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Pediatric head trauma is very common and accounts for most of the emergency hospital visits. It is also the most common cause for a pediatrician to refer a child for neuroimaging. Pediatric head injury causes lot of morbidity and mortality in children and can be due to accidental or abusive injury. Falls are most common in small children, whereas motor vehicle accident is more common in older children and adolescents. Pediatric brain injury differs from adult brain injury due to immature brain, mechanism of injury, and difficulty in neurological evaluation in children. The radiologist needs to be familiar with these to correctly interpret the scans and guide clinicians in appropriate patient care.

Cystic changes in the lungs in neonatal age group as well as children are commonly encountered in day-to-day practice of paediatric chest imaging. It is therefore important to know the patterns of cystic disease, many of which are classical with definitive treatment options, to enable appropriate clinical care. This article briefly reviews the common conditions presented in our patient population with cystic changes in the lungs. The lesions have be classified as Congenital or autoimmune and Acquired conditions. The acquired lesions are largely infective in nature and represent a wide variety of infectious conditions.

Congenital radial head dislocation is a rare anomaly of the pediatric musculoskeletal system. The most common type is posterior, with anterior and lateral dislocations being less common. Unilateral cases are even more uncommon and were earlier thought to be non-existent. Our case report describes a young girl with unilateral congenital anterior radial head dislocation with progressive development of cubitus valgus deformity, which is a very rare occurrence. On reviewing literature, only few such cases have been described. Our patient also had a history of developmental dysplasia of hip and a congenital intra-hepatic porto-systemic shunt, which in addition to the morphological appearances of the radial head and capitellum, suggested a congenital etiology.

Congenital aortic diseases are one of the most common congenital cardiovascular diseases referred for radiological imaging. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) studies give comprehensive information regarding the anatomy and anomalies of the aorta in its entirety. The wider field of view available on cross-sectional imaging by CT and MRI plays a vital role in the robust assessment of aortic pathologies. Further, these imaging techniques are objective and reproducible with very little inter-observer variability. Multi-planar and 3D rendering of cross-sectional image data, especially CT angiogram gives an excellent depiction of the pathologies, especially where surgical intervention is required.

Background: Double outlet right ventricle (DORV) with two well-developed ventricles and with a remote ventricular septal defect (VSD) may present a therapeutic challenge. Echocardiographic imaging of such complex cases does not always provide all of the information required to decide on an operative approach (biventricular or univentricular) and to design an intracardiac baffle to direct left ventricular outflow through the VSD and to the aorta for biventricular repair. A three dimensional (3D) printed model of the heart based upon data derived from computed tomography (CT) or magnetic resonance imaging (MRI) may contribute to a more complete appreciation of the intracardiac anatomy. Methods: From April to September 2015, six consecutive patients with DORV and remote VSD underwent CT/MRI scans. Data sets from these studies were used to generate life-size 3D models using a 3D printer. We compared the assessment of 3D printed heart model findings with information obtained from echocardiography, CT, or cardiac MRI and with details of the surgeon’s intraoperative direct observations when available. Quantification of the information provided by the 3D model was achieved using a unique scale that was created for the purpose of this study. The accuracy and utility of information derived preoperatively from the models were assessed. Results: Six data sets from six patients were analyzed. Five data sets could be successfully used to create sandstone models using 3D printing. The five patients ranged from 7 months to 11 years of age and weighed 6.7 to 26 kg. The spatial orientation of the heart in the thorax, the relationships of the great arteries and the semilunar valves, the size and location of the VSD were well appreciated in all models, as were the anticipated dimensions and orientation of a surgically planned interventricular baffle. Three of the five patients underwent successful biventricular repair. Conclusion: The 3D printed models scored higher than conventional imaging, with respect to most aspects of the surface spatial orientation and intracardiac anatomy. The models are a useful adjunct in preoperative assessment of complex DORV. The unique scale helps quantify the advantages and limitations of the 3D heart models.

Tuberculosis (TB) remains a worldwide scourge and its incidence appears to be increasing due to various factors, such as the spread of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). The insidious onset and non-specific constitutional symptoms of genitourinary tuberculosis (GUTB) often lead to delayed diagnosis and rapid progression to a non-functioning kidney. Due to hematogenous dissemination of TB, there is a potential risk of involvement of the contralateral kidney too. Imaging plays an important role in the making of a timely diagnosis and in the planning of treatment, and thus helps to avoid complications such as renal failure. Imaging of GUTB still remains a challenge, mainly on account of the dearth of literature, especially related to the use of the newer modalities such as magnetic resonance imaging (MRI). This two-part article is a comprehensive review of the epidemiology, pathophysiology, and imaging findings in renal TB. Various imaging features of GUTB are outlined, from the pathognomonic lobar calcification on plain film, to finer early changes such as loss of calyceal sharpness and papillary necrosis on intravenous urography (IVU); to uneven caliectasis and urothelial thickening, in the absence of renal pelvic dilatation, as well as the hitherto unreported 'lobar caseation' on ultrasonography (USG). Well-known complications of GUTB such as sinus tracts, fistulae and amyloidosis are described, along with the relatively less well-known complications such as tuberculous interstitial nephritis (TIN), which may remain hidden because of its 'culture negative' nature and thus lead to renal failure. The second part of the article reviews the computed tomography (CT) and MRI features of GUTB and touches upon future imaging techniques along with imaging of TB in transplant recipients and in immunocompromised patients.

Left atrial appendage aneurysm (LAAA) is a rare congenital anomaly, usually identified incidentally on a chest radiograph performed for another indication. Our case is that of an 11-month-old male infant who was incidentally diagnosed as having a giant LAAA while being clinically evaluated for pneumonia. The lesion was accurately diagnosed on preoperative, non-contrast, free-breathing cardiac MRI (CMR). LAAA has a peculiar appearance, resembling a “giant dog ear”—a sign first described on cardiac angiography and holding true on CMR as well. Fast free-breathing sequences on CMR, especially on 3 T, provide high-resolution images and eliminate the need for other pre-operative imaging that are either invasive, involve radiation exposure, require general anaesthesia or a combination of these.

A three-dimensional (3D) printed heart model based on contrast-enhanced MR angiography data was obtained in an 8-month-old male child with double-outlet right ventricle. The model could successfully show the spatial relationship between the aortic annulus, the pulmonary valve and the ventricular septal defect. The patient underwent complete intracardiac repair based on the 3D model. MR angiography images could be successfully used to create a true-size 3D heart model, which significantly helped in assessing the routability of the ventricular septal defect to the aorta, leading to successful intracardiac repair in our patient.

Coronary stent fracture is a known complication of coronary arterial stent placements. Multiple long-term risks are also associated with drug eluting stents. 64-slice multidetector CT (MDCT) coronary angiography has been shown to detect poststent complications such as instent stenosis, thrombosis, stent migration and stent fractures. We report a case of stent fracture in a patient who underwent RCA stenting with associated RCA perforation and almost complete thrombosis of the RCA and peristent fibrinoid collection. This is a rare case of stent fracture with perforation of the RCA. The paper highlights the role of 64-row multidetector computed tomography (MDCT) in evaluation of such poststent placement complications.