Although diagnosing head trauma can be difficult in the absence of a history, it is important to consider inflicted head trauma in infants and young children presenting with nonspecific clinical signs.

OBJECTIVE-Neuroendocrine cell hyperplasia of infancy is a form of childhood interstitial lung disease originally reported as persistent tachypnea of infancy. Reports of small series of cases and anecdotal experience have suggested that this disorder may have a consistent CT pattern. The purpose of this study was to review the CT findings in children with neuroendocrine cell hyperplasia of infancy to determine the findings at high-resolution CT, the diagnostic accuracy of CT compared with biopsy, and interrater reliability. MATERIALS AND METHODS-Images from 23CT examinations of children with biopsyproven neuroendocrine cell hyperplasia of infancy and six CT examinations of children with other childhood interstitial lung diseases were reviewed by two pediatric radiologists with special expertise in thoracic imaging. Identifying digital data were removed, and images were reviewed without clinical data. A CT assessment form was completed for each patient.RESULTS-Ground-glass opacification was the most common finding in patients with neuroendocrine cell hyperplasia of infancy. The right middle lobe and lingula were most commonly involved. Air trapping with a mosaic pattern was the second most common finding. Interrater reliability was very good with a kappa value of 0.93. The sensitivity and specificity of CT in the diagnosis of neuroendocrine cell hyperplasia of infancy were at least 78% and 100%.CONCLUSION-Neuroendocrine cell hyperplasia of infancy can have a characteristic appearance on high-resolution CT scans, the imaging findings being useful in differentiating neuroendocrine cell hyperplasia of infancy from other types of childhood interstitial lung disease.© American Roentgen Ray Society Address correspondence to: A. S. Brody (alan.brody@cchmc.org). The appearance aids radiologists in suggesting a specific diagnosis but does not exclude this diagnosis; in 17-22% of cases, the readers in this study did not suggest the diagnosis of neuroendocrine cell hyperplasia of infancy when it was present. Immunostaining for bombesin, a procedure not routinely performed, is necessary for pathologic confirmation of the diagnosis, therefore, CT findings suggesting the diagnosis can affect the pathologic evaluation. Improved understanding of the imaging appearance of neuroendocrine cell hyperplasia of infancy on thin-section CT scans should help determine the role of imaging in the evaluation of these children. NIH Public AccessWe reviewed the CT findings of 23 patients with histologically confirmed neuroendocrine cell hyperplasia of infancy and of six patients with other pathologically confirmed forms of childhood ILD with the intent of determining the high-resolution CT (HRCT) findings of neuroendocrine cell hyperplasia of infancy, the accuracy of CT findings of neuroendocrine cell hyperplasia of infancy compared with biopsy findings; and interrater reliability with use of a standardized CT assessment form in the diagnosis of neuroendocrine cell hyperplasia of infancy. Materials and MethodsImages from 29 CT examinat...

IPFTs in NEHI subjects are feasible, demonstrate significant obstruction and air trapping, and correlate with future RA O2 sat and FEV1 . IPFTs may provide valuable clinical information when caring for NEHI patients. Pediatr Pulmonol. 2013; 48:1008-1015. © 2012 Wiley Periodicals, Inc.

Although not specific for child abuse, discovery of these intracranial CT abnormalities in young patients should prompt careful evaluation of family and injury circumstances for indicators of non-accidental trauma.

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