PEDIATRIC ULTRASOUND : requisites and applications.

Preface for the Second Edition
Acknowledgements
Contents
Part I: Basics/Theory/Methods
	1: US Physics
		1.1	 US Waves
		1.2	 Propagation and Modulation of US
			1.2.1	 Acoustic Impedance
			1.2.2	 Impedance Change
			1.2.3	 Reflection
			1.2.4	 Absorption
			1.2.5	 Deflection
			1.2.6	 Focus
			1.2.7	 Resolution
		1.3	 Emission, Transmission, Reception and Amplification
			1.3.1	 Emission
			1.3.2	 Transmission
			1.3.3	 Reception
			1.3.4	 Amplification
		1.4	 Signal Processing
			1.4.1	 Preprocessing
			1.4.2	 Post-Processing
			1.4.3	 Time Gain Compensation (TGC)
			1.4.4	 Sound Energy = Output
			1.4.5	 Gain
			1.4.6	 Frame Rate/Persistence
		1.5	 Components of US Device
			1.5.1	 Transducers
			1.5.2	 Other Parts of US Device
		1.6	 Modern US Techniques
			1.6.1	 High-Resolution US (HR-US)
			1.6.2	 Image Compounding
			1.6.3	 Harmonic Imaging (HI)
			1.6.4	 Extended Field of View US
			1.6.5	 US Texture Analysis
			1.6.6	 Potential Future for Other Modern Paediatric US Applications
	2: US Methods, Artefacts, Biologic Effects, Practice
		2.1	 A (Amplitude)-Mode
		2.2	 (T)M-Mode (Time-Motion-Mode)
		2.3	 B (Brightness)-Mode
		2.4	 Doppler Sonography
		2.5	 Artefacts
			2.5.1	 General Remarks
			2.5.2	 Common Artefacts
				2.5.2.1	 Side Loop Artefact
				2.5.2.2	 Bowing Artefact
				2.5.2.3	 Noise
				2.5.2.4	 Marginal Shadowing
				2.5.2.5	 Posterior Enhancement—Increased through Transmission
				2.5.2.6	 Reverberation Artefact
				2.5.2.7	 Increment or Slice Thickness/Beam Width Artefact
				2.5.2.8	 Mirror Image Artefact
				2.5.2.9	 Shadowing
				2.5.2.10	 Refraction Artefact
				2.5.2.11	 Anisotropy
		2.6	 Biologic Effects
			2.6.1	 General Remarks
			2.6.2	 Thermal Effects
				2.6.2.1	 Tissue Heating
				2.6.2.2	 Biological Effects, Tissue Heating
			2.6.3	 Mechanical Effects and Resonance
				2.6.3.1	 Cavitation
			2.6.4	 Potential Risks of Diagnostic US
				2.6.4.1	 Specific Risks
				2.6.4.2	 Guidelines and Recommendations
			2.6.5	 Various Methods and Indices that Allow Estimation of Biological Risks
				2.6.5.1	 Mechanical Index (MI)
				2.6.5.2	 Thermal Index (TI)
				2.6.5.3	 Display of Actual Indices
		2.7	 How to Perform Paediatric US
			2.7.1	 Requisites
				2.7.1.1	 Indications
				2.7.1.2	 Environmental Requisites
				2.7.1.3	 Specific Needs in Children
				2.7.1.4	 Specific Needs in Infants and Newborns
			2.7.2	 Positioning
			2.7.3	 Device Handling
				2.7.3.1	 General Remarks
				2.7.3.2	 Choice of Device and Transducer
				2.7.3.3	 How to Start Investigation
			2.7.4	 Transducer Selection
				2.7.4.1	 General Remarks
				2.7.4.2	 Neurosonography (See Chap. 8)
				2.7.4.3	 Small Part and Musculo-Skeletal US (See Respective Chapters)
				2.7.4.4	 Chest US (See Chap. 12)
				2.7.4.5	 Abdominal US (See Respective Chapters)
