Computed tomography in children: a new diagnostic technique

Computed tomography in diagnosis of intracranial tumors versus tubers in tuberous sclerosis

Intraventricular gliomas producing obstruction of the foramen of Monro were observed by computed tomography in 4 of 8 patients with tuberous sclerosis. Bilateral tumors arising from the caudate nuclei were present in one patient. Characteristic subependymal calcified tubers were also seen, but contrast enhancement occurred only in the tumors and not in the tubers. The location of the tumor prevented communication between the 2 lateral ventricles so that surgical placement of a single ventricular shunt resulted in only unilateral relief of hydrocephalus. Shunting in one case was ineffective because of high cerebrospinal fluid viscosity due to elevated protein concentration.

Computed tomography in the evaluation of chest lesions in the pediatric patient

The role of computed tomography (CT) in the management of chest masses in the pediatric patient is emphasized and illustrated. Thirty-seven patients with various chest lesions who had both CT and conventional radiologic evaluations are reviewed. CT was the most consistently accurate examination, especially in the evaluation of disease extent and relationship with other organs. CT was the only modality to provide clinically useful information in 27% of the cases, and it provided significant additional information in another 24% of the group.

Chest computed tomography in infants and children. An analysis of 50 patients

Chest computed tomography (CT) scans were performed in 50 pediatric patients. The techniques and inherent problems are presented. CT provides detailed anatomic information about the chest wall, mediastinum, and lungs. Pediatric chest CT is particularly valuable in the evaluation of extrapleural masses, parenchymal metastatic disease, and posterior mediastinal tumors.

Computerized tomography in cerebral-palsied children

Of a total of 160 patients with cerebral palsy, 80 were studied by computerized tomography. In the congenital group, abnormal studies were found in two of the 12 patients with diplegia, 16 of 18 with hemiplegia, 14 of the 18 with quadriplegia and five of the seven with atonic diplegia. 18 of 21 patients with acquired disease had abnormal CT scans. Computerized tomography is a useful tool for demonstrating the anatomical lesion responsible for cerebral-palsied patients' clinical findings. It is also useful in making a prognosis of functional outcome, and in defining lesions which are correctable by neurosurgery.

Computed cranial tomography in children

The CT head scan is a valuable new device for the diagnosis of intracranial pathology in children. It is especially useful in detection of cerebral tumors, hydrocephalus, blood-fluid collections, and congenital anomalies. Because of its expense, it cannot be recommended for use in screening of children with seizures, headaches, or nonprogressive focal neurologic signs. Other new ultrasonic and tomographic techniques are being developed, making it advisable to use the radiologist as a clinical consultant in selection of appropriate neuroradiologic procedures in children.

Computed tomography of cerebral palsy: evaluation of brain damage by volume index of CSF space

Between 1976 and 1978, we examined 110 Japanese children with cerebral palsy using a CT 1000 and a CT 1010 (EMI). In 92% of all patients, there were abnormal findings. Cortical atrophy was seen in 51%, ventricular dilatation in 86%, localized low density areas in 22%, brain anomalies in 10% and asymmetry of cerebral hemisphere in 31%. In spastic hemiplegia, the characteristic CT revealed asymmetrical ventricular dilatation without cortical atrophy and localized low density areas in the cerebral hemisphere contralateral to the palsy. In spastic tetraplegia, CT revealed moderate to marked diffuse cerebral atrophy or brain anomalies. In athetosis, CT revealed normal or slight cerebral atrophy. In 60 cases where a CT 1010 was used, we calculated the volume index of CSF space by computer, Eclipse S/200, and analyzed the relationship between the clinical features of cerebral palsy and the volume index of CSF space.

Arteriovenous aneurysm of the vein of Galen. A clinical, angiographic CT scan and neuropathological study

An autopsied case of arteriovenous aneurysm of the vein of Galen in a 31/2-month-old female is reported. Arteriovenous aneurysm of the vein of Galen is a rare vascular malformation of the central nervous system consisting of a saccular dilatation of the vein which receives blood shunted through enlarged arteries. These peculiar structural and hemodynamic characteristics differentiate this particular malformation from the other AVMs of the central nervous system. In infants the arteriovenous aneurysm of the vein of Galen is characterized clinically by hydrocephalus and cardiomegaly. In the present paper the clinical features and diagnostic indications are discussed and, in particular, the role of computerized cranial tomography (CT) is emphasized as a rapid and noninvasive procedure for detection of intracranial disorders.

Computer reconstructed sagittal and coronal CT scans. Applications in neurological disorders of infants and children

Recent technical advances in computed tomography (CT) allow sagittal and coronal image reconstruction by computer manipulation of data from thin-section transverse scans. Three cases are presented to illustrate this new supplementary modality in the pediatric patient. The technique, diagnostic implications and value of orthogonal plane image reconstruction are discussed.

Computed tomography in diagnosis of abdominal masses in infancy and childhood. Comparison with excretory urography

Computed tomography (CT) of the abdomen and pelvis was performed in 26 instances of suspected mass in 24 infants and children. The information obtained was compared to that of standard abdominal radiography and excretory urography (IVP). Results were analyzed prospectively. CT was able to detect and define masses more precisely than abdominal radiography and IVP. The information obtained by CT, in a single noninvasive examination emitting minimal ionising radiation, seems comparable to that offered by a combination of multiple radiological and other imaging procedures. It is conceivable that with accumulating experience and further technological improvement CT may become an excellent screening procedure in the investigation of abdominal and pelvic masses. The high cost of CT scanning may be offset by the benefits cited.

Computerised axial tomography and acute neurological problems of childhood

The results of computerised axial tomography (CAT) in 80 children with neurological symptoms and/or signs of less than 3 months' duration are discussed in relation firstly to intracranial pathology and secondly to clinical presentation. 26 children had intracranial space-occupying lesions (tumour, abscess, haemorrhage, infarct). CAT was abnormal in 25 of these and diagnostic in 18. A further 20 children had meningitis or encephalitis, and CAT was abnormal in 12. In contrast with this high rate of scans showing pathology, CAT was abnormal in only 4 of the remaining 34 children who had less definite or no intracranial disease. Analysis of clinical presentation showed that 42 of 69 children presented with persisting neurological signs and of these, 25 had an intracranial space-occupying lesion and 29 had abnormal CAT. Only 5 of 27 children who had symptoms alone or signs lasting less than 24 hours had abnormal CAT, and no intracranial lesion requiring specific treatment was missed. CAT is useful for demonstrating the site, size, and nature of many lesions. The scan may not initially be abnormal in brain stem gliomas and in small subdural collections of fluid.

Computed tomographic scanning in children

Computed tomographic scanning (CT) has been effectively utilized in evaluating the pediatric patient. Our experience with CT of the chest and abdomen in 19 patients has been described. The advantages offered by CT include: a unique anatomic display, the lack of morbidity, and an acceptable radiation dosage. Few technical disadvantages exist. Further application of this unique technique can be predicted.

Computerized transverse axial tomography in the newborn

7 babies, aged 6 days--8 wk, who presented with abnormal neurological signs during the first days of life were investigated by computerized transverse axial tomography. 3 babies had suffered perinatal asphyxia. Only 1 baby required a general anaesthetic to facilitate the investigation. Structural intracranial lesions were seen in 6 babies and comprised hydranencephaly, cerebral agenesis with grossly dilated lateral ventricles, unilateral cerebral oedema, subarachnoid cyst of localized cerebral atrophy.

Computerized tomography in the management of intracranial bleeding in hemophilia

Computerized tomography was used to evaluate the severity of six episodes of suspected intracranial bleeding in four patients with hemophilia. In all instances the CT scan rapidly provided information on the extent and location of the intracranial hemorrhage. Results of the initial scan provided a rational basis for therapy, and subsequent scans were a noninvasive means of evaluating the effects of treatment. If available, computerized tomography is a valuable aid in the management of the hemophiliac patient with intracranial bleeding.