paediatric radiology,Radiological signs in paediatrics,paediatric problems in radiology

1. PAEDIATRIC RADIOLGOY
-DR.ANJAAN AUGUSTINE

2. HYALINE MEMBRANE DISEASE/RDS
Radiographic features
• Plain radiograph
• low lung volumes
• diffuse, bilateral and symmetrical granular opacities
• bell-shaped thorax
• air bronchograms
• surfactant therapy-asymmetric improvement as more
surfactant may reach certain parts of the lungs than
others.
• Ultrasound
• retrodiaphragmatic hyperechogenicity

3. Bilateral opacities in neonate

4. • Differential diagnosis
• TTN: lung volumes are normal to slightly
hyperinflated in transient tachypnea of the
newborn and decreased in respiratory distress
syndrome
• Pulmonary edema/hemmorage
• Pulmonary venous congetsion

5. PNEUMONIA
Lobar pneumonia
• consolidation of a single
lobe.
-the most common
presentation of
community acquired
pneumonia.
• The larger bronchi
remain patent- air
bronchograms.

6. Lobular pneumonia
(bronchopneumonia)
-patchy consolidation
with poorly defined
airspace
opacities usually
involving several
lobes
most commonly due to
S. aureus.

7. Interstitial pneumonia
• Interstitial pneumonia is
caused by inflammatory
cells located
predominantly in the
interstitial tissue of the
alveolar septa causing
diffuse or patchy ground
glass opacification.
-viral pneumonia,
Mycoplasma, Chlamydia,
or Pneumocystis.

8. Round pneumonia
• Round pneumonia is an
infectious mass-like opacity
seen only in children, most
commonly due to
streptococcus pneumoniae.
• Infection remains
somewhat confined due to
incomplete formation of
pores of Kohn

9. COLLAPSE
• Direct signs of atelectasis are from lobar volume loss
and include:
-Displacement of the fissures
-Vascular crowding.
• Indirect signs of atelectasis are due to the effect of
volume loss on adjacent structures
-Elevation of the diaphragm.
-Rib crowding on the side with volume loss.
-Mediastinal shift to the side with volume loss.
-Overinflation of adjacent or c/l lobes
-hilar displacement

15. CLE
• Congenital Lobar Emphysema
• (CLE) is the overinflation of one or more lung
lobes. The left upper lobe is most frequently
affected.

16. • X-RAY:
• Immediate postpartum period
• affected lobe -opaque and homogeneous because of fetal lung
fluid diffuse reticular pattern that represents distended lymphatic
channels filled with fetal lung fluid.
• Later findings
• appears as an area of hyperlucency in the lung with oligemia
(i.e. paucity of vessels)
• mass effect with mediastinal shift and hemidiaphragmatic
depression
• Lateral film with the patient lying on the affected side will show
little or no change in lung volume
• lateral film may show posterior displacement of the heart

17. Hyperinflation and poor vascularization of
left upper lobe with contralateral
mediastinal shift.

18. • CT
• confirm the diagnosis,
evaluate the mediastinal
vascular structures, and
to rule out other
abnormalities.
• shows above features in
greater detail
• attenuation of vascular
structures in affected
lobe
• may also show atelectasis
of adjacent lobes

19. • Differential diagnosis
• Bronchial atresia
• CPAM
• Pulmonary artery hypoplasia
• filamin A mutation

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