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To evaluate the efficiency of laser thermocoagulation under computed tomography (CT) guidance in the treatment of osteoid osteoma within a strictly pediatric group. Twenty-five patients aged 4 to 17 years were treated under CT by laser thermocoagulation. The nidus measured on average 10.1 mm. Pain relief was the main item for evaluation of the effectiveness of our treatment. Follow-up ranged from 3 months to 61 months (mean, 26 months). Technical success was achieved in 100%. Thermocoagulation proved to be initially effective in 24 of 25 children (96%) and had a positive long-term effect in 23 of 25 children (92%). We had four minor complications and one severe complication (partial osteonecrosis of the talus). Laser thermocoagualation is an effective treatment for osteoid osteoma in pediatric patients. [ABSTRACT FROM AUTHOR]

Summary: Objective: To describe the chest radiographs of infants hospitalized for acute bronchiolitis and to assess whether patient management changed after radiography. Study design: All infants hospitalized in our pediatric unit with a first episode of acute bronchiolitis from October 2010 to March 2012 were included in the study. Infants with chronic disease or transferred from a pediatric intensive care unit were excluded. The following data were collected: sex, age, neonatal history, atopy, tobacco exposure, admission criteria, treatment, laboratory parameters, ultrasonography and its outcome, results of chest radiography on admittance, the reason for a second chest radiograph, change in management as a result of the radiograph. Results: The study comprised 232 infants (median age 2.2 months, boys 56%, positive respiratory syncytial virus 73.4%). Among them, 227 children had a routine chest radiograph revealing distension and/or bronchial wall thickening (n =141, 62.4%), focal opacity (19.9%), or atelectasis (17.7%). This radiograph led to the prescription of antibiotics in six patients (2.6%) and allowed the diagnosis of vascular abnormality to be made in one case (0.4%). Thirty-five patients (15.4%) had a second chest radiograph during their hospitalization owing to oxygen dependency (n =21), respiratory distress (n =11), persistent fever (n =2), or no reason specified (n =1). Pneumonia (n =7) and/or atelectasis (n =15) were then found in 62.9%. Patient management (antibiotics, postural maneuvers) was modified in six patients (17.1%). Conclusions: Routine chest radiographs contribute only partially to the treatment of infants hospitalized for acute bronchiolitis. However, radiography is useful when the hospitalized child does not improve at the expected rate or if the disease is severe. The indication of chest radiography in infants hospitalized for acute bronchiolitis should be discussed on a case by a case basis. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate the caregivers’ opinions regarding decision-making in termination of pregnancy (TOP) for fetal anomaly. Material and methods: Questionnaire survey using a semi-structured survey based on visual analogue scales, sent to all multidisciplinary centres for prenatal diagnosis in France. Answers were received from 26 centres nation-wide. Results: Response rate was 39% (213 responses received over 550 questionnaires sent). Fifty-five percent of respondents were women, 90% physicians, 7,5% midwives. A vast majority (69.8%) believes that their own convictions play a bigger role in decision in real practice than in their ideal. The major decisional factors in decision-making for TOP are: the long-term prognosis of the anomaly, a specialized opinion on its curability, the quality of the information given to the future parents, their expressed opinion, the existence of a multidisciplinary decision, the ability of the future parents to understand the medical data, the obtention of a medical consensus, the proof level of the medical information. For only 55% of the respondents, the current legal framework is adequate to manage the situations that result from prenatal diagnostic practices today. The question of late third-trimester TOP raises ethical debate: over a third (37%) see no ethical difference between TOP and withdrawal of care during the neonatal period; the majority (48% versus 43%) feel that ethically speaking a neonate and a foetus at 39weeks gestational age (GA) should not be treated differently; 37% of the respondents feel that current practice is likely to lead to eugenism. Discussion and conclusion: As far as TOP is concerned, the huge discrepancies in responses from the professionals highlight the ongoing ethical debate, especially concerning the concept of informed choice in TOP, which we believe should be entirely revisited. [Copyright &y& Elsevier]