			2.7.5	 Course of Investigation and Measurements
				2.7.5.1	 General Remarks
				2.7.5.2	 Transducer Handling
				2.7.5.3	 Measurements
		2.8	 Documentation and Interpretation
			2.8.1	 Image Documentation
				2.8.1.1	 Media for Documentation
			2.8.2	 Report
				2.8.2.1	 How to Issue a Report
				2.8.2.2	 Diagnosis
				2.8.2.3	 Predefined Reports
				2.8.2.4	 Nomenclature
	3: (Color) Doppler US: Theory, Artefacts, Typical Applications in Childhood
		3.1	 Doppler Sonography
			3.1.1	 The Doppler Phenomenon
			3.1.2	 Different Techniques and Applications of Doppler Sonography
				3.1.2.1	 Continuous Wave Doppler (CW)
				3.1.2.2	 Pulsed Wave Doppler (PW)
				3.1.2.3	 Duplex-Doppler Sonography/Spectral Flow Analysis
				3.1.2.4	 Colour-Coded Doppler Sonography or Colour Doppler Sonography (CDS)
				3.1.2.5	 Amplitude-Coded Colour Doppler Sonography (aCDS)
				3.1.2.6	 Other Flow-Sensitive US Techniques
				3.1.2.7	 Important Parameters and Measurements (Fig. 3.7)
		3.2	 Artefacts in (Colour) Doppler Sonography
			3.2.1	 Aliasing
			3.2.2	 Spectral Broadening
			3.2.3	 Sample Volume Artefact
			3.2.4	 Filtering Artefacts
			3.2.5	 Scaling Problems
			3.2.6	 Gain-Induced Errors
			3.2.7	 Angle Correction
			3.2.8	 Motion Artefact
			3.2.9	 Twinkling Artefact
			3.2.10	 Others
		3.3	 How to Perform (Colour) Doppler Investigations
			3.3.1	 Limitations
			3.3.2	 Interpretation
		3.4	 Three- and Four-Dimensional US (3D-/4DUS)
			3.4.1	 Physics and Techniques
			3.4.2	 Typical Paediatric 3DUS Applications
				3.4.2.1	 Neonatal Neurosonography
				3.4.2.2	 3DUS of the Kidney
				3.4.2.3	 Urinary Bladder 3DUS
				3.4.2.4	 3DUS of the Paediatric (Female) Genitalia
				3.4.2.5	 Musculoskeletal 3DUS Applications
				3.4.2.6	 Small Part 3DUS Applications
				3.4.2.7	 Other Potential 3D-/4DUS Applications
			3.4.3	 Benefits of 3D-/4DUS
			3.4.4	 Restrictions of 3D-/4DUS
			3.4.5	 Potential Future Paediatric 3DUS Applications
	4: Contrast-Enhanced US, and Ultrasound Elastography in Childhood
		4.1	 Contrast-Enhanced Ultrasound (ce-US)
			4.1.1	 Basics
			4.1.2	 ce-US Applications-General Remarks
			4.1.3	 Contrast-Enhanced Voiding Urosonography (ce-VUS)
			4.1.4	 Other Intracavitary Use of ce-US: Sono-Genitography, Sonographic Pyelography and Many Potential Others
			4.1.5	 Intravenous ce-US (CEUS)
				4.1.5.1	 Potential Applications/Indications of CEUS in Neonates, Infants and Children-Summary
				4.1.5.2	 Dose Recommendations
			4.1.6	 Future ce-US Potential
		4.2	 Ultrasound-/Sonoelastography
			4.2.1	 Methods
				4.2.1.1	 Strain Elastography
				4.2.1.2	 Transient Elastography (TE)
				4.2.1.3	 Shear Wave Elastography (SWE)
			4.2.2	 Applications
				4.2.2.1	 Focal Lesions
				4.2.2.2	 Diffuse Changes
				4.2.2.3	 Possible Indications—Summary
