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Response from authors Preventing postnatal urinary tract infection is one of the prime advantages of prenatal diagnosis of genitourinary abnormafities. Choosing a prophylactic regimen is therefore of great importance. In this series, only 3 % of neonates developed a urinary tract infection. The fact that most occurred in the first month of life is also a critical fac-

tor. Those familiar with neonatal and pediatric practice realize that the usual medications used for adult prophylaxis such as sulfa-based medications and furadantoin derivatives me contraindicated during the immediate neonatal period. Therefore, amoxicillin, although not perfect, remains one of the most logical choices. In those neonates with both reflux and significant obstruction, early reconstruction may be logical.

Literature in pediatric radiology Pediatric Nenrosnrgery (Basel) Pediatric intracranial aneurysms: simple and complex cases. Herman, J.M. et al. (Rekate, H.L., Barrow Neurol. Inst., 350West Thomas Rd., Phoenix, A Z 85013, USA) 17:66 (1992) Thallium-201 single-photon emission computed tomography imaging in a pediatric brain tumor. Bhargava, S. et al. (Coel, M , Nucl. Med. Dept., The Queen's Med. Center, 1301 Punchbowl St., Honolulu, HI 96813, USA) 17:95 (1992) An ll-year-old girl with psychomotor regression. Harris, C.E et al. (Dept. of Pathol., Univ. Med. Center, 50 North Med. Dr., Salt Lake City, UT 84132, USA) 17:98 (1992) Vertebral artery aneurysm. A unique hazard of head banging by heavy metal rockers. Egnon, M.R. et ai. (Health Sciences Center, 12th floor, Room 080, SUNY at Stony Brook, New York, NY 11794-8122, USA) 17:135 (1992) Epidural metastasis of testicular yolk sac tumor: an unusual cause of spinal cord compression. Colak, A. et al. (Tip Faktiltesi Caddesi, 36/5 Abidinpasa, Ankara, Turkey) 17:139 (1992) Acute cerebellitis: case report and review. Horowitz, M.B. et aL (Pang, D., Dept. of Ped. Neurosurg., Children's Hosp., 3705Fifth Av., Pittsburgh, PA 15213, USA) 17:142 (1992) Chiari I malformations and hydromyelia-compiications. Menezes, A.H. (Div. of Neurosurg., Univ. Hosp., 200Hawkins Dr., Iowa City, IA 52242, USA) 17:146 (1992) Pediatria Poiska (Warszawa) Pulmonary seguestration - radiological investigations. [In PoI.] Winnicki, S. Zaklad Rad. IMiD, ul. Kasprzaka17a, PL-01-211 Warszawa, PoP ska) 1:36 (1991) A case of renovascular hypertension in a child aged 20 months. [In Pol.] Januszewicz, R et al. (Centrum Zdrowia Dziecka, Aleja Dzieci PoP skich 24, PL-04-736, Warszawa, Polska) 66:98 (1991) Complications of urinary bilharziosis in a boy aged 11 years. [In Pol.] Zwolifiska, D., Maszkiewicz, W. (Katedra i Klinika Nefrolog. Ped. AM, ul. M. Sklodowskiej-Curie 50/52, PL-50-369 Wroclaw, Polska) 66:101 (1991) Pediafriia (Moskva) A clinico-epidemioIogical study of developmental abnormalities of the central nervous system and estimation of the efficacy of their prevention by ultrasonography of the fetus and genetic monitoring. [In Russ.] Minkov, I. R (Head of Ped., Ped. Faculty, Med. Inst., Odessa, SUS) 1:10 (1992)

C o m p i l e d by E. Willich, H e i d e l b e r g Severe herpes virus infections in the newborn. [In Russ.] Kudashov, N.I. et al. (All Union Center of Health Prof., Ministery of Health Prot., Moskva, SUS) 1:38 (1992) Radiologia Jugoslavica (Ljubljana) Radiotherapy of intracranial childhood tumours with 9 M V linear accelerator (Neptun 10-P). Kocsis, B. et al. (Orrostovabbkepzo 20 Intezet, Sugartherapieas Tanszek, Budapest XII, Rath Gyorgy ut. 7-9, E E 21, H-1525 Budapest, Hungary) 25:339 (1991) Indian Journal of Radiology & Imaging (Bombay) The modern perspective of imaging in pediatric head injuries. Harwood-Nash, D.C. (Dept. of Rad., Univ., The Hosp. for Sick Children, Toronto, Ontario, Canada) 2:7 (1992) Transluminat renal angioplasty in nonspecific arteritis (Takayasu's disease) in the presence of coexisting abdominal aortic disease: a new approach. Sharma, S. et al. (Dept. of Cardiovascular Rad., All India Inst. of Med. Sciences, New Delhi 110029, India) 2:57 (1992) Acta Paediatrica Japonica (Tokyo) Pulmonary arteriography with retrograde injection of contrast medium via radial artery: efficacy in neonates with ductus-dependent decreased pulmonary flow. Okaiima, Y. et al. (Dept. of Ped., School of Med., Univ., 1-8-1 Inohana, Chibashi, Chiba 280, Japan) 34:60 (1992) A case of small round cell tumor of the thoracopulmonary region with myogenic and neurogenic elements. Goji, J. et al. (Sano, K., Dept. of Ped., Univ. School of Med., 7-chome Kusunoki-cho, Chuo-ku, Kobe650, Japan) 34:65 (1992) A case report of purulent pericarditis with cardiac tamponade: echocardiographic findings. Abo, K., Dept. of Ped., Univ. School of Med., 1-15-1 Kitasato, Sagamihara, Kanagawa228, Japan) 34:80 (1992) Early-onset gelastic seizures. Report of two cases. Kanazawa, O. et al. (Dept. of Ped., Faculty of Med., Univ., Kyoto 606, Japan 35:13 (1989) American Journal of Diseases of Children (Chicago) Sonography of multinodular thyroid gland in chip dren and adolescents. Garcia, C.J. et al. (Daneman, A., Dept. of Diagn. Imaging, The Hosp. for Sick Children, 555 Univ. Av., Toronto, Ontario, Canada, M5G IX8) 146:811 (1992)

