Official Proceedings - AIUM

American Institute of Ultrasound in Medicine Proceedings J Ultrasound Med 32(suppl):S1–S134, 2013Conclusions—The vast majority (94%) of unstable hips becamestable on FU examination; 91% of these hips were morphologicallynl at initial US, while 9% were morphologically abnl at the initial study butbecame morphologically nl on FU. Approximately 6% of total hips analyzedremained unstable on FU, 4% of these being morphologically nlhips. While these findings can be comforting to parents whose babies havehip instability, they also support the current practice of obtaining FU sonogramsuntil stability is achieved.1538513 Neonatal Ovarian Cysts: Can Sonography Predict Torsion?Dinesh Chinchure, 1 * Chiou Li Ong 2 1 Diagnostic Radiology,Khoo Teck Puat Hospital, Singapore; 2 Diagnostic Imaging, K.K. Women’s and Children’s Hospital, SingaporeObjectives—The purpose of this study was to evaluate whethersonography can predict torsion in neonatal ovarian cysts.Methods—Seven surgically proven cases of neonatal ovariancysts were included in this retrospective study. The patients were dividedinto 2 groups: torsion and nontorsion. These 7 patients were evaluated forclinical presentation, sonographic features, and surgical and pathologic findings.The findings on follow-up sonography after surgery were also noted.Results—The sonographic appearance was variable. Of the 4cases with torsion, 2 lesions had internal echoes with a “fishnet appearance.”The other 2 lesions were predominantly cystic on sonography withinternal echoes and echogenic nodules. A calcific focus was present in 1of these echogenic nodules. One of the cysts had a fluid-fluid level. In thenontorsion group, only 1 of the lesions had a mixed echogenic appearance.The other 2 lesions were cystic with low-level internal echoes in 1of the cysts. The surgical procedure performed in the torsion group wassalpingo-oophorectomy in 2 patients and oophorectomy in 1 patient. In 1patient, cystectomy was attempted without success. In the nontorsiongroup, only cystectomy was performed with preservation of normalovaries, which was confirmed on follow-up sonography.Conclusions—The sonographic features of cysts with a fishnetappearance, a fluid-debris level, and echogenic nodules favor torsion. Theformer sign has so far not been described as a sonographic predictor forneonatal ovarian torsion.1539741 Sonographic Evaluation of Pediatric Skeletal Lesions: Is ItWorthwhile?Henrietta Kotlus Rosenberg,* Neil Lester Radiology, MountSinai Medical Center, New York, New York USAObjectives—To demonstrate how ultrasound (US) may serveas a readily available, cost-effective, noninvasive, nonionizing, practicaltool for the evaluation of a variety of skeletal abnormalities in the pediatricage range.Methods—We reviewed the clinical and imaging findings in31 patients in whom US demonstrated abnormalities related to the skeletalsystem, excluding patients with hip joint effusions or developmentaldysplasia of the hip.Results—US proved useful in the following situations: evaluationof a hard superficial immobile mass (osteoma shin; 1), absent medialend clavicle on x-ray in the region of a neck mass (US showed an aneurysmalbone cyst in the medial end clavicle; 1), to determine if a soft tissuemass involves adjacent bone (nodular fasciitis surrounding the clavicularhead; 1), diagnosis and follow-up of fracture (displaced/nondisplaced) in aninfant (4), diagnosis of osteomyelitis in patients with cellulitis (4), questionof fracture underlying cephalohematoma or subgaleal hematoma (4),rib mass (osteochondroma; 1; or a mass in costochondral junctions: contourdeformities in the costochondral cartilage; 6), firm posterior knee mass(Baker’s cyst; 1), firm anterior knee mass (septated cystic mass in the suprapatellaregion due to rheumatoid disease; 1), immobile hard scalp mass dueto an epidermoid cranial vault (1), painful mass in the occipital bone withsoft tissue components extending through the skull externally and internallydue to Langerhan’s histiocytosis (1), indeterminate mass in the clavicleclinically thought to be posttraumatic sequelae, resolved on follow-up(1), assessment of craniosynostosis (3), ad differentiation of a pathologic entityfrom a normal anatomic structure (lump on the back of a slender babyproven to be a normal posterior spinous process; 1).Conclusions—US is worthwhile for evaluation of a wide rangeof pediatric skeletal abnormalities and helps determine if the a lesion is onethat is “touch” or “don’t touch.” To maximize diagnostic accuracy, the imagershould have thorough knowledge of the clinical history, physical findings,and laboratory and other imaging findings. In equivocal cases or inthose patients in whom the field of view is insufficient for complete visualizationof an obvious lesion or if malignancy is suspected, US serves totriage those patients in whom further imaging is necessary.1539575 Evaluation of Automated Multiplanar 3-/4-DimensionalSonography in Prenatal Diagnosis of Conotruncal CardiacDefects: Analysis of 150 CasesElena Sinkovskaya,* Sharon Horton, Anna Klassen, AlfredAbuhamad Division of Maternal-Fetal Medicine, EasternVirginia Medical School, Norfolk, Virginia USAObjectives—The aim of this study was to assess potential clinicalapplicability of automated multiplanar imaging (AMI) in prenatal detectionof conotruncal heart defects.Methods—Detailed 2D echocardiography was performed in75 fetuses with normal cardiac anatomy and 75 fetuses with conotruncalheart anomalies between 18 and 23 weeks’ gestation by a trained sonographer.In addition, 3D/spatiotemporal image correlation volumes of thefetal chest were acquired at the level of the 4-chamber view. Two volumedata sets per case (with and without color Doppler) were included in thestudy. The initial scan was interpreted and reported based on the 2D images.The volume data sets were independently reviewed offline usingAMI software by a pediatric cardiologist with experience in fetal heart assessment.The diagnostic value, image quality, as well as time for acquisitionand reading of AMI were evaluated and compared with the original2D report. The prenatal diagnosis was confirmed in all cases by postnatalechocardiography, angiography, operative findings, or autopsy.Results—A summary of the results is provided in Table 1.Conclusions—The developed software demonstrates an excellentdisplay of the diagnostic landmarks of conotruncal defects withappropriate image quality in most cases. This should help improve the detectionof these heart anomalies in the future. Automated sonography alsohas the potential for improving the efficiency of ultrasound imaging byreducing the time needed to complete an ultrasound examination, therebyresulting in increased throughput of ultrasound laboratories.Table 1Parameter 2D AMI PAcquisition time, min 16 ± 4 0.3 ± 0.1