Background: Systematic flexible bronchoscopy is advocated in the initial management of childhood pulmonary tuberculosis. Methods: Our aim was to describe and to compare the systematic flexible bronchoscopy findings of 53 children (6.5 + or - 4.4 years; 52.8% boys) with active pulmonary tuberculosis to their initial clinical and radiological (chest x-ray, n=53; CT, n=45) features in an 11-year retrospective study. Results: Flexible bronchoscopy was normal in 51% of cases. A severe tracheobronchial involvement (extrinsic compression >50% or obstructive endoluminal mass >25% of the lumen) was found in 10 patients. Flexible bronchoscopy guided therapy in 13 cases (steroids n=12, bronchoscopic extraction of a granuloma n=1) and permitted isolation of Mycobacterium tuberculosis in three patients (5.7%). No useful information was obtained by flexible bronchoscopy in 73.5% of cases. No correlation was found between flexible bronchoscopy findings and clinical features or x-ray findings. Conversely, a strong correlation was found between severe bronchoscopic involvement and tracheobronchial luminal narrowing on CT. The CT negative predictive value was 100% (95% CI 91% to 100%). Based on CT results, flexible bronchoscopy could have been avoided in about 60% of our patients. Conclusions: Flexible bronchoscopy remains a very relevant tool in the diagnostic and therapeutic management of childhood pulmonary tuberculosis but resulted in treatment modification or microbiological proof in a minority of our patients. We propose that flexible bronchoscopy in children with pulmonary tuberculosis be limited to those who show tracheobronchial luminal narrowing on an initial CT scan. [ABSTRACT FROM AUTHOR]

Several photographs are presented depicting the result of a fetal cardiac magnetic resonance imaging which describes the cardiac anatomy of fetus inside the womb.

Objective To evaluate the functional prognosis of kidneys affected prenatally by urinomas. Methods This was a retrospective review of cases of fetal urinoma reported in the literature, as well as two of our own cases. Results Twenty-three patients with a prenatal diagnosis of urinoma (five bilateral) were included in the analysis. Postnatal ipsilateral renal function was observed in only six of the 28 renal units (i.e. around 20%). Conclusions Although the precise causes of urinomas are still unknown, this review shows that in the event of a fetal urinoma, the probability of a non-functional dysplastic ipsilateral kidney lies at around 80%. In-utero puncture only appears to be justified in cases where fluid accumulation has mass effects on adjacent major structures. [ABSTRACT FROM AUTHOR]

Abstract: Management of cystic lymphangioma necessitate for optimal diagnosis and treatment the expertise of a trained multidisciplinary team including dermatologists, radiologists, plastic and vascular surgeons. An initial imaging work-up of these lesions by ultrasound Doppler examination and MR imaging are necessary before treatment planning. Depending of the size, the location, the risk for the adjacent organs, a therapeutic decision may be mandatory. Percutaneous sclerotherapy is a safe and efficient treatment. It is the treatment of choice that must be proposed in first intention. [Copyright &y& Elsevier]

Objectives To investigate the correlation between fetal lung volume (FLV), measured with magnetic resonance imaging (MRI), and postnatal mortality in newborns with prenatally diagnosed isolated congenital diaphragmatic hernia (CDH). Methods In a 4-year prospective multi center study, 77 fetuses with isolated CDH diagnosed between 20 and 33 necks' gestation underwent fast spin-echo T2- weighted lung MRI. These MRI-FLV measurements were compared with a previously published normative curve obtained in 215 fetuses without thoracoabdominal malformations and with normal ultrasound biometric findings. FLV measurements were correlated with postnatal survival. The mean gestational age at MRI was 31.3 weeks. Results The measured/expected FLV ratio was significantly lower in the newborns with CDH who died compared with those who survived (23.6 ± 12.2 vs. 36.1 ± 13.0, P < 0.001). When the ratio was below 25%, there was a significant decrease in postnatal survival (19% vs. 40.3%, P = 0.008). Survival was significantly lower for neonates when one lung could not be seen by fetal MRI compared with those fetuses with two visible lungs on MRI (17.9% vs. 62.1%, P < 0.001). Conclusion In isolated CDH, FLV measurement by MRI is a good predictor of postnatal mortality due to pulmonary hypoplasia. [ABSTRACT FROM AUTHOR]

We report the case of a fetus with a sonographic mid-gestation diagnosis of hyperechogenic cerebellum suspected to be of hemorrhagic origin on fetal brain magnetic resonance imaging (MRI). No etiological factors for fetal hemorrhage were found other than a maternal heterozygocity for factor V Leiden. Following termination of the pregnancy, autopsy confirmed the prenatal diagnosis of massive cerebellar hemorrhage without underlying vascular anomaly. As an additional tool to ultrasonography, fetal brain MRI can affirm the hemorrhagic origin of hyperechogenic cerebellar lesions, especially by showing a high signal on T1-weighted images. [ABSTRACT FROM AUTHOR]