Radiologicai case of the month: retrocardiac pneumomediastinum. Pollack, A. et al. (Wood, B. R, Children's Hosp., 4650 Sunset Blvd., Los Angeles, CA 90027, USA) 146:831 (1992) Radiological case of the month: unrecognized subaponeurotic hemorrhage. Levkoff, A.H. et al. (Wood, B.E, Dept. of Rad., MS81, Children's Hosp., 4650 Sunset Blvd., Los Angeles, CA 90027, USA) 146:833 (1992) American Journal of Neuroradiology (Baltimore) Recurring patterns of inflammatory sinonasal disease demonstrated on screening sinus CT. B abbel, R. W. et al. (Harnsberger, H. R., Dept. of Rad., Univ. Med. Center, 50 North Med. Dr., Salt lake City, UT 84132, USA) 13:903 (1992) CT and MR evaluation of intracranial involvement in pediatric HIV infection: a ciinical-imaging correlation. Kauffman, W.M. et al. (Sivit, C.J., Dept. of Diagn. Imaging and Rad., Children's Nat. Med. Center and the George Washington Univ. School of Med. and Health Sciences, 111 Michigan Av., NW, Washington, DC 20010, USA) 13:949 (1992) MR and CT evaluation of profound neonatal and infantile asphyxia. Barkovich, A.J. (Neurorad. Section, L371, Dept. of Rad., Univ., San Francisco, CA 94143-0625, USA) 13:959 (1992) American Journal of Perinatoiogy (New York) Right-sided hydrothorax and central venous catheters in extremely low birth-weight infants. Seguin, J. H. (Div. ofNeonatol., Dept. ofPed., Univ. Med. Center, 3901 Rainbow Blvd., Kansas City, KS 66160, USA) 9:154 (1992) Noninvasive diagnosis of superior sagittal sinus thrombosis in a neonate. Govaert, E et al. (Dept. of Ped., Neonatal Unit, Univ. Hosp., De Pintelaan 185, B-9000 Gent, Belgium) 9:201 (1992) American Journal of Roentgenology (Baltimore) Lesions of skin and brain: modern imaging of the neurocutaneous syndromes. Pont, M.S., Elster, A.D. (Elster, A.D., Dept. of Rad., Bowman Gray School of Med., Wake Forest Univ., Med. Center Blvd., Winston-Salem, NC27157-1022, USA) 158:1193 (1992) Swyel:James syndrome: CT findings in eight patients. Moore, A.D.A. et al. (Godwin, J.D, Dept. of Rad, SB-05, Univ. of Washington, Seattle, WA 98195, USA) 158:1211 (1992) MR diagnosis of macrodystrophia lipomatosa. Blacksin, M. et al. (Dept. of Rad., Univ. of Med. and Dentistry, Med. School, Newark, NJ 07103, USA) 158:1295 (1992) continued on p. 412

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gap. They show that these findings occur with almost equal frequency in foetuses and babies. The spectrum of size and distribution of the cysts is similar in both age groups. None of the postnatal sonograms - including follow-up observations into the second year of life - reveal any additional cerebral changes. Since no association with special, particularly chromosomal diseases was demonstrable in any of the patients and the children's general and, above all, neurological development was normal, it can be postulated that cystic structures of the choroid plexus detected at ultrasound most likely represent a clinically irrelevant variant of the norm and, therefore, do not require follow-up ultrasound examination. References 1. D e R o o TR, Harris RD, Sargent SK, D e n h o l m TA, Crow H C (1988) Fetal choroid plexus cysts: prevalence, clinical significance, and sonographic appearance. A J R 151: 1179

2. Dittrich M, Straf3burg H-M, Dinkel E, Hackel6er B-J (1985) Zerebrale Ultraschalldiagnostik in P~idiatrie und Geburtshilfe. Springer, Berlin, p 27 3. Fakhry J, Schnechter A, Tenner MS, Reale M (1985) Cysts of the choroid plexus in neonates: documentation and review of the literature. J Ultrasound Med 4:561 4. Furness M E (1987) Choroid plexus cysts and trisomy 18. Lancet II: 693 5. Hertzberg BS, Kay HH, Bowie JD (1989) Fetal choroid plexus lesions. Relationship of antenatal sonographic appearance to clinical outcome. J Ultrasound Med 8:77 6. Ostlere S J, Irving HC, Lilford RJ (1990) Fetal choroid plexus cysts: a report of 100 cases. Radiology 175:753 7. Ostlere SJ, Irving HC, Lilford RJ (1987) Choroid plexus cysts in the fetus. Lancet I: 1491 8. Ricketts NEM, Lowe EM, Patel NB (1987) Prenatal diagnosis of choroid plexus cysts. Lancet I: 213 9. Shuangshoti S, N e t s k y M G (1966) Neuroepithelial (colloid) cysts of the nervous system. Neurology 16:887 10. Twining P, Zuccullo J, Clewes J, Swallow J (1991) Fetal choroid plexus cysts: a prospective study and review of the literature. Br J Radio164:98

Literature in pediatric radiology American Journal of Roentgenology

(Baltimore)

