9 MiscellaneousLesions....................... 145
5.2.3 HemangiomasandVascularMalformations.... 124 RecommendedReadings.................... 151
6 Mediastinum...................................................................................... 154
IngmarGassnerandGiselaSchweigmann
6.1 NormalAnatomyandVariants............. 154 6.2.2 Trachea ................................... 159
6.2.3 Esophagus................................. 159
6.1.1 Thymus .................................. 154 6.2.4 CongenitalVascularAnomalies............... 163
6.1.2 Trachea................................... 157 6.2.5 MediastinalMasses......................... 170
6.1.3 Esophagus................................ 157
6.1.4 HeartandGreatVessels..................... 157 6.3 MediastinalUltrasoundinIntensiveCare:
ComplicationsAssociatedwithCentral
6.2 Pathology................................ 157 VenousAccess ............................ 177
6.2.1 Thymus .................................. 157 RecommendedReadings.................... 179
7 PleuraandThorax ................................................................................ 182
JoostvanSchuppenandRickR.vanRijn
7.1 IndicationsforUltrasonography........... 183 7.3 Pathology ................................ 186
7.2 AnatomyandNormalVariants............. 183 7.3.1 ChestWall................................. 186
7.3.2 PleuralSpace............................... 200
7.2.1 ThoracicWall ............................. 183 7.3.3 Lungs..................................... 202
7.2.2 Pleura.................................... 184 7.3.4 Breast..................................... 202
7.2.3 Lungs .................................... 184 7.3.5 Diaphragm ................................ 208
7.2.4 Breast.................................... 184 RecommendedReadings.................... 211
7.2.5 Diaphragm................................ 186
vi
|11.05.15-09:43
Contents
8 PeritonealCavityandRetroperitonealSpace.................................................. 214
RickR.vanRijn
8.1 NormalAnatomy ......................... 214 8.2.4 Peritonitis ................................ 225
8.2.5 Pneumoperitoneum........................ 229
8.2 Pathology................................ 215 8.2.6 PeritonealTumors.......................... 229
8.2.7 RetroperitonealTumors..................... 234
8.2.1 AbdominalVessels ......................... 215 8.2.8 CysticCongenitalAnomalies................. 238
8.2.2 Lymphadenopathy ......................... 219 RecommendedReadings................... 243
8.2.3 IntraperitonealFluidCollections ............. 221
9 LiverandBiliarySystem......................................................................... 246
RickR.vanRijnandRAJNievelstein
9.1 NormalAnatomyandVariants............. 246 9.3.1 CongenitalAnomalies ...................... 249
9.3.2 Infection.................................. 258
9.2 NormalMeasurements.................... 249
9.3.3 AcquiredBiliaryPathology.................. 266
9.2.1 PortalVenousFlow......................... 249 9.3.4 Trauma................................... 287
9.2.2 HepaticArterialFlow....................... 249 9.3.5 Tumors................................... 292
9.2.3 HepaticVenousFlow ....................... 249 9.3.6 Pneumobilia .............................. 317
9.3.7 MiscellaneousConditions................... 317
9.3 Pathology................................ 249 RecommendedReadings................... 321
10 Spleen............................................................................................. 324
SamuelStafrace
10.1 NormalAnatomyandVariants............. 324 10.2 Pathology................................ 332
10.1.1 Embryology............................... 324 10.2.1 AbnormalitiesofLocationandNumber ....... 332
10.1.2 AnatomicalConsiderations .................. 324 10.2.2 AbnormalitiesofSize....................... 335
10.1.3 TechniqueandNormalUltrasoundAppearances 325 10.2.3 TraumaticInjuryoftheSpleen............... 348
10.1.4 EchogenicityandChangesinEchogenicitywithAge 325
10.1.5 Vascularity................................ 327 10.3 Acknowledgements....................... 354
10.1.6 NormalVariants............................ 327
10.1.7 NormalSplenicSize ........................ 331 RecommendedReadings................... 358
11 PediatricIntestinalUltrasonography........................................................... 360
SimonRobben
11.1 Esophagus................................ 360 11.6.1 OtherCausesofColitis...................... 394
11.2 GastroesophagealJunction ................ 363 11.7 Rectum.................................. 397
11.3 Stomach ................................. 364 11.8 Anus..................................... 397
11.4 SmallBowel.............................. 367 11.9 NeonatalBowelObstruction............... 403