Congenital genu recurvatum (CGR) is an extremely rare condition observed at birth. It is associated with, among other malformations, genetic entities such as the Larsen syndrome. When CGR is isolated, orthopedic treatment will usually lead to a good functional prognosis. We report the first case of isolated CGR diagnosed prenatally and suspected to be a consequence of reduced amniotic fluid volume due to leakage following amniocentesis. The etiology and management options for CGR are briefly discussed. [ABSTRACT FROM AUTHOR]

Background: The significant number of qualitative and quantitative ultrasound markers described for first‐trimester screening of open spina bifida (OSB) and other posterior brain defects (oPBD) has resulted in their complex implementation and interpretation for a widespread screening and in a lack of consensus regarding diagnostic accuracy. Objectives: To assess and compare the accuracy of qualitative and quantitative cranial sonographic markers at 11–14 weeks of gestation for the detection of OSB and oPBD. Search strategy: A systematic literature search was performed in MEDLINE and COCHRANE from 2009 to April 2020. Selection criteria: Studies assessing the diagnostic accuracy of quantitative and/or qualitative ultrasound signs to predict OSB and oPBD were included. Cohort studies and case–control studies were also considered. Data collection and analysis: Two reviewers independently extracted data and assessed the risk of bias. The overall pooled estimate and a summary receiver operating characteristic curve was estimated for each subgroup (qualitative and quantitative assessment). Main results: Twenty‐three studies were included in our meta‐analysis. The pooled sensitivity and specificity for qualitative assessment were 76.5% and 99.6%, and for quantitative assessment were 84.5% and 96.3%, respectively; specificity for the qualitative ultrasound signs was significantly higher (P = 0.001). The overall sensitivity of cranial sonographic markers for the screening of oPBD was 76.7% and specificity was 97.5%. Conclusions: The qualitative approach demonstrated greater specificity, so this would appear to be more appropriate for daily screening, as a first‐line tool, whereas the quantitative approach should be reserved for expert ultrasound. This study highlights the relevance of first‐trimester qualitative ultrasound signs in the screening of open spina bifida. This study highlights the relevance of first‐trimester qualitative ultrasound signs in the screening of open spina bifida. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which discusses a case of a 27-year-old primigravida who was diagnosed of Blake's pouch cyst after first-trimester observation of enlarged intracranial translucency.

A letter to the editor is presented in response to the article "The impact of two-dimensional versus three-dimensional ultrasound exposure on maternal-fetal attachment and maternal health behavior in pregnancy," by B. Sedgmen, C. McMahon, D. Cairns, B. J. Benzie and R. L. Woodfield.

An abstract of the article "Prenatal elastography in fetal baboons pregnancy: a reproducibility study" by E. Quarello and colleagues is presented.

Les malformations ano-rectales sont répandues dans le monde, mais leur diagnostic prénatal est rarement réalisé. Nous rapportons le cas d’un nouveau-né dont le diagnostic ante-natal de fistule urétro-rectale en H a permis une prise en charge adaptée. Une femme enceinte de 28 ans présente à l’échographie et l’IRM à 27 semaines d’aménorrhée (SA) une dilatation liquidienne importante du colon fœtal. À 34SA, l’IRM montre une majoration de la distension liquidienne colique sans atteinte du grêle, éliminant la diarrhée fœtale et orientant vers une fistule uro-rectale. À la naissance, l’enfant ne présente aucun trouble du transit ou urinaire. Malgré cela, nous réalisons une IRM à 6 jours qui retrouve une distension recto-sigmoidienne, sans fistule visible. Afin d’étayer notre hypothèse, une urétro-cystographie rétrograde met en évidence une fistule urétro-rectale sus-montanale. Le diagnostic est confirmé lors d’une cystoscopie, et on retrouve une sténose anale. Le nouveau-né bénéficie d’une cure chirurgicale et présente un suivi à deux ans sans complication. Devant toute dilatation liquidienne colique prénatale, il faut évoquer une fistule en H conduisant à la réalisation du bilan standard de malformation ano-rectale et d’une cystographie néonatale à la recherche de la fistule. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article about fetal intrapericardial teratomas by J. A. Ramirez in the 2004 issue.