Posttraumatic adrenal hemorrhage in children: CT findings in 34 patients. Sivit, C.J. et al. (Dept. of Diagn. Imaging and Rad., Children's Nat. Med. Center, 111 Michigan Av., N.W., Washington, DC 20010, USA) 158:1299 (1992) Neonatal intestinal ischemia with bowel perforation: an in utero complication of maternal cocaine abuse. Hall, T. R. et al. (Dept. of Rad. Sciences, Univ., School of Med., 10833 Le Conte Av., CHSB2-248, Los Angeles, CA90024-1721, USA) 158:1303 (1992) Congenital absence of the left pulmonary artery associated with double-outlet right ventricle. Kremer, S. et al. (Spindola-Franco, H., Dept. of Rad., Montefiore Med. Center, Albert Einstein College of Med., 111 E.210th St., Bronx, NY 10467, USA) 158:1309 (1992) Fast spin-echo MR imaging of the brain and spine: current concepts. Jones, K.M. et al. (Dept. of Rad., Brigham and Women's Hosp., Harvard Med. School, 75 Francis St., Boston, MA 02115, USA) 158:1313 (1992) Schistosomal granuloma of the spinal cord: evaluation with MR imaging and intraoperative sonography. Silbergleit, R., Silbergleit, Ri. (Silbergleit, Ri., Univ. Med. School, Ann Arbor, MI 48109, USA) 158:1351 (1992) Abdominal case of the day: complicated appendicitis. Shaft, M. I. et al. (Dept. of Rad., Vanderbilt Univ. Med. Center, 1161 21st Av., S., Nashville, TN 37232-2675, USA) 158:1364 (1992) Pediatric case of the day. Case 1: Aneurysmalbone cyst. Case 2: Fibromuscular dysplasia (intimal fibroplasia) with aneurysm. Case3: NonHodgkin's lymphoma in the pancreas. Case 4: Giant posterior mediastinal cystic hygroma. Heller, R.M. et al. (Hermanz-Schulman, M., Dept. of Rad., Vanderbilt Univ. Med. Center, 116121st Av., S., Nashville, TN37232-2675, USA) 158:1372 (1992)

Continued from p. 405 Ovarian cysts are common in premenarchaI girls: a sonographic study of 101 children 2-12 years old. Cohen, H.L. et al. (Dept. of Rad., North Shore Univ. Hosp., Cornell Univ. Med. College, 300Community Dr., Manhasset, NYl1030, USA) 159:89 (1992) Ewing's sarcoma of the hand. Escobedo, E. M. et al. (Dept. of Rad., Univ. Med. Center, Stanford, CA 94305, USA) 159:101 (1992) Evolution of white matter lesions in neurofibromatosis type 1: MR findings. Sevi&, R.J. et al. (Dept. of Rad., Univ., 545 Parnassus Av., San Francisco, CA 94143, USA) 159:171 (1992) Cerebellar and cerebral abnormalities in Rett syndrome: a quantitative MR analysis. Murakami, J.W. et al. (Courchesne, E., Dept. of Neurosciences, School of Med., Univ., San Diego, La Jolla, CA 92093, USA) 159:177 (1992) Iatrogenic air in the cavernous sinus. Adams, M. et al. (Quint, D.J., Dept. of Rad., Box 30, Neurorad. (B1D530H), Univ. Hosp., 1500E. Med. Center Dr., Ann Arbor, MI 48109-0030, USA) 159:189 (1992) Archives of Surgery (Chicago)

Foreign bodies within a Meckel's diverticulum. Velanovich, V. et al. (General Surgery Serv., Madigan Army Med. Center, Tacoma, WA, USA) 127:864 (1992) Canadian Association of Radiologists Journal

(Montreal) Heterotopic ossification in children after iliopsoas release. Reed, M.H. et al. (Dept. of Rad., The Children's Hosp., 840 Sherbrook St., Winnipeg, MB R3A 1S1, Canada) 43:195 (1992) Infradiaphragmatic pulmonary sequestration. Sargent, M.A. et al. (Liu, RC.E, Dept. of Diagn. Imaging, The Hosp. for Sick Children, 555 Univ. Av., Toronto, ON M5G 1X8, Canada) 43:208 (1992)

Antenatal and postnatal findings in intra-abdominal pulmonary sequestration. Matzinger, M.A.E. et al. (Dept. of Diagn. Rad., Children's Hosp. of Eastern Ontario, 401 Smith Rd., Ottawa, ON KIH 8L1, Canada) 43:212 (1992) Gastroduodenal involvement in chronic granulomatous disease of childhood. Smith, F.J., Taves, D.H. (Taves, D.H., Dept. of Rad., St.Joseph's Health Centre, PO Box 5777, London, ON N6A 4L6, Canada) 43:215 (1992) Canadian Journal of Medical Radiation Technology (Ottawa)

Child abuse -mistaken diagnosis? Rahm, N. (Bass Memorial Baptist Hosp., Enid, OK, USA) 23:71 (1992) Clinical Nuclear Medicine (Philadelphia) Skeletal scintigraphy: radiographic artifacts. Kessler, J. R. et al. (Dept. of Rad., St.Joseph's Hosp., Milwaukee, WI, USA) 17:511 (1992) Leaking mycotic aneurysms identified on RBC venography. Dupont, J., Greenberg, I.D. (Section of Nucl. Med., Health Sciences Centre, 820 Sherbrook St., Winipeg, Manitoba, Canada) 17:513 (1992) Journal of Bone and Joint Surgery. American Volume (Boston)

Eosinophilic granuloma of the ischium: long-term evaluation of a patient treated with steroids. De Camargo, O. P. et al. (Dept. of Orthop., School of Med., R. Ovidio Pires de Campos, Univ., S~o Paulo, Brazil 05403) 74-A: 445 (1992) Journal of Neurosurgery (Baltimore)

Scoliosis in pediatric Chiari malformations without myelodysplasia. Muhonen, M.G. et al. (Menezes, A. H., Div. of Neurosurg., 42GH, The Univ. Hosp. and Clinics. Iowa City, IA 52242, USA) 77:69 (1992) continued on p. 416

416

germinal matrix haematoma and its tendency to resolve on follow-up sonography. In conclusion, it is suggested that cranial sonography be performed on infants with an open fontanelle and CTventriculography is the method of choice in the assessment of ventriculomegaly when the diagnosis of noncommunicating hydrocephalus is entertained in children. This allows the exclusion of an otherwise radiographically occult CPC which is a benign and accessible lesion amenable to complete removal. In order to avoid late diagnosis and the more interventional CT-ventriculography, we suggest that neonates or infants with sonographic findings of asymptomatic CPC have follow-up sonography in 6 months time or before the anterior fontanelle is closed, particularly for those which are located in the anterior third ventricle. In contrast to previous reports of symptomatic CPC beyond 2 cm in size, we have seen from our cases that smaller cysts can produce obstructive symptoms when located in the region of the foramen of Monro.

Acknowledgement. We thank Drs. M. McGee-Collett, M. Besser and M. deSilva for their invaluable contribution to this study.

