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The field and applications of postmortem imaging are exponentially growing. Its potential to identify the cause of death in trauma and ballistic cases is now properly documented, as well as its use in drug mule identification. In pediatric and perinatal practice, large significant series are less available, except for MRI and central nervous system analysis where scientific evidence is now robust. In this review, after a short historical review and analysis of current problems and challenges, we will try to depict the way we see the future of this subspecialty of postmortem cross-sectional imaging, including all specific situations: terminations of pregnancy, intrauterine death, sudden unexpected infant death and identification issues.

Approximately one fourth of cases of inflammatory bowel disease (IBD) occur during childhood and children are more prone than their adult counterparts to have severe disease at presentation. To investigate these diseases MR imaging is no longer an emerging tool. Numerous reviews and articles have been published on this topic underlying the advances of imaging but also the complexity and the financial impact on management of such diseases. In children it seems reasonable to consider US as the first imaging examination to perform, especially when the diagnosis of IBD is unknown. However, we believe that recent and future technical progress, especially the ability of MR to display reproducible data, and the need for gold standard evaluation of new medical therapies will increase the role of MR enterography.

We report the unique association of a rectosigmoid venous malformation and an aneurysm of the portal vein in a 7-year-old child. Doppler ultrasonography allowed the diagnosis; MRI confirmed the diagnosis and demonstrated the extent of the abnormality. The treatment and evolution over a period of 6 years is recorded. The relationship between these two entities and treatment is discussed.

The use of high frequency (7-12 MHz) transducers on state of the art US units equipped with Doppler imaging provides excellent evaluation of the pediatric pancreas that compares to other cross-sectional imaging techniques. The availability of multidetector CT imaging reduces the need for sedation but requires additional review of the indications and protocols to avoid unnecessary radiation exposure. Evaluation of pancreatitis and tumors remains the main indication. Advances in MR imaging and MRCP has lead to very good results in children. Storage diseases of the pancreas can be diagnosed at MRI. The length of the examinations, the need for sedation and the limited spatial resolution remain the main pitfalls of MR imaging of the pancreas in pediatric patients.

Background: Preoperative diffusion-weighted MRI (DW-MRI) has been described as an efficient method to differentiate good and poor responders to chemotherapy in osteosarcoma patients. A DW-MRI performed earlier during treatment could be helpful in monitoring chemotherapy. Objective: To assess the accuracy of DW-MRI in evaluating response to chemotherapy in the treatment of osteosarcoma, more specifically at mid-course of treatment. Materials and methods: This study was carried out on a prospective series of adolescents treated for long-bone osteosarcoma. MR examinations were performed at diagnosis (MRI-1), at mid-course of chemotherapy (MRI-2), and immediately before surgery (MRI-3). A DW sequence was performed using diffusion gradients of b0 and b900. The apparent diffusion coefficients (ADC1, ADC2, ADC3, respectively), their differentials (ADC2 − ADC1 and ADC3 − ADC1), and their variation (ADC2 − ADC1/ADC1 and ADC3 − ADC1/ADC1) were calculated for each of these three time points. Results: Fifteen patients were included. Patients with no increase in ADC showed a poor response to chemotherapy on their histology results. At mid-course, the three calculated values were significantly different between good and poor responders. ADC2 − ADC1 enabled us to detect, with 100% specificity, four out of seven of the poor responders. There was no significant difference in the values at MRI-3 between the two groups. Conclusion: DW-MRI performed both at baseline and mid-course of neoadjuvant chemotherapy is an efficient method to predict further histological response of osteosarcoma. This method could be used as an early prognostic factor to monitor preoperative chemotherapy. [ABSTRACT FROM AUTHOR]

Exponential improvements in imaging techniques over the last ten years, through patients’ and physicians’ wishes for less invasive fetal work-up, now allow us to better explore and understand fetal lung physiology during pregnancy. Diagnostic and prognostic consequences at stake are huge, especially for fetuses at risk of pulmonary hypoplasia. We will decline in three parts (normal lung, malformative lung and pulmonary hypoplasia), through a review of the literature and enlightened by our experience, the potentialities and limitations of all imaging modalities (Ultrasound, Doppler, 3D, MRI). Then, we will dwell on future leads and the need for large-scale collaborative studies. [Copyright &y& Elsevier]