Abstract: Dysmorphology is the study of congenital malformations and anatomic variations of the individuals. Up to 2500 dysmorphic or malformative syndromes are described, most of them being characterized by mental retardation. Craniofacial dysmorphology may be the keystone of syndrome identification, although limb anomalies are sometimes important diagnostic clues. The advances of fetal imaging, particularly the development of 3D ultrasound techniques, allow a detailed analysis of the fetal face. Dysmorphology requires experience of rare syndromes and a perfect knowledge of normal facial appearance and variations. In utero, this approach must combine the skills of both a practitioner with expertise in fetal ultrasound and a pediatric dysmorphologist. Furthermore, facial changes have to be analyzed according to the context of the pregnancy and family history. Identification of patent facial anomalies may be a clue for the diagnosis of severe fetal syndromes and diseases. Conversely, when fetal malformations or abnomalities of the fetal growth are identified, a careful facial analysis can be proposed in order to rule out well-known syndromes with a poor prognosis. However, from an ethical point of view, parents should not be aware of a possible facial dysmorphism unless there is a precise diagnosis and options concerning the pregnancy. [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]

Purpose: The fetal development of the mandible is nowadays quite understood, and it is already known that craniofacial growth reaches its highest rate during the first 5 years of postnatal life. However, there are very few data focusing on the perinatal period. Thus, the present article is addressing this concern by studying the mandible morphology and its evolution around the birth with a morphometric method.Methods: Thirty-one mandibles modelled in three dimensions from post-mortem CT-scans were analyzed. This sample was divided into two subgroups composed of, respectively, 15 fetuses (aged from 36 gestational weeks), and 16 infants (aged to 12 postnatal weeks). 17 distances, 3 angles, and 8 thicknesses were measured via the prior set of 14 landmarks, illustrating the whole mandible morphology.Results: Although this methodology may depend on the image reconstruction quality, its reliability was demonstrated with low variability in the results. It highlighted two distinct growth patterns around birth: fetuses mandibles do not significantly evolve during the perinatal period, whereas, from the second postnatal weeks, most of the measurements increased in a homogeneous tendency and in correlation with age.Conclusions: The protocol developed in this study highlighted the morphologic evolution of the mandible around birth, identifying a different growth pattern from 2 postnatal weeks, probably because of the progressive activation of masticatory muscles and tongue. However, considering the small sample size, these results should be thorough, so identification and management of anatomic abnormalities could eventually be achieved. [ABSTRACT FROM AUTHOR]

Résumé Objectifs Un protocole local de prise en charge des enfants hospitalisés pour bronchiolite aiguë, établi dans les suites d’une étude réalisée en 2012, recommande la réalisation d’une radiographie thoracique en cas d’évolution inhabituelle ou de suspicion de diagnostic différentiel. L’objectif de notre étude était d’évaluer nos pratiques professionnelles après diffusion de ce protocole. Matériel et méthodes Étude rétrospective descriptive réalisée sur les 2 sites de pédiatrie générale du centre hospitalier universitaire (CHU) de Marseille entre octobre 2013 et mars 2015, incluant tout nourrisson hospitalisé pour un premier épisode de bronchiolite aiguë sans pathologie chronique sous-jacente. Résultats Sur 599 nourrissons inclus (âge médian de 3,7 mois, 54 % de garçons), 355 (59,3 %) avaient eu au moins une radiographie thoracique (soit une baisse de 38,5 % en 3 ans). Elle était anormale dans 96,3 % des cas : syndrome bronchique ou distension thoracique (56,7 %), foyer de condensation (23,5 %), trouble ventilatoire (19,5 %). Une prescription hors protocole a été notée dans 42,5 % des cas. Le résultat de cet examen avait modifié la prise en charge pour 52 nourrissons : antibiothérapie pour pneumonie (86,5 %), diagnostic d’une cardiopathie (0,2 %). L’utilisation de la radiographie et de l’antibiothérapie avait été statistiquement différente d’un centre à l’autre. Discussion Notre protocole a permis une réduction significative du nombre de radiographies thoraciques. Un grand nombre reste réalisé en dehors de nos recommandations, débouchant sur une prescription d’antibiotique pour pneumonie encore large. Conclusion La diminution du nombre de radiographies thoraciques dans le cadre d’une hospitalisation pour bronchiolite reste insuffisante. Summary Objective A management protocol for infants hospitalized for acute bronchiolitis, established after the study conducted in our unit in 2012, recommends a chest X-ray when the clinical course is unusual or if a differential diagnosis is suspected. The goal of this study was to evaluate professional practices after the introduction of this new management protocol. Study design Retrospective descriptive study in two pediatric units from October 2013 to March 2015, including infants (0–23 months) hospitalized for their first episode of acute bronchiolitis without any underlying chronic condition. Result Overall, 599 infants were included (median age, 3.7 months, 54 % boys). Nearly six out of ten ( n = 355, 59.3 %) had at least one chest radiograph (38.5 % fewer than in 2012). It was abnormal in 96.3 % of cases, revealing distension and/or bronchial wall thickening (56.7 %), focal opacity (23.5 %), or atelectasis (19.5 %). An X-ray was performed out of the recommendations in 42.5 % of cases. The chest X-ray result led to management changes in 52 infants with prescription of antibiotics for pneumonia (86.5 %) and allowed the diagnosis of heart disease in one case (0.2 %). Management of acute bronchiolitis (X-ray and antibiotics) was statistically different between the two pediatric units. Discussion This protocol led to a significant decrease in the number of chest X-rays. However, many are still performed out of the recommendations, resulting in an increase of antibiotic use for pneumonia. Conclusion The decrease in use of chest X-rays in acute bronchiolitis for hospitalized infants was significant but remains insufficient. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented concerning fetal magnetic resonance imaging.