References 1. Clark SL, Devore GR, Sabey PL (1989) Prenatal diagnosis of the foetal choroid plexus. Obstet Gyneco172:585-586 2. Gabrielli S, Reece AR, Pilu G, Perolo A, Rizzo N, Bovicelli C, Hobbins JC (1989) ~Ihe clinical significance of prenatally diagnosed choroid plexus cysts. A m J Obstet Gyneco1160:1207-1210 3. Thorpe-Beeston JG, Gosden CM, Nicolaides K H (1990) Choroid plexus cysts and chromosomal defects. Br J Radio163:783-786 4. Hertzberg B, Kay H, Bowie J (1989) Foetal choroid plexus lesions relationship of antenatal sonographic appearances to clinical outcome. J Ultrasound Med 8:77-82 5. Fakhry J, Schechter A, Tenner M, Reale M (1985) Cysts of the choroid plexus in neonates: documentation and review of the literature. J Ultrasound Med 4:561-563 6. Czervionke L, Daniels D, Meyer G, Pojunas K, Williams A, Houghton V (1987) Neuroepithelial cysts of the lateral ventricle: M R appearance. A N J R 8:609-4513 7. Nakase H, Morimoto T, Sakaki T, Takahashi Y, Nakagawa H, Iwasam S (1991) Bilateral choroid plexus cysts. A N J R 12:1204-1205 8. Maeder R Holtas S, Basibuyuk L, Salford L, Tapper U, Brun A (1990) Colloid cysts of the third ventricle: correlation of M R and CT findings with histology and chemical analysis. A J R 155: 135141 9. Schackelford G, Fulling K, Glasier C (1983) Cysts of the subependymat germinal matrix: sonographic demonstration with pathologic correlation. Radiology 149:117-121

Literature in pediatric radiology Journal of Neurosurgery (Baltimore)

Radiation therapy for juvenile pilocytic astrocytoma of the pituitary stalk. Takeuchi, J. et al. (Dept. of Neurosurg., Utano Nat., Hosp., 8 0 n doyama, Narutaki, Ukyo, Kyoto 616, Japan) 77: 139 (1992) Isolated intramedullary spinal artery aneurysm presenting with quadriplegia. Handa, T. et al. (Dept. of Neurosurg., Univ. School of Med., 65 Tsuruma-cho, Showa-ku, Nagoya 466, Japan) 77:148 (1992) Journal of Pediatrics (St. Louis)

Evaluation of renal scars by technetium-labeled dimercaptosuccinic acid scan, intravenous urography, and ultrasonography: a comparative study. Shanon, A. et al. (Feldman, W., Div. of General Ped., Hosp. for Sick Children, 555 Univ. Av., Toronto, Ontario M5G 1X8, Canada) 120:399 (1992) Incidence and natural course of trabecular ventricular septal defect: two-dimensional echocardiography and color Doppler flow imaging study. Hiraishi, S. et al. (Dept. of Ped., Univ. School of Med., 1-15-1, Kitasato, Sagamihara, Kanagawa 228, Japan) 120:409 (1992) Pancreatifis in young children with cystic fibrosis. Atlas, A.B. et al. (Children's Hosp., Fifth Av. and DeSoto, Pittsburgh, PA 15213, USA) 120: 756 (1992) Clinical and laboratory observations. Robbins, C., Holzman, I. R. (Mount Sinai Med. Center, 1 Gustave L. Levy Place, New York, NY 10029, USA) 120:786 (1992)

Continued from p. 412 Magnetic resonance imaging in the diagnosis of growth hormone deficiency. Argyropoulou, M. et al. (Brauner, R., Paed. Endocrinolog. Unit. H6pitai des Enfants Malades, 149 rue de S6vres, F-75015 Paris, France) 120:886 (1992) Journal of Pediatric Surgery (New York)

Double duodenal atresia/stenosis: a report of four cases. Stringer, M. D. et al. (Dept. of Paed. Surg., Inst. of Child Health, Guilford St., London WCIN 1EH, England) 27:576 (1992) Perforation during hydrostatic reduction of intussusception: proposed mechanism and review of the literature. Bramson, R.T., Blickman, J.G. (Blickman, J.G., Div. of Ped. Rad., General Hosp., Harvard Med. School, Boston, MA 02114, USA) 27:589 (1992) Intraanal ultrasound: a new aid in the diagnosis of pelvic processes and their relation to the sphincter complex. Schaarschmidt, K., Willital, G.H. (Kinderchirurg. Klinik, Univ., AlbertSchweitzer-Str.33, W-4400Mtinster, FRG) 27: 604 (1992) Characteristics and management of patients with fetal neuroblastoma. Hosoda, Y. et al. (Dept. of Ped. Surg., Juntendo Univ., School of Med., Hongo 2-1-1, Bunkyo-ku, Tokyo 113, Japan) 27: 623 (1992) Surgicalmanagement of duplex ureteroceles. Monfort, G. et al. (Centre Hosp. Univ. de La Timone H6pital des Enfants, 1, Blvd. Jean-Moniin, F-13385 Marseille Cedex5, France) 27:634 (1992)

Renal infarction associated with an extraadrenal pheochromocytoma. Levine, C., Levine, E. (Dept. of Rad., DC069.10 Room M289, Health Sciences Center, Univ., One Hospital Dr., Columbia, MO 65212, USA) 27:657 (1992) Wilms' tumor: a new case for urinary extravasation. Andrews, E E. et al. (Miser, J.S., Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA) 27:660 (1992) So-called benign fibrous histiocytoma: report of a case. Hoeffel, J.C. (Children's Hosp., F-54500 Vandoeuvre, France) 27:672 (1992) Medical and Pediatric Oncology (New York)

Cranial computed tomographic findings in children with newly diagnosed acute lymphoblastic leukemia: a prospective follow-up study during treatment. Vainionpfig, L. et al. (Dept. of Ped., Univ., Kajaaninfie52A, SF-90220Oulu, Finland) 20:273 (1992) Pediatric Cardiology (New York)

Association of distal displacement of the left subclavian artery and coarctation of the aorta. Kantoch, M. et al. (Pieroni, D.R., E.C.Lambert Dept. of Cardiol., The Children's Hosp., 219 Bryant St., Buffalo, NY 14222, USA) 13:164 (1992) Echocardiographic diagnosis of fistula between the left circumflex coronary artery and the left atrium. Zahn, E.M. et al. (Smallhorn, J.E, Div. of Cardiol., The Hosp. for Sick Children, 555 Univ. Av., Toronto, Ontario, Canada M5G 1xg) 13:178 (1992) continued on p. 429

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states which cause edema of the renal pelvis can produce this non-specific finding. Acknowledgement. We wish to thank D e b r a Wilkinson for her patient and efficient preparation of the manuscript.