	5: Paediatric Limited Field of View US/Point of Care US (POCUS) and Emergency US: When, How and for What
		5.1	 Requirements
		5.2	 Typical Applications
		5.3	 “FAST” US (Focused Assessment with Sonography for Trauma)
		5.4	 “(e)RUSH” (Rapid Ultrasound in Shock and Hypoxia)
		5.5	 Miscellaneous Other Typical POCUS/Sonoscope Applications
		5.6	 Restrictions, Pitfalls and Risks of Limited Field US
Part II: Diagnostic Flow Charts, Imaging Algorithms, and Graphs
	6: Imaging and Imaging Algorithms for Common Queries in Childhood
		6.1	 Introduction
		6.2	 How to Approach Common Urogenital Conditions in Childhood
			6.2.1	 Urinary Tract Infection (UTI)
			6.2.2	 Foetal and Neonatal Urinary Tract Dilatation
			6.2.3	 Urinary Tract Dilatation Later in Childhood and Follow-Up of Neonatally Diagnosed PUJO, UVJO, High-Grade VUR, Complicated Duplex Kidney
				6.2.3.1	 Pelvi-Ureteric Junction Obstruction (PUJO)
				6.2.3.2	 Uretero-Vesical Junction Obstruction (= UVJO)/“Megaureter” (MU)
				6.2.3.3	 Gross Vesico-Ureteric Reflux (VUR)
			6.2.4	 Urolithiasis (and Nephrocalcinosis)
			6.2.5	 Cystic Kidney Disease (CKD)
			6.2.6	 Torsion (Ovary, Testis)
			6.2.7	 Genital Malformations
			6.2.8	 Renal Hypertension
		6.3	 US in Other Common Paediatric Abdominal Conditions and Queries
			6.3.1	 Necrotizing Enterocolitis (NEC)
			6.3.2	 Vomiting Infants and Children
			6.3.3	 Acute Abdomen
			6.3.4	 Acute Appendicitis
			6.3.5	 Splenomegaly
			6.3.6	 Cholestasis
			6.3.7	 Pancreatitis
			6.3.8	 Biliary Atresia
			6.3.9	 Abdominal Trauma
			6.3.10	 Abdominal Tumours
		6.4	 Miscellaneous Other Common Queries and Assessment for Systemic Conditions
			6.4.1	 Pneumonia, Pleural Effusion
			6.4.2	 Enlarged Mediastinum
			6.4.3	 Painful Hip/Limping Child: Osteomyelitis
			6.4.4	 US in Systemic and Syndromatous Disease
	7: Measurements and Volume Calculations: Basic Considerations, Graphs and Illustrations for Standardisation
		7.1	 General Considerations
		7.2	 How to Measure
		7.3	 Artifacts and Other Aspects that May Impact Measurements
			7.3.1	 Miscellaneous Other Considerations
Part III: US Investigations of the Various Organs
	8: Neurosonography in Neonates, Infants and Children
		8.1	 Requisites
			8.1.1	 Equipment and Transducer Needs
			8.1.2	 Indications for Brain US
			8.1.3	 How to Investigate
		8.2	 Normal Findings
			8.2.1	 Transfontanellar Access
			8.2.2	 Alternate Access Findings
			8.2.3	 Colour Doppler Sonography (CDS)
			8.2.4	 Normal Variances in Preterm Babies
				8.2.4.1	 Periventricular Echogenicities
				8.2.4.2	 Ventricular Asymmetry
				8.2.4.3	 Ventriculomegaly
				8.2.4.4	 Cisterna Magna
				8.2.4.5	 Vascular Variations
		8.3	 Pathologic Findings
			8.3.1	 Neural Tube Defects
				8.3.1.1	 Anencephaly
				8.3.1.2	 Meningomyelocele and Encephalocele
				8.3.1.3	 Arnold Chiari Malformation
				8.3.1.4	 Dandy–Walker Malformations