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Nine criteria were identified as a useful means of detecting subtle abnormalfties of duodenal position.The normal duodenojejunalfiexure was found to be readily displaceable in neonates and could be pushed to the right of the spine in over two- In the control group, barium was administered orally or via a nasogastric tube in a right lateral position.Upon initial barium accumulation in the bulb and second duodenum, the patient was rolled supine. Posteroanterior camera spot radlographs were obtained rapidly (in Downloaded from www.ajronline.org by 54.202.233.140 on 05/12/18 from IP address 54.202.233.140.

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A normal chest radiograph is evidence against the presence of a vascular ring in symptomatic children. Both lateral and frontal radiographs are important in diagnosis.

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The results of cranial ultrasonography in 32 term infants who had hypoxic-ischemic encephalopathy (HIE) and in 26 control infants were reviewed. Small or nonvisualized ventricles were present in 94% of the patients with HIE and in 62% of the control subjects. In 20 of the 32 patients (63%) with HIE, ultrasound demonstrated parenchymal abnormalities; the most common finding was periventricular hyperechogenicity (12/32 patients). There was a single false positive result in the control group. Fifty per cent of patients with HIE who had abnormalities demonstrated on ultrasonograms died (within 15 days of birth), whereas none of the infants who had normal ultrasound findings died. Moreover, 80% of surviving patients who had abnormal ultrasound findings had residual neurological deficits versus only 11% of those with normal ultrasound findings. Our results indicate that ultrasound is effective in detecting parenchymal changes in patients with HIE, parenchymal echoes are a more reliable sign of HIE than ventricular size, and the finding of parenchymal lesions on ultrasound scans appears to be predictive of abnormal motor development.

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The objective of this study was to determine if color flow Doppler ultrasonography based on patterns of perfusion can aid in providing a specific diagnosis of ovarian masses associated with pelvic pain. Color flow Doppler images of 42 ovarian lesions in 42 adolescent girls (age range, 10 to 17 years) were analyzed prospectively. The color flow patterns were classified into three main categories: lesions with no vascularity; lesions with peripheral vascularity; and lesions with internal vascularity. The diagnoses included 22 hemorrhagic ovarian cysts, seven simple cysts, three cystadenomas, seven inflamed ovaries (five with microabscesses and two with dominant cystic abscesses), and three ovarian torsions. A peripheral pattern of flow was observed in 29 of 34 (85%) cystic lesions, including 18 hemorrhagic and six simple cysts, three cystadenomas and two abscesses. Peripheral flow was also identified in four enlarged ovaries, two with inflammatory 0 varian lesions can be difficult to differentiate from each other on the basis of conventional gray-scale ultrasonography. 1 -6 Color Doppler sonography is an important supplement to disease and two with torsion. Internal flow was noted in five patients with enlarged ovaries due to inflammatory disease. Intraovarian flow was absent in three patients with torsion and in five of 34 cystic lesions. Internal ovarian flow was identified in 90% of normal ovaries. Resistive indices, obtained in 33 abnormal ovaries, were higher in cystic lesions than in inflammatory lesions, although the values over~ lapped.Our findings showed that internal ovarian flow can be found in inflammatory processes and normal ovaries, but the absence of flow also is nonspecific and can be found in a variety of ovarian cystic lesions as well as in torsion. This overlap limits the usefulness of color Doppler ultrasonography for differentiating cystic ovarian lesions associated with pain in adolescent girls. KEY WORDS: Ovary; Cysts, ovarian; Cystadenoma; Abscess, ovarian.gray-scale technique because it allows evaluation of the pattern of blood flow within and around mass lesions. Recent studies in women have attempted to differentiate ovarian mass lesions on the basis of flow patterns on color Doppler ultrasonography?- 9 The lesions in these series differ significantly from those seen in childhood, which limits the usefulness of the data. The purpose of this study is to evaluate the usefulness of transabdominal color Doppler ultrasonography in adolescent girls for the diagnosis of painful ovarian masses based on the pattern of blood flow. PATIENTS AND METHODSThe gray~scale and color Doppler sonographic findings were analyzed prospectively in 42 girls with