References

1. Avni EF, Van Gansleke D, Thoua Y, Matos C, Lemaitre L, Schulman CC (1988) US demonstration of pyelitis and ureteritis in children. Pediatr Radio118:134

2. Birnholz JC, Merkel FK (1985) Submucosal edema of the collecting system. A new ultrasonic sign of severe, acute renal allograft injection. Radiology 154:190 3. Babcock DS (1987) Sonography of wall thickening of the renal collecting system. J Ultrasound Med 6:29 4. Nicolet V, Carignan L, D u b u c G, Herbert G, Bourdon F, Paquin F (1988) Thickening of the renal collecting system: a nonspecific finding at US. Radiology 168:411 5. Friedland GW, Frosberg L (1972) Striations of the renal pelvis in children. Clin Radio123:58 6. Cunningham J J, Bacani-Faulls M (1990) Sonographic "white line sign" for detection of minimal mucosal thickening in renal transplants. Urology 35:367

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Pediatric Clinics of North America (Philadelphia)

Archives of Disease in Childhood (London)

Journal of Bone and Joint Surgery. British Volume

Sports injuries in children and the clumsy child. Ehrlich, M.G. et al. (Dept. of Orthop., Hosp., 593 Eddy St., Providence, RI 02903, USA) 39: 433 (1992)

Impaired motor function (clumsiness) in 5-yearold children: correlation with neonatal ultrasound scans. Levene, M. et al. (Univ. Dept. of Paed. and Child Health, Clarendon Wing, The General Infirmary, Leeds LS2 9NS, England) 67:687 (1992) Computed tomography findings in partial seizures. Minford, A.M.B., Forsythe, W.I. (Dept. of Paed., St.Luke's Hosp., Bradford BD50NA, England) 67:693 (1992) Traumatic neonatal intracranial bleeding and stroke. Govaert, R et al. (Neonatal Unit, Dept. of Paed. Univ. Hosp., De Pintelaan 185, B-9000 Gent, Belgium) 67:840 (1992) Athetoid cerebral palsy with cysts in the putamen after hypoxic-ischaemic encephalopathy. Rutherford, M.A. et al. (Dubowitz, L.M.S., Hammersmith Hosp., Dept. of Paed., Du Cane Rd., London W12 OHS, England) 67:846 (1992) Randomised trial of umbilical arterial catheter position: Doppler ultrasound findings. Kempley, S. %, Gamsu, H. R. (Frederick Still Ward, King's College Hosp., London SE5 9RS, England) 67: 855 (1992)

(London) Epidemiological, clinical and radiological aspects of osteopoikilosis. Benli, I.T. et al. (Iqei Sokak, 21/13 Yens,ehir, Ankara, Turkey TR06420) 74-B: 504 (1992) Hip dysplasia in hereditary motor and sensory ueuropathies. Pailthorpe, C. A., Benson, M. K.D'A. (Benson, M. K. D'A., The Nuffield Orthop. Centre, Windmill Rd., Headington, Oxford OX3 7LD, England) 74-B: 538 (1992) Open fractures of the tibia in children. Hope, R G., Cole, W.G. (Cole, W.G., Royal Children's Hosp., Flemington Rd., Parkville, Victoria 3052, Australia) 74-B: 546 (1992) Seat-belt injuries of the spine in young children. Rumball, K., Jarvis, J. (Jarvis, J., Div. of Orthop., Children's Hosp. of Eastern Ontario, 401 Smith Rd., Ottawa, Ontario, Canada K 1H 8L1) 74-B: 571 (1992) The ossific nuclei and the cartilage anlage of the talus and calcaneum. Howard, C.B., Benson, M.K.D'A. (Benson, M.K.D'A., The Nuffield Orthop. Centre NHS Trust, Windmill Rd., Headington, Oxford OX3 7LD, England) 74-B: 620 (1992)

Pediatrics (Evanston Jl)

Pulmonary disease with hemorrhage in HenochSchOnlein purpura. Olson, J.C. et al. (Dept. of Ped., Med. College, Milwaukee, WI, USA) 89: 1177 (1992) Delayed diagnosis of pediatric cervical spine injury. Orenstein, J.B. et al. (Emergency Med. Trauma Center, Children's Nat. Med. Center, Washington, DC 20010, USA) 89:1185 (1992) A longitudinal study of atlanto-dens relationships in asymptomatic individuals with Down syndrome. Pueschel, S.M. et al. (Child Development Center, Dept. of Ped., Hosp., Brown Univ. Program in Med., Providence, RI, USA) 89:1194 (1992) Radiology (Easto n PA) Pediatric musculoskeletal tumors: use of dynamic, contrast-enhanced MR imaging to monitor response to chemotherapy. Fletcher, B.D. et al. (Dept. of Diagn. Imaging, St.Jude Children's Research Hosp., 332 N Lauderdale, Memphis, TN 38101-0318, USA) 184:243 (1992) Epi- and metaphyseat changes in children caused by administration of bisphosphonates. Van Persijn van Meerten, E.L. et al. (Kroon, H.M., Dept. of Diagn. Rad., Univ. Hosp., Rijnsburgerweg 10, NL-2333 AA Leiden, The Netherlands) 184:249 (1992) Galactosemia: evaluation with MR imaging. Nelson, Jr., M.D. et al. (Dept. of Rad., Children's Hosp., 4650Sunset Blvd., Los Angeles, CA 90027, USA) 184:255 (1992) M-mode sonography of the caudal spinal cord in patients with meningomyelocele. Schumacher, R. et al. (Dept. of Rad., Children's Hosp., Johannes Gutenberg Univ., Langenbeckstr. 1, W-6500 Mainz, FRG) 184:263 (1992) Radiologic Clinics of North America (Philadel-

phia) Opportunistic infections and tumors in immunocompromised children. Ainbrosino, M.M. et al. (Dept. of Rad., Univ. Med. Center, New York, NY, USA) 30:639 (1992)

