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Biomedical subjects

M A Hall-Craggs

Publications and source records attributed to M A Hall-Craggs.

At least 19 recordsLinked to original sources
PubMed1992

The magnetic resonance appearances of the normal thymus in children.

The normal thymus in children is highly variable in size and shape. In some cases this has led to the misdiagnosis of mediastinal pathology and an unnecessary thoracotomy. Twenty-five children without suspicion of mediastinal pathology and five children with suspected mediastinal pathology were imaged using magnetic resonance imaging (MRI). MRI is recommended to distinguish between the normal and abnormal thymus in difficult cases where other imaging techniques are inconclusive.

Child↗
PubMed1991

Parotid haemangioma in infants: MR imaging at 1.5T.

Parotid gland neoplasms are uncommon and account for less than 2% of human tumours. Haemangiomas account for about 50% of parotid tumours in infants and children compared to only 2% in adults. As the clinical course of infantile haemangiomas may be self limiting and the initial treatment is expectant, early and accurate diagnosis is essential. We report 3 cases of paediatric parotid haemangioma and discuss the Magnetic Resonance (MR) characteristics of these tumours. In two cases the diagnosis was proven histologically and in one case Computed Tomography (CT) was also performed.

Female↗
PubMed1991

Wilms' tumour: pre- and post-chemotherapy CT appearances.

Pre-operative chemotherapy is used in our institution for patients with Wilms' Tumours (WT) when surgical 'operability' is in doubt. To date, the computed tomographic (CT) appearances of chemotherapy-induced changes in WT have not been described. We have analysed CT examinations of 18 children undergoing pre-operative chemotherapy to assess the effects of treatment on size, extent and qualitative changes of the tumour. Clinical response to chemotherapy was associated with a reduction in tumour size of at least 50%. Cystic changes were commonly seen within tumours following chemotherapy. CT did not reliably differentiate lymph nodes involved by tumour from those showing only reactive change. Pre-chemotherapy CT scans were incorrect in predicting liver invasion in 4/18 (22%) cases: of these, two were right-sided tumours, and two were bilateral.

Child↗
PubMed1991

CT and MR imaging in lateral sinus thrombosis.

Establishing a pre-operative diagnosis of lateral sinus thrombosis can be difficult, as the clinical features are non-specific and laboratory tests unhelpful. CT may demonstrate abnormal high density of the lumen of the sinus, which does not enhance after intravenous contrast medium. Enhancement of the dura surrounding the sinus may be prominent, causing the 'empty triangle' or 'delta sign' which may suggest the diagnosis. Magnetic resonance (MR) imaging may show both lack of flow and abnormal signal from the sinus, thus providing definitive evidence of thrombosis.

Adolescent↗
PubMed1990

Metastatic neuroblastoma: new abnormalities on bone scintigraphy may not indicate tumour recurrence.

Neuroblastoma is a potentially curable childhood malignancy with survival rates of 20% reported even in advanced disease. Technetium-labelled methylene diphosphonate (Tc99m-MDP) scanning is well established as a method of assessing bone disease. We report four patients, with advanced neuroblastoma in complete or partial remission, in whom new abnormalities on bone scintigraphy were due to benign lesions. Correct management depends on the precise diagnosis of such lesions.

Bone Diseases↗
PubMed1990

Primary malignant liver tumors in childhood: assessment of resectability with high-field MR and comparison with CT.

Nine children (mean age 20 months), with proven primary malignant hepatic tumors have been examined prospectively by high-field magnetic resonance (MR) imaging to assess tumor resectability. All patients had comparative ultrasonography (US), 8 patients had X-Ray computed tomography (CT), and surgical correlation was available in 8 patients. The hepatic and portal veins and the inferior vena cava were visualized in all patients on MR and in 4 of 8 patients on CT. MR accurately defined liver parenchymal involvement in all 8 patients who had surgical exploration. CT underestimated disease in 2 cases, and defined tumour margins less clearly than MR. MR identified abnormal extrahepatic tissue when present, but was unable to distinguish viable tumor from necrotic tumor or reactive nodes. High quality short TR/short TE spin echo images were obtained by combining cardiac triggering and signal averaging. Short TI inversion recovery images demonstrated tumor and lymphadenopathy most clearly. We conclude that MR is the imaging method of choice for the assessment of liver tumor resectability in children.

Child, Preschool↗
PubMed1990

Inferior right hepatic veins: MR assessment of prevalence and potential clinical significance in children.

The prevalence of Inferior Right Hepatic Veins (IRHVs) in 82 children who had magnetic resonance imaging (MRI) of the abdomen was assessed. IRHVs larger than or equal in size to the Superior Right Hepatic Vein were found in 23% (19/82). In two patients with radiological evidence of Superior Hepatic Venous occlusion and without radiological evidence of portal hypertension, venous drainage was accomplished via large IRHVs. The findings suggest that, in children, IRHVs may act as efficient collaterals and help protect the liver from the consequences of high IVC obstruction.

