Results: Results of DR revealed that 22 kidneys were obstructed, while19 units presented obstructive pattern on CDSG (12 without jets andseven with diminished jet frequency). In hydronephrotic kidneys con-sidered nonobstructed on DR, the ureteral jets on CDSG were observedin all cases, except in one. The CDSG ureteral jet study presents asensitivity of 86% IC 95% � 78.6% to 98.2%), a specificity of 95.8%IC 95% � 87% to 99%). The positive LR is 20; (IC 95% � 4.4 to50.2), the coefficient of agreement (�) is 0.84 (IC 95% � 0.74 to 0.99)and the diagnostic odds-ratio is 109.25 (IC 95% � 19.3 to 213).Conclusions: Asymmetric ureteral jet was a good indicator of obstruc-tion in children with unilateral hydronephrosis, correlating adequatelywith the DR and can be used either as a primary diagnostic procedureor in follow-up of hydronephrosis in pediatric population.

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The ultrasound features of musculoskeletal infection in children:A pictorial reviewTeo H, KK Hospital, Singapore

This pictorial essay will illustrate the imaging features of the widespectrum of musculoskeletal (cellulitis, abscess, pyomyositis, septicarthritis, osteomyelitis) infection in children with an emphasis onultrasound. It will also highlight the role that ultrasound can play in themanagement of these patients as well as recommend an imagingalgorithm in the management of these patients incorporating all imag-ing modalities.

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Primary pyomyositis in children: Sonographic appearanceKessler A, Ovadia D, Ben Sira L, Weintrob S, Graif M, Tel Aviv-Souraski Medical Center, Tel Aviv, Israel

Objectives: Primary pyomyositis is rare, subacute, deep bacterial in-fection of skeletal muscle not associated with contiguous infection ofthe skin, bone or soft tissues. Most common in first to second decadesof life, male predominance.Methods: Fourteen children (mean age 8.2 y) diagnosed and success-fully treated for primary pyomyositis are presented with emphasis onimaging, especially sonographic evaluation. Sites of infection wereiliopsoas, obturator, hip adductors, levator scapula, thoracolumbarparaspinal and gastrocnemius muscles. The imaging modalities in-volved were plain radiographs, isotope scans, ultrasonography, CT andMRI. The follow up studies were mainly ultrasound.Results: Sonographic findings included thickening and hypoechoge-nicity along affected muscles, fluid collections between muscle fibersc/w abscess formation and required drainage. Iliopsoas and hip muscleswhen involved were associated with hip effusion. The infection re-solved completely in 11 patients; one patient developed acute compart-ment syndrome of the calf and later osteonecrosis of the tibial shaft.Conclusions: US was helpful for detection of pyomyositis, for percu-taneous drainage, for ruling out bony involvement and for routinemonitoring until full recovery.

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Sonographic pattern of hydrocephalus among infants in theSahelian Belt of NigeriaSaidu SA, Maaji SM, Nzeh DA, Shehu BB, Ismail NJ, Department ofRadiology, Usmanu Danfodiyo University Teaching Hospital,Nigeria; Department of Radiology, University of Ilorin, Nigeria;Department of Surgery, Usmanu Danfodiyo University TeachingHospital, Nigeria

Objectives: Evaluation of the ultrasound appearances in children pre-senting with clinical signs and symptoms of raised intracranial pressuresuggestive of hydrocephalus.Methods: A retrospective review of transfontanelle US scans done in64 children (39 boys and 25 girls) attending the Department of Radi-ology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Ni-geria, over a period of 2 years from October 2003 through October2005 was carried out. The patients had a mean age of 5.0 � 4.6 months(range, 1 to 48 months) at the time of their US examination. Some ofthe clinical indications for US scan included: congenital hydrocephalus,encephalocele, meningomyelocele and meningitis.Results: Fifty-two patients (81.3%) had hydrocephalus of congenitalorigin. Eleven cases (17.2%) had post-meningitic hydrocephalus whileonly one case (1.6%) was post-haemorrhagic. Twenty-five patients(48.0%) of the congenital cases were due to cerebral aqueduct stenosis.Eleven (21.2%) of the congenital cases were from obstruction at theexit foramina of Luschka and Magendie resulting in the communicatingtype of hydrocephalus.Conclusions: Hydrocephalus is a known cause of neurological mor-bidity among infants in developing countries. Majority of the cases arecongenital in origin and most commonly due to cerebral aqueductstenosis. Transfontanelle US is cheap, affordable, nonhazardous andshould serve as the first-line investigation of infants with suspectedhydrocephalus.

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The value of color Doppler ultrasound in evaluating theprognosis of neonatal hypoxic ischemic encephalopathyHe J, Hunan Provincial Children’s Hospital, China

Objectives: To probe into the value of ultrasonic examination by colorDoppler method in evaluating the prognosis of neonatal hypoxic isch-emic encephalopathy (HIE).Methods: We pursued observing the cerebral blood stream parameter,bi-dimension sound serial image alteration of lateral ventricle andcerebral parenchyma on 22 cases of infants clinically diagnosed HIEand 10 cases of normal newborns by color Doppler ultrasound andbi-dimension ultrasound examination.Results: There is obvious change in the cerebral arterial blood streamand hemodynamics of the asphyxia newborns on the first day afterborn.. Resistant index (RI) varied in different style.Conclusions: The step-up of the cerebral artery RI is the manifestationof cerebral ischemia. The reduction of RI is the marker of brainsuper-filling. The early alteration of cerebral white matter softening isthat the echo of cerebral parenchyma persists reinforcing and maldis-tribution as well as the alteration of massive appearance.

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Diagnostic ultrasonography of the spinal canal in newbornsCheon J-E, Eo H, Jung AY, Youn BJ, Kim I-O, Kim WS, Yeon KM,Seoul National University Children’s Hospital, Korea

US has proved useful in the diagnosis of a variety of pediatric spinedisorders. US often offers advantages over CT and MR imaging byavoiding sedation and eliminating exposure to radiation. This exhibitaims to illustrate the value of high-resolution US for characterizingintraspinal abnormalities in newborns. We present US anatomy of thespine and a variety of spine disorders in newborns; myelomeningocele,spinal lipoma, dorsal dermal sinus, tight filum terminale syndrome,diastematomyelia, terminal myelocystocele, caudal regression syn-drome and hydromyelia or syringomyelia. Acquired intraspinal dis-eases such as infection and transient alterations after lumbar puncturecan also be detected with US.

Abstracts P273