British Journal of Radiology (London)

Radiotherapy to the surviving kidney after unilateral nephrectomy in bilateral Wilms' tumour. Kirkbride, E, Plowman, EN. (Plowman, EN., Dept. of Radiotherapy, St.Bartholomew's Hosp., West Smithfield, London ECIA7BE, UK) 65:510 (1992) Two cases of isolated deficiency of all four limbs diagnosed antenatatly with a review of the literature. Wong, W.L. et al. (Clinical Rad. Dept., St.Thomas Hosp., London SE1 7EH, UK) 65: 598 (1992) Clinical Radiology (Edinburgh)

Duplex Doppler ultrasound for the detection of vascular occlusion following liver transplantation in children. Lomas, D.J. et al. (Univ., Dept. of Rad., Addenbrooke's Hosp., Hills Rd., Cambridge CB2 200, England) 46:38 (1992) Case report: mesenteric lipoblastoma. Schulman, H. et al. (Dept. of Rad., Soroka Med. Centre, PO Box 151, Beer-Sheva 84101, Israel) 46:57 (1992)

Annales de P6diatrie (Paris)

Infantile cystinosis: a new Tunisian case. [In French]. Pousse, H. et ai. (Serv. de P6d., CHU, 5000 Monastir, Tunisie) 39:365 (1992) Posterior urethral valves in Senegalese children. A review of fourteen cases. [In French]. Fall, I. et al. (Unit6 de Chirurg. Infantile, H6pital A. Le Dantec, av. Pasteur, Dakar, S6n6gal) 39:375 (1992) European Journal of Pediatric Surgery" (Stuttgart)

Splenic cysts in pediatric patients. A report on 8 cases and review of the literature. Musy, E-A. et al. (Le Coultre, C., Clinique de Chirurgie Pddiatrique, H6pital Cantonal Univ., CH-1211 Gentve 4, Switzerland) 2:137 (1992) Massive bleeding into the upper gastro-intestinal tract in hereditary chronic calcifying pancreatifis in the child. Ehrensperger, J. (Kinderchirurg. Abt., Kinderspital Wildermeth, CH-2502 Biel, Switzerland) 2:141 (1992) Echinococcus g!"anulosusinfection of the liver and lung in an 8 1/a-yeal~old boy. Meyer, V. et al. (Morger, R., Ostschweizerisches Kinderspital, Claudiusstr. 6, CH-9006 St. GaUen, Switzerland) 2:144 (1992) continued on p. 457

457 6. Merten D E Carpenter B L M (1990) Radiologic imaging of inflicted injury in the child abuse syndrome. Pediatr Clin North A m 37:815-837 7. Hailer JO, Kleinman PK, Merten D E Cohen HL, Cohen MD, Hayden PW, Keller M, Towbin R, Sane S (1991) Diagnostic imaging of child abuse. Pediatrics 87:262-264 8. Silverman FN (ed), (1985) Caffey's pediatric X-ray diagnosis. 8th edn. Year Book Medical Publishers, Chicago, pp 33%340 9. Cawley KA, Dvorak AD, Wilmot M D (1983) Normal anatomic variant: scintigraphy of the ischiopubic synchondrosis. J Nucl M e d 2 4 : 1 4 16 10. Taylor GA, Fatlat ME, Potter BM, Eichelberger M R (1988) The role of computed tomography in blunt abdominal trauma in children. J Trauma 28:1660-1664

11. Cooper A, Floyd T, Barlow D et al. (1988) Major blunt abdominal trauma due to child abuse. J Trauma 28:1483-1487 12. Kleinman PK, Rastopoulos VD, Brill P W (1981) Occult nonskeletal trauma in the battered-child syndrome. Radiology 141: 393-396 13. Pena SD, Medovy H (1973) Child abuse and traumatic pseudocysts of the pancreas. J Pediatr 83:1026-1028 14. Sivit CJ, Taylor GA, Eichelberger M R (1989) Visceral injury in battered children: a changing prospective. Radiology 173: 65% 661 15. McCort J, Vaudagna J (1964) Visceral injuries in battered children. Radiology 82:424-428 16. Touloukian RJ (1968) A b d o m i n a l visceral injuries in battered children. Pediatrics 42:642-646

Literature in pediatric radiology

Continued from p. 429

European Journal of Pediatric Surgery (StuttgarO

Neuropediatrics (Stuttgart)

A rare complication due to sulfuric acid ingestion. Tamisani, A.M. et al. (Surg. Emergency and Ped., Surg. Dept., Giannina Gaslini Inst., Largo G. Gaslini, 5, 1-16148 Genova Quarto, Italy) 2: 162 (1992) Fractures of the sacrum and disk herniation: rare lesions in the pediatric surgical patient? Ehrensperger, J. (Kinderchirurg. Abt., Kinderspital Wildermeth, CH-2500 Biel, Switzerland) 2:173 (1992)

CNS in congenital muscular dystrophy without mental retardation. Pihko, H. et al. (Children's Central Hosp., SF-00290 Helsinki, Finland) 23: 116 (1992) Leigh syndrome associated with a deficiency of the pyruvate dehydrogenase complex: results of treatment with a ketogenic diet. Wijburg, E A. et al. (Dept. of Ped., Univ. Hosp. (AMC), Meibergdreef 9, NL-1105 AZ Amsterdam, The Netherlands) 23:147 (1992) Unilateral thalamic haemorrhage in the pre-term and full-term newborn. De Vries, L. S. et al. (Casaer, E, Dept. of Paed. and Neonatal Med., Univ. Hosp. Gasthuisberg, B-3000 Leuven, BeI~um) 23:153 (1992) Encephalopathy of infancy with intracerebral caldfication and chronic spinal fluid lymphocytosis. Another case of the Aicardi-Goutihres syndrome. B6nnemann, C. G., Meinecke, E (Meinecke, E, Abt. fur Med. Genetik am Altonaer Kinderkrankenhaus, Bleickenallee 38, W-2000 Hamburg 50, FRG) 23:157 (1992)

Fortschritte auf dem Gebiete der R6ntgenstrahlen und der neuen bildgebenden Verfahren (Stuttgart)

Apophyses of the sacro-ifiac joints on CT. [In Germ.] Funke, M. et al. (Abt. R6ntgendiagn. I, Klinikum der Georg-August-Univ., RobertKoch-Str. 40, W-3400 G/3ttingen, FRG) 157:43 (1992) Epiphyseal dysplasia of the hip. Diagnosis and differential diagnosis with MRI. [In Germ.] Grimm, J., Just, M. (Orthop. Univ.-Klinik, W-6500 Mainz, FRG) 157:47 (1992) Pelvi-uretelic stenosis in infancy - comparison of diuresis sonography and diuresis excretory urography. [In Germ.] Rohrschneider, W., Tr6ger, J. (Abt. P~d. Rad., Rad. Klinik d. Univ., Im Neuenheimer Feld 153, W-6900Heidelberg, FRG) 157:72 (1992) Cystic lesions of the seminal vesicles - demonstration by MRI. [In Germ.] Grebe, R et al. (Klinik und Poliklinik far Rad., Univ.-Kliniken, Langenbeckstr. 1, W-6500 Mainz, FRG) 157:79 (1992) Acro-osteolysis of the phalanges and phaeochromocytoma. Hoeffel, J.C. et al. (Dept. of Rad., H6pital d'Enfants, All6e du Morvan, F-54511 Vandoeuvre, France) 157:100 (1992)

Piidiatrische Praxis (Mi~nchen)

M6glichkeiten der farbkodierten Dopplersonographie im Kindesalter (1). Deeg, K. H. (Kinderkfinik, Buger Str.80, W-8600Bamberg, FRG) 44:9 (1992) Arteriopathia calcificans infantum. Scharf, J. et al. (Klinik far Kinder und Jugendliche, der Univ. Erlangen-Ntirnberg, Loschgestr. 15, W-8520 Erlangen, FRG) 44:53 (1992) Pediatric Nephrology (Berlin)

Wilms' tumor. Warrier, R.E, Regueira, O. (Dept. of Ped., LSU Med. Center, 1542 Tulane Av., New Orleans, LA 70112, USA) 6:358 (1992)

Monatsschrift Kinderheilkunde (Berlin)

Etiology and diagnosis of cerebral infarction in childhood. [In Germ.] Lackmann, G.-M. et al. (Klinik ftir Kinder- und Jugendmed., Stfidt. Klinikum, Pacelliallee 4, W-6400 Futda, FRG) 140: 405 (1992)

Pediatric Surgery International (Berlin)

Adenoma of the gallbladder associated with a gallstone in a child. Kim, S.Y. et al. (Div. of Ped. Surg., Fatima Hosp., 302-1, Sinam-Dong, DongKu, Taegu 701-600, Korea) 7:341 (1992)

Renal ultrasonography in oesophageal atresia. Lander, A. D. et al. (Dept. of Surg., Inst. of Child Health, 30 Guilford St., London WCIN 1EH, UK) 7:351 (1992) Intussusception: recurrence following gas (oxygen) enema reduction. Renwick, A. A. et al. (Beasley, S.W., Dept. of General Snrg, Royal Children's Hosp., Ftemington Rd., Parkville, Vic3052, Australia) 7:361 (1992) Ovarian cysts in the newborn. Hengster, E, Menardi, G. (Dept. of Ped. Surg., Univ. Hosp., Anichstr. 35, A-6020 Innsbruck, Austria) 7:372 (1992) Mediastinal cystic hygroma in infancy and childhood. Ratan, J. et al. (Mitra, D.K., Dept. of Ped. Surg., AII India Inst. of Med. Sciences, New Delhi-110029, India) 7:380 (I992) Extrathoracic pulmonary sequestration detected by antenatal ultrasonography. Gross, G. J. et al. (Dept. of Ped. Cardiol., The Children's Hosp., 300 Longwood Av., Boston, MA 02115, USA) 7: 382 (1992) Lymphangioma of the right diaphram. Seo, T. et al. (Dept. of Surg., Branch Hosp., Univ. School of Med., 1-1-20, Daikohminami, Higashi-ku, Nagoya, 461, Japan) 7:384 (1992) Hepatopulmonary hydatid disease. Singh, J.P., Garg, R (Gard, R, 687/27 Swasthya Vihar, Opp, Med. Crossing, Model Town, Rohtak-124001, (Haryana) India) 7:387 (1992) Vascular compression of the duodenum in a newborn. Boyer, K., Parker, P. (Parker, E, Atlanta Ped. Surg., E C., 1276-B McConnell Dr., Decatur, GA 30033, USA) 7:389 (1992) Prenatal ultrasonic diagnosis of a cystic adrenal mass with postnatal hemorrhage and in situ neuroblastoma. Lanning, M., Lanning, R (Dept. of Ped., Univ., SF-90220 Oulu, Finland) 7:396 (1992) Strahlentherapie und Onkologie (Miinchen)

High voltage irradiation of a cavernous giant haemangioma? An impressive case example. [In Germ.] Proske, H., Pfab, R. (Abt. fiir Strahlentherapie, Med. Zentrum ftir Rad, Klinikum der Philipps-Univ., Baldingerstr., W-3550 Marburg/ Lahn, FRG) 168:350 (1992) continued on p. 466

466

Discussion Myelolipoma is an uncommon adrenal lesion whose etiology is unknown. It is suggested that they are caused by metaplasia of mesenchymal stem cells, which are the precursors of both adrenal and myeloid tissues [2]. The reported incidence at autopsy ranges from 0.08 % to 0.2%. It is characteristically small ( < 5 cm) but varies in size from microscopic loci to 8 cm in diameter [1, 4, 5]. The age range in affected individuals is 20-90 years, with the greatest prevalence in the fourth to sixth decades of life [6]. Myelolipomas are known to affect the right and the left adrenal glands equally. Various pathogenetic mechanisms have been proposed to explain the development of myelolipoma [5]. No correlation has been found between adrenal myelolipomas and extra medullary hematopoiesis. Patients are usually asymptomatic, although abdominal or flank pain may present in larger tumours because of haemorrhage, necrosis, or mechanical

compression of surrounding structures [1,6]. Ultrasonography and CT are more sensitive than plain-film radiography and are valuable imaging techniques in the diagnosis of fatty tumors of the adrenal glands. Fatty lesions are solid and usually echogenic on sonography, but sometimes are hypoechoic [3] as in our case, and have characteristic low attenuation numbers on CT. The sonographic and CT appearance of myelolipoma depends on the relative percentage of its constituents. When haemorrhage, calcification, or myeloid material in a myelolipoma is extensive, the tumor's fat content may notbe recognised easily on ultrasonography or CT scans. Such a mass may be radiological indistinguishable from other adrenal neoplasms, including adrenal carcinoma and neuroblastoma. The specific ultrasonographic or CT diagnosis of adrenal myelolipoma can only be suggested by the presence of mature fat [6]. The differential diagnosis of a suprarenal fatty mass includes retroperitoneal lipoma

Literature in pediatric radiology Ultrasehali in Klinik und Praxis (Berlin)

Postmortem ultrasonography and morphology of the fetal and neonatalbrain. Methods and results. [In Germ.] Lu, J.H. et al. (Kowalewski, S., Abt. Neonatol. der Univ., Adenauerallee 119, W-5300 Bonn 1, FRG) 7:60 (1992) Acta Radiologica

(Copenhagen)

Ductus arteriosus aneurysm imaging using modern diagnostic methods. Lam'fl~, S. et al. (Dept. of Diagn. Rad., Univ. Hosp., S-22185 Lund, Sweden) 33:285 (1992) Assessment of liver iron overload in thalassemicpatients by MR imaging. Villari, N. et al. (Dip. di Fisiopatol. Clinica, Univ. degli Studi di Firenze, Viale Morgagni 86, 1-50134 Florence, Italy) 33: 347 (1992) Aeta Paediatrica

(Oslo)

Ultrasonographicscreening for renal abnormalities in three-year-old children. Mihara, M. et al. (Dept. of Ped. and Child Health, Univ. School of Med, 67 Asahi Machi, Kurume City 830, Japan) 81:326 (1992)

and liposarcoma or renal angiolipoma protruding from the upper pole. In conclusion, ultrasonography and CT scan can greatly facilitate the correct preoperative diagnosis of myelolipoma of the adrenal,

References 1. Desai SB, Dourmashkin L, Kabakow BR, Leiter E (1979) Myelolipoma of the adrenal gland: case report, literature review and analysis of diagnostic features. Mt Sinai J Med 46:155 2. Figueroa G, Tedeschi L (1966) Myelolipoma of the adrenal gland. Bost Med Q 2:34 3. Musante F, Derchi EL, Zappasodi F, Bazzocchi M, Riviezzo CG, B anderali A, Cicio R G (1988) Myelolipoma of the adrenal gland: sonographic and CT features. A J R 151:961 4. Olsson CA, Krane RJ, Klungo RC, Selikowitz SM (1973) A d r e n a l myelolipoma. Surgery 73:665 5. Plaut A (1958) Myeloliporna in the adrenal cortex. A m J Patho134:487 6. Vick CW, Z e m a n RK, Mannes E, Cronan JJ, Walsh JW. Adrenal myelolipoma: CT and ultrasound findings. Urol Radio164:7

Continued from p. 457 The primary empty-sella syndrome and diabetesinsipidus in a child. Hung, W., Fitz, C.R. (Div. of Ped. Endocrinology and Metabolism, Georgetown Univ. Children's Med. Center, 3800 Reservoir Rd., NW, Washington, DC 20007, USA) 81: 459 (1992) PediatricNeurosurgery

(Basel)

Skull base in trigonocephaly. Genitori, L. et al. (Dept. of Ped. Neurosurg., Hhpital des Enfants La Timone, F-13005 Marseille, France) 17:175 (1992) Demonstration of cerebral radiation injury with metabolic positron emissiontomographyimages. Mineura, K. et al. (Neurosurg. Serv., Univ. Hosp., 1-1-1 Hondo,Akita 010, Japan) 17:200 (1992) Congenital scalp defects: Adams-Oliver syndrome. Arand, A. G. et al. (Crone, K.R., Div. of Neurosurg., Children's Hosp. Med. Center, Elland and Bethesda Av., Cincinnati, OH 45229-2899,USA) 17:203 (1992)

Gliomas of the tectum and periaqueductal region of the mesencephalon. Boydston, W. R. et al. (Sanford, R. A., Semmes-Murphey Clinic, 920 Madison Av., Suite 201, Memphis, TN 38103, USA) 17:234 (1992) Computerized tomography appearance of accidental infusion of air into the venous sinuses. Peled, N. et al. (The Hosp. for Sick Children, Dept. of Diagn. Imaging, 555 Univ. Av.,Toronto, Ontario, M5G IX8, Canada) 17:251 (1992) Australian and New Zealand Journal of Surgery

(Victoria) Basal ganglia teratomas: report of three cases. Ng, H.K. et al. (Dept. of Anatomical and Cellular Pathol., Prince of Wales Hosp., Shatin, Hong Kong) 62:436 (1992) Spontaneous bone graft resorption in os odontoideum. Edmunds, I.A., Cummine, J.L. (Hosp., Westmead, NSW 2145, Australia) 62:502 (1992) Cubonavicular coalition: an unusual cause of peroneal spastic flat foot. Williamson, D. M., Torode, I.P. (Torode, I. E, Dept. of Orthop. Surg., Royal Children's Hosp, Parkville, Vic. 3052, Australia) 62:506 (1992)

Literature in pediatric radiology.

405 Response from authors Preventing postnatal urinary tract infection is one of the prime advantages of prenatal diagnosis of genitourinary abnormaf...
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