Premature newborn baseline screening head ultrasound exam on day of life 7

US of intraventricular hemorrhage
Coronal (above left), left sagittal (above middle) and right sagittal (above right) US of the head shows a round echogenic focus in the left germinal matrix. There was also an echogenic focus in the occipital horn of the left lateral ventricle (not provided). The ventricular system was normal in size. Followup exam from 2 weeks later (below) shows interval decrease in size and cavitation of the echogenic foci in the left germinal matrix and occipital horn of the left lateral ventricle. The ventricular system is minimally increased in size.

The diagnosis was left grade II neonatal intraventricular hemorrhage.

School ager with diffuse abdominal pain

US and CT of ovarian torsion
Sagittal US of the pelvis (above left) shows an enlarged right ovary with multiple peripheral follicles. Axial CT with contrast of the abdomen (above right) shows the right ovary to be enlarged with multiple peripheral follicles and to be malpositioned in the midline of the pelvis while the coronal CT (below) shows the right ovary to be in a position in the midline above the bladder.

The diagnosis was ovarian torsion.

Preschooler with a right abdominal mass and elevated alpha fetal protein

CT and MRI of hepatoblastoma
Axial CT with contrast of the abdomen (above left) shows a large, inhomogenous multifocal mass on the right side of the abdomen that enhances less than the liver and that did not appear to arise from the right adrenal gland or right kidney. Axial T2 (above right) and axial (below left) and coronal (below right) T1 MRI with contrast of the abdomen show the mass arising from and involving nearly the entire liver and encasing the portal veins.

The diagnosis was hepatoblastoma.

Preschooler with right facial swelling

CT and MRI of first branchial cleft cyst
Axial CT with contrast of the face (above) shows a low density, poorly circumscribed lesion with faint rim enhancement expanding the right parotid gland. Inflammatory changes are noted in the adjacent subcutaneous tissues. Axial T2 MRI of the face from 7 months later (below left) shows areas of oval high signal intensity weaving in and out of the plane of the image representing a tract from the posterior aspect of the right parotid gland to the right external auditory canal which on axial DWI MRI (below right) also shows high signal intensity representing diffusion restriction in the tract.

The diagnosis was a parotid abscess due to an infected first branchial cleft cyst.

Infant with projectile vomiting

US of hypertrophic pyloric stenosis
Sagittal US of the pylorus (middle) shows the calipers on the hypoechoic pyloric muscle which is thickened and elongated, measuring 3.7 mm thick and 20 mm in length. Transverse US of the pylorus (right) shows the circumferentially thickened and hypoechoic pyloric muscle whose boundaries are marked by the calipers surrounding the echogenic mucosa in the center of it.

The diagnosis was hypertrophic pyloric stenosis.

Teenager on chemotherapy with fever

CXR and CT of invasive aspergillosis
CXR on day 8 of the fever (above left) shows opacities in the left upper lobe and right middle lobe. Axial CT without contrast of the chest on day 13 of the fever (above right) shows parenchymal opacities surrounded by irregular ground glass density (halo sign). CXR on day 20 of the fever (below left) shows interval cavitation of the bilateral lung lesions which on axial CT with contrast of the chest on day 34 of the fever (below right) shows central necrosis in the lesions which is detached from the wall (air crescent sign).

The diagnosis was invasive aspergillosis.