Child↗
PubMed1990

Neonatal hemangiomatosis presenting as infantile spasms.

The previously unreported association of neonatal hemangiomatosis and infantile spasms is described in a 4-month-old female. The high mortality and morbidity of this neurocutaneous syndrome necessitates prompt recognition and investigation, to enable identification of associated internal lesions.

Brain Neoplasms↗
PubMed1990

Ataxia, developmental delay and an extensive neuronal migration abnormality in 2 siblings.

Two siblings with developmental delay and a non-progressive cerebellar ataxia are described. The electroencephalograms in both children showed a rather unusual pattern of high amplitude 10-12/s rhythms maximal anteriorly, while extensive neuronal migration abnormalities were apparent on Magnetic Resonance scans. There were no dysmorphic features, metabolic abnormalities, chromosomal defects or evidence of prenatal environmental toxins. It is considered that these siblings have an autosomal recessive neuronal migration defect which has not previously been reported.

Brain↗
PubMed1990

Myelination patterns on magnetic resonance of children with developmental delay.

Magnetic resonance (MR) imaging was performed in 30 children with unexplained developmental delay who had associated neurological abnormalities such as seizures, spasticity, hypotonia, ataxia or poor vision. No child had a history of regression, preterm birth or neonatal cerebral injury. CT scans were performed before MR in all cases and were either normal or showed only mild atrophy. At least two MR sequences were obtained for all patients. Nine children had delayed or absent myelination on MR, one had patchy white-matter abnormalities, and in one patient myelination was topographically normal, but of inappropriately low signal intensity. MR was abnormal in six of seven children who had abnormal brainstem auditory evoked potentials (BAEP), and was normal in nine of 11 patients who had a normal BAEP. MR may have a useful rôle in demonstrating abnormal white-matter maturation in children with unexplained neurodevelopmental delay, particularly when abnormalities are found on BAEP studies.

Brain↗
PubMed1990

Sedation in children scanned with high-field magnetic resonance; the experience at the Hospital for Sick Children, Great Ormond Street.

Patient movement is the most common cause of image degradation when performing magnetic resonance scans in children. This is a particular problem scanning at high field, as noise levels of up to 90 dB may be reached. Movement can be reduced by adequate sedation. We present the results of two sedation protocols when scanning with a 1.5T Magnetom scanner. Optimal scan quality can be achieved in up to 85% of scans using Pethco combined with triclofos in children aged 1 month-2 years, and trimeprazine combined with papaveretum in children over 2 years. When heavy sedation is used, patient selection must be cautious, and there is a minimum acceptable level of monitoring including close physical observation, electrocardiographic and apnoea monitoring.

Child↗
PubMed1990

Impact of vessel distortion on transcranial Doppler velocity measurements: correlation with magnetic resonance imaging.

Because transcranial Doppler ultrasound is a blind procedure, it is not possible to routinely correct for insonation angle errors, which are presumed to be small. In anatomically normal brains this is a valid assumption; however, in some patients with distorted vascular anatomy (as in hydrocephalus) a small insonation angle cannot be assumed, and measurements of flow velocity may be misleadingly low. The orientation of the middle cerebral arteries was studied on magnetic resonance images of 17 control patients and three patients with hydrocephalus, and estimates of insonation angle errors in velocity measurements were made. When asymmetrical vessel distortion is present, relative flow to each hemisphere may not be accurately reflected in the measured velocities. Under these circumstances, the resistivity index may be a more reliable hemodynamic parameter.

Blood Flow Velocity↗
PubMed1989

4-S neuroblastoma on high field MR.

The appearance of 4-S neuroblastoma imaged with high field strength MR are reported. The correlative pathological findings are described.

Adrenal Gland Neoplasms↗
PubMed1989

Early onset leukodystrophy with distinct facial features in 2 siblings.

Two siblings with marked subcutaneous tissue atrophy, delayed dentition and a degenerative neurological condition characterised by nystagmus, ataxia and spasticity are described. Myelin was almost totally absent on the magnetic resonance image brain scan performed on one sibling. There was no history of photosensitivity and ultraviolet irradiation of cultured fibroblasts did not inhibit RNA synthesis. We believe that these children have a previously undescribed syndrome, which, although clinically similar to Cockayne syndrome, is readily distinguished from it.

Ataxia↗
PubMed1989

Central nervous system malformations in Mohr's syndrome.

A boy with severe developmental delay, bilateral, symmetrical hallucal duplication, and accessory alveolar frenula was found to have radiological evidence of a large arachnoid cyst compressing the cerebellum and brain stem. We review neurological abnormalities in Mohr's syndrome.

Abnormalities, Multiple↗
PubMed1989

Moebius' syndrome with unilateral cerebellar hypoplasia.

A case is reported of a child with Moebius' syndrome who also has unilateral cerebellar hypoplasia. We suggest that this combination of abnormalities could result from a vascular disruption occurring in the basilar artery early in its development.

Abnormalities, Multiple↗