Résumé Cette revue iconographique se propose dans un premier temps de faire le point sur les grands principes de l’approche segmentaire des cardiopathies congénitales, son origine, ses définitions et ses objectifs en particulier. Dans un second temps, au travers d’illustrations échographiques nous envisagerons son application pratique en dépistage prénatal. Enfin, par des exemples iconographiques en échographie et en IRM, nous discuterons son utilisation potentielle en évaluation diagnostique fœtale. This pictorial essay will initially present the origin, definitions, objectives and main principles of the segmental approach to congenital heart diseases. Then, through ultrasound scans iconography we will consider its practical applications to prenatal screening. Eventually, through both ultrasound and MRI cases, we will discuss its potential use in fetal diagnostic evaluation. [ABSTRACT FROM AUTHOR]

Résumé Les champs d’application de l’imagerie post-mortem sont en croissance exponentielle depuis 10 ans. Son potentiel pour identifier la cause du décès dans des situations traumatiques et balistiques est maintenant correctement documenté. Dans la pratique pédiatrique et périnatale, des grandes séries sont moins nombreuses, sauf pour l’IRM et en particulier l’analyse du système nerveux central où les preuves scientifiques sont maintenant robustes. Après un bref rappel historique et l’analyse de l’état de l’art, nous allons essayer de décrire les défis actuels et la façon dont nous voyons l’avenir de cette sur-spécialité de l’imagerie en coupe post-mortem, en particulier dans les situations spécifiques à la périnatalité. The fields of application of post-mortem imaging have been exponentially growing for 10 years. Its potential to identify the cause of death in trauma and ballistic cases is now properly documented. 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. After a short historical and state-of-the-art review, we will try to depict the way we see the future of this sub-specialty of post-mortem imaging, especially in specific perinatal situations. [ABSTRACT FROM AUTHOR]