11.5 Appendix................................. 387 11.10 Conclusion............................... 412
11.6 LargeBowel.............................. 393 RecommendedReadings................... 412
12 Pancreas .......................................................................................... 416
MariaRaissakiandMarinaVakaki
12.1 ExaminationTechnique.................... 416 12.3 Pathology................................ 426
12.2 NormalAnatomy,Variants,and 12.3.1 DevelopmentalAnomalies .................. 426
Pseudo-lesions............................ 417 12.3.2 Pancreatitis............................... 428
vii
|11.05.15-09:43
Contents
12.3.3 InheritedDisorders ........................ 436 12.3.5 CysticMasses.............................. 444
12.3.4 Neoplasms................................ 440 RecommendedReadings.................... 449
13 Kidneys ............................................................................................ 452
MariaBeatriceDamasio,AnnNystedt,Lil-SofieOrdingMuller,andGiorgioPioggio
13.1 NormalAnatomyandVariants............. 452 13.8 RenovascularDisease...................... 481
13.1.1 Kidneys .................................. 452 13.8.1 RenalArteryStenosis ....................... 481
13.1.2 Ureters................................... 455 13.8.2 RenalVeinThrombosis...................... 482
13.1.3 Bladder................................... 456
13.9 ParenchymalNephropathy................. 485
13.2 CongenitalAnomaliesoftheKidneyandthe
UrinaryTract............................. 456 13.9.1 GlomerularNephropathies................... 487
13.9.2 TubularNephropathies...................... 487
13.2.1 RenalHypodysplasia ....................... 457 13.9.3 InterstitialNephropathies.................... 488
13.2.2 UreteropelvicJunctionStenosis.............. 457 13.9.4 VascularNephropathies ..................... 489
13.2.3 UreterovesicalJunctionStenosis.............. 457
13.2.4 UreterovesicalReflux....................... 457 13.10 RenalTrauma ............................. 490
13.2.5 DuplicateCollectingSystem................. 460
13.2.6 HorseshoeKidney.......................... 461 13.10.1 RenalTraumaGrading....................... 491
13.3 UrolithiasisandNephrocalcinosis.......... 464 13.11 PediatricRenalTransplantation ............ 491
13.4 KidneyCystsandCysticNephropathies..... 467 13.11.1 EarlyPostoperativeAssessment .............. 491
13.11.2 DifferentialDiagnosisofEarlyGraftDysfunction 491
13.5 Autosomal-DominantPolycystic 13.11.3 DifferentialDiagnosisofLong-Term
KidneyDisease ........................... 469 GraftDysfunctionandImagingAspects........ 496
13.5.1 Autosomal-RecessivePolycysticKidney 13.12 BladderandUrethra....................... 500
Disease................................... 470
13.5.2 Nephronophthisis.......................... 472 13.12.1 CongenitalBladderAnomalies................ 500
13.5.3 GlomerulocysticDisease.................... 472 13.12.2 UrethralAnomalies......................... 502
13.5.4 MedullarySpongeKidneyDisease............ 472 13.12.3 Utricle .................................... 503
13.5.5 MulticysticKidneyDisease.................. 472 13.12.4 UrachalAnomalies.......................... 503
13.5.6 SimpleCysts .............................. 473 13.12.5 Calculi .................................... 504
13.5.7 ComplicatedCysts ......................... 473 13.12.6 Infection .................................. 504
13.12.7 Neoplasm ................................. 504
13.6 RenalTumors............................. 474
13.13 Contrast-EnhancedCystosonography....... 506
13.6.1 MalignantTumors.......................... 474
13.6.2 BenignTumors ............................ 478 RecommendedReadings.................... 509
13.7 UrinaryTractInfection.................... 480
14 AdrenalGlands.................................................................................... 512
ClaireGowdyandAnniePaterson
14.1 EmbryologyoftheAdrenalGlands......... 512 14.5.2 AdrenalHemorrhageinthe
OlderChild ................................ 514
14.2 NormalAnatomy......................... 512
14.5.3 AdrenalCysts.............................. 514
14.3 NormalSonographicAppearance.......... 512 14.5.4 AdrenalAbscesses.......................... 517
14.5.5 CongenitalAdrenalHyperplasia .............. 517
14.4 NormalVariants.......................... 513
14.5.6 AdrenalHyperplasiainOlderPatients......... 518
14.5.7 AdrenalHypoplasia......................... 518
14.5 Pathology................................ 514
14.5.8 MedullaryTumors:NeurogenicTumors........ 519
14.5.9 MedullaryTumors:Pheochromocytoma ....... 520
14.5.1 NeonatalAdrenalHemorrhage............... 514
14.5.10 AdrenalCorticalTumors..................... 520
viii