OBJECTIVE: To measure radiologically obtained skull diameters and, based on these data, calculating the cranial index and size to compare with diameter measurements and indices reported in the literature, particularly those reported by Haas. MATERIALS AND METHODS: The present study evaluated 732 individuals with no cranial disease, whose skull diameters were measured, Subsequently, the authors calculated the cranial index and size which demonstrate the different phases of the skull growth by inner-table to inner-table measurements. RESULTS: The comparative study of diameters averages by inner-table measurements has demonstrated a clearly progressive skull growth in the first year of life for both genders, and a slower growth as from the second year. Overall diameters averages did not present any significant difference between male and female individuals. CONCLUSION: Cranial index and size are good skull growth indicators, especially in the first four years of life, a period characterized by an accelerated growth in the first year and a moderate growth until the fourth year. After this age, a slight and stable growth occurs with a decrease in the statistical value. No statistically significant difference was found for both genders. It is recommended that mean diameters are utilized for both genders; and it is suggested that the cranial index is utilized until four years of age, and the cranial size after the age of four, as the ideal parameter for following up the skull growth.

Keywords: Cranial diameters, Cranial size, Cranial index, Childhood, Radiography

Necrotizing enterocolitis is one of the most frequent and severe gastrointestinal emergencies occurring in the neonatal period. Once necrotizing enterocolitis is suspected a simple abdominal x-ray is a routine examination and this film will play an essential role in the diagnosis of the disease and the follow-up care of the patient, as well as in the detection of complications. In the present study we reviewed the pertinent literature and described the radiological findings, illustrated with cases from our institution. We concluded that the radiological diagnosis of necrotizing enterocolitis done at all stages contributes for an immediate therapeutic management, reducing the complications and improving the patient's survival.

Keywords: Necrotizing enterocolitis, Newborn, Radiological diagnosis

Thoracic asymmetries characterized by increased radiolucency of the lungs are important causes of morbidity in infants and children. Evaluation of affected patients frequently requires multiple imaging methods to diagnose the abnormality and to plan the surgical correction. The authors review and illustrate the characteristics of both common and rare thoracic asymmetries with emphasis on the radiological findings. The usefulness of different imaging methods in the diagnosis and treatment of these conditions is evaluated. The differential diagnosis as well the pitfalls and diagnostic difficulties are also discussed.

Keywords: Thoracic diseases, Congenital cystic adenomatoid malformation, Congenital lobar emphysema, Congenital diaphragmatic hernia

OBJECTIVE: To describe the different tomographic findings in hypodense hepatic lesions in children and its differential diagnosis. MATERIALS AND METHODS: Computed tomographic studies were obtained from 50 patients (age range: 0-16 years) with low-density liver lesions previously diagnosed by ultrasound. Images were made before and after administration of intravenous contrast medium. Image findings were analyzed and afterwards correlated with anatomopathological diagnosis. RESULTS: Forty-seven of 50 cases were confirmed, 30 by anatomopathological diagnosis. Most of then were benign lesions, hemangioma in 20%. Such lesions presented a homogeneous contrast absorption, mainly at the delayed phase, differing from malignant lesions. Metastasis was the most frequently found malignant lesion (18%). CONCLUSION: Computed tomographic study is of great value in complementing the diagnosis of hypodense hepatic lesions in children, and must follow ultrasound diagnosis as a routine procedure.

Keywords: Hypodense hepatic injuries, Computed tomography, Childhood

OBJECTIVE: To evaluate the prevalence and appearance of incidental paranasal sinuses abnormalities in children with no clinical evidence of rhinosinusitis using CT scans. MATERIALS AND METHODS: CT scans of the head or orbits of children between 0 and 18 years of age performed due to problems not related to rhinosinusitis were studied. RESULTS: Sixty-four children were included (mean age 5.7 years; standard deviation = 3.9). Incidental sinuses abnormalities were found in 46 cases (72%). In most cases the abnormalities were mild (25/46) and mucosal thickening was the most common finding. Complete opacification and fluid levels occurred in 12 children. More than one cavity was affected in 33 patients and abnormalities were most frequently seen in maxillary sinuses, followed by ethmoid sinuses. Bilateral and symmetric findings were common. The prevalence and intensity of abnormalities were higher in children below three years of age. CONCLUSION: Incidental abnormalities are highly prevalent and tend to be mild in children without symptoms of rhinosinusitis. The most prevalent abnormality was mucosal thickening. Moderate and severe abnormalities occur in children below three years of age.

Keywords: Computed tomographic scans, Rhinosinusitis, Incidental abnormalities, Paranasal sinuses, Radiology, Pediatrics

The authors report a case of a two year-old girl with an extrarenal Wilms' tumor in the retroperitoneum. Abdominal plain films, intravenous urography, abdominal ultrasound and computed tomography examinations showed a retroperitoneal mass adjacent to the right kidney. The patient underwent surgery with complete resection of the mass. The diagnosis of Wilms' tumor was confirmed by histopathological study. Extrarenal Wilms' tumor is an extremely rare malignancy which is almost always presented in medical literature as a case report. The tumor may arise in the retroperitoneum, uterus and ovaries, inguinal groove, testes, skin, and even in the thorax. The exact mechanism of occurrence of this tumor in extrarenal tissues has not yet been established. The diagnosis relies on histopathological study, generally after surgical intervention.

Keywords: Extrarenal Wilms' tumor, Retroperitoneum, Radiology

Radiograph of the nasopharynx is still the most commonly used imaging method to investigate the adenoidal tissue. Due to the variety and complexity of proposed methods to measure the adenoid size, some radiologists prefer subjective evaluation, which can, however, be imprecise and inaccurate. We review and describe several methods to determine the adenoid size, taking into account the practicity, accuracy and precision with the aim of pointing out the best methods to be applied in daily routine practice.

Keywords: Adenoids, Nasopharynx, Airway obstruction, Radiology

OBJECTIVE: To compare duplex ultrasound and computed tomography (CT) angiography in terms of their performance in detecting endoleaks, as well as in determining the diameter of the aneurysm sac, in the postoperative follow-up of endovascular abdominal aortic aneurysm repair. MATERIALS AND METHODS: This was a prospective study involving 30 patients who had undergone endovascular repair of infrarenal aortoiliac aneurysms. Duplex ultrasound and CT angiography were performed simultaneously by independent radiologists. Measurements of the aneurysm sac diameter were assessed, and the presence or absence of endoleaks was determined. RESULTS: The average diameter of the aneurysm sac, as determined by duplex ultrasound and CT angiography was 6.09 ± 1.95 and 6.27 ± 2.16 cm, respectively. Pearson's correlation coefficient showing a statistically significant correlation (R = 0.88; p < 0.01). Comparing the duplex ultrasound and CT angiography results regarding the detection of endoleaks, we found that the former had a negative predictive value of 92.59% and a specificity of 96.15%. CONCLUSION: Our results show that there is little variation between the two methods evaluated, and that the choice between the two would have no significant effect on clinical management. Duplex ultrasound could replace CT angiography in the postoperative follow-up of endovascular aneurysm repair of the infrarenal aorta, because it is a low-cost procedure without the potential clinical complications related to the use of iodinated contrast and exposure to radiation.

Keywords: Aneurysm; Aorta, abdominal; Endovascular procedures; Ultrasonography; Angiography/methods.