Résumé Objectifs Évaluer les caractéristiques tissulaires du placenta par élastographie ShearWave transabdominale chez la babouine gestante. Matériels et méthode Pendant 9 mois (03/2013–12/2013) deux opérateurs (EQ, GG) ont réalisé des échographies du placenta pendant la grossesse des babouines gestantes de la station de primatologie partenaire du projet. Le repérage du placenta était réalisé au préalable en échographie 2D. Le mode élastographie était ensuite activé. Trois mesures ont été réalisées par opérateur pour chaque placenta. Les coefficients de corrélation intra-classe intra- et inter-observateur ont été calculés pour l’appréciation objective (élastographie) de la maturité placentaire. Résultats Pendant la période de l’étude, 21 babouines gestantes ont été incluses et ont été échographiées entre 1 et 3 fois chacune. Les mesures ont pu être effectuées par les deux opérateurs dans 100 % des cas. Les CCI intra- et inter-observateur des valeurs uniques sont respectivement 0,657 – IC 95 % (0,548–0,752) et 0,458 – IC 95 % (0,167–0,675). Les CCI intra- et inter-observateur des valeurs moyennes sont respectivement 0,852 – IC 95 % (0,784–0,901) et 0,628 – IC 95 % (0,286–0,806). Conclusion L’étude par élastographie ShearWave du placenta de babouines gestantes par voie transabdominale est possible. Les reproductibilités intra- et inter-opérateur de cette méthode sont bonnes en utilisant la moyenne de trois mesures. L’étude objective via l’élastographie ShearWave du degré de maturité placentaire ne semble pas pour l’instant être utilisable en pratique clinique. Des études de plus larges cohortes sont nécessaires. Objectives To evaluate tissue characteristics of the placenta by transabdominal ShearWave Elastography in pregnant baboon. Materials and method For 9 months (03/2013–12/2013) two operators (EQ, GG) performed ultrasound of the placenta during pregnancy pregnant baboons station partner primatology project. The identification of the placenta was performed previously in 2D ultrasound. The elastography method was then activated. Three measurements were carried out by operator for each placenta. The intraclass correlation coefficients within and between observers were calculated for the objective assessment (elastography) of placental maturity. Results During the study period, 21 pregnant baboons were included and ultrasounds were performed between 1 and 3 times each. The measurements have been carried out by two operators in 100% of cases. The intra- and inter-observer ICC for single values are respectively 0.657 – 95% CI (0.548 to 0.752) and 0.458 – 95% CI (0.167 to 0.675). The intra- and inter-observer ICC for average values are respectively 0.852 – 95% CI (0.784 to 0.901) and 0.628 – 95% CI (0.286 to 0.806). Conclusion The study by transabdominal ShearWave Elastography of placenta's pregnant baboons is possible. The intra- and inter-operator reproducibility of this method is good using the average of three measurements. The objective study via elastography ShearWave of the degree of placental maturity seems not yet be used in clinical practice. Studies of larger cohorts are needed. [ABSTRACT FROM AUTHOR]

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]

Summary: We report on 2 recent and misleading cases of infants hospitalized for Chlamydia trachomatis pneumonia: the first one, 29 days old, had a clinically relevant presentation but was born by caesarean section; the second one, 43 days old, presented with acute respiratory distress. Microbiological diagnosis was achieved by the specific detection of C. trachomatis by molecular biology from a nasopharyngeal sample. These 2 clinical cases illustrate the need to systematically look for C. trachomatis during bacterial-like pneumonia in infants under 3 months of age. [Copyright &y& Elsevier]

Summary: We report the case of a 10-month-old girl hospitalized with RSV acute bronchiolitis who developed necrotizing pneumonia with pyopneumothorax due to Panton-Valentine leukocidin-secreting Staphylococcus aureus. The outcome was fortunately favorable with antibiotics and pleural drainage. [Copyright &y& Elsevier]

Summary: We report a case of spontaneous hemothorax in a 9-year-old boy due to costal exostosis in the context of hereditary multiple exostosis disease. This is an unusual complication, whose pathophysiology remains unclear. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Congenital diarrhea is very rare, and postnatal diagnosis is often made once the condition has caused potentially lethal fluid loss and electrolyte disorders. Prenatal detection is important to improve the immediate neonatal prognosis. We aimed to describe the prenatal ultrasound and magnetic resonance (MRI) imaging findings in fetuses with congenital diarrhea. METHODS: The study reports the pre- and postnatal findings in four fetuses that presented with generalized bowel dilatation and polyhydramnios. We analyzed the fetal ultrasound and MRI examinations jointly, then compared our provisional diagnosis with the amniotic fluid biochemistry and subsequently with the neonatal stool characteristics. RESULTS: In each of the four cases an ultrasound examination between 22 and 30 weeks' gestation showed moderate generalized bowel dilatation and polyhydramnios suggesting intestinal obstruction. MRI examinations performed between 24 and 32 weeks' gestation confirmed that the dilatation was of gastrointestinal (GI) origin, with a signal indicating intraluminal water visible throughout the small bowel and colon. The expected hypersignal on T1-weighted sequences characteristic of physiological meconium was absent in the colon and rectum. This suggested that the meconium had been completely diluted and flushed out by the water content of the bowel. The constellation of MRI findings enabled a prenatal diagnosis of congenital diarrhea. The perinatal lab test findings revealed two cases of chloride diarrhea and two of sodium diarrhea. CONCLUSION: Congenital diarrhea may be misdiagnosed as intestinal obstruction on prenatal ultrasound but has characteristic findings on prenatal MRI enabling accurate diagnosis; this is important for optimal neonatal management. [ABSTRACT FROM AUTHOR]

The article presents a study which evaluates the role of magnetic resonance imaging (MRI) and prenatal ultrasound in the diagnosis of congenital diarrhea in fetuses. It says that after evaluating the MRI examinations and fetal ultrasound of four fetuses, the provisional diagnosis was compared with the amniotic fluid biochemistry, then with the neonatal stool characteristics. The results show that the gathering of MRI findings provides an accurate prenatal diagnosis of congenital diarrhea.

Abstract: Pleuropulmonary blastoma is a rare childhood intrathoracic neoplasm, associated with a poor outcome. We report the case of a 7 week-old boy with a pleuropulmonary blastoma classified as type I. Disease was discovered at a chest X-ray performed as a work-up for a benign acute viral bronchiolitis. The final diagnosis was brought by pathology: a bronchopulmonary malformation had not been ruled out by clinical, radiological and macroscopic findings. Pleuropulmonary blastoma is a rare childhood intrathoracic neoplasm, for which the poor outcome and tough diagnosis justify a surgical attitude when an intrathoracic bullous lesion is found in an infant. [Copyright &y& Elsevier]

An abstract of the article "Comparison of postmortem ultrasound and autopsy in 75 cases of perinatal death," by L. Tuchtan and colleagues is presented.

An abstract of the article "Outcome of fetuses associated with aberrant right subclavian artery (ARSA)" by H. Pico and others is presented.

An abstract of the article "Fetal MRI for diagnosis of bowel malposition" by G. Gorincour, A. Dabadie and M. Colombani is presented.

Objectif discuter et illustrer les signes de torsion d’annexe en IRM dans la population pédiatrique. Evaluer son intérêt. Matériels et méthodes étude rétrospective de 19 cas, d’âge moyen 13 ans, opérés après diagnostic de torsion d’annexe à l’IRM. Relecture des données cliniques, échographiques, des IRM, des comptes-rendus opératoires, histologiques et comparaison des deux groupes. Résultats le diagnostic de torsion à l’IRM a été confirmé en chirurgie dans 13 cas, dont 2 étaient des torsions tubaires isolées. 6 cas étaient des faux positifs de torsion en IRM dont 4 kystes hémorragiques de l’ovaire, une péritonite appendiculaire associée à un kyste ovarien, et un ovaire normal. L’IRM a redressé le diagnostic de torsion, non vu en échographie dans 8 cas dont 3 ovaires ont pu être sauvés par détorsion. Les signes IRM les plus fréquents en cas de torsion étaient les signes tubaires (oedème, tour de spire) et les signes d’ischémie. L’hémorragie intraovarienne en cas de torsion était corrélée en anatomopathologie à de l’infarcissement hémorragique. 38% des torsions étaient associées à une masse ovarienne. Conclusion l’IRM réalisée en urgence présente un intérêt diagnostic et pronostic dans les suspicions de torsion d’annexe en pratique pédiatrique. [ABSTRACT FROM AUTHOR]

Objectif: Étudier la capacité de l’IRM fœtale de détecter une malrotation intestinale. Matériel et Méthodes: Étude rétrospective sur 5 ans de notre base de données d’IRM fœtales non cérébrales. Résultats: Quatre cent une IRM fœtales furent analysées. Dans 34 cas (8,5%), le jéjunum proximal était considéré en position anormale, càd ailleurs que dans le flanc gauche sous l’estomac sur les séquences pondérées en T2. Dans 22 cas (65%), le jéjunum était situé dans l’hémi-thorax gauche dans le cadre d’une hernie diaphragmatique gauche (groupe A). Dans 7 cas (20%) il était en position extra-abdominale dans le cadre d’un laparoschisis (group B). Dans 5 cas (15%) il était anormalement situé dans l’abdomen, en position médiane ou dans le flanc droit, avec un estomac en position normale (group C). Tous les cas des groupes A et B ont été confirmées en période post-natale ou à l’autopsie. Dans 4 cas du groupe C (syndrome de Prune-Belly, poche colonique, atrésie digestive, cardiopathie) la malrotation n’était pas suspectée en échographie et était confirmée après la naissance. Dans le dernier cas, l’intestin était refoulé à droite par une duplication digestive géante, et le TOGD post-natal était normal. Conclusion: Grâce à son excellente résolution en contraste en pondération T2, l’IRM fœtale identifie avec précision une position anormale du jéjunum, en dehors de toute suspicion échographique, avec une excellente corrélation postnatale. [ABSTRACT FROM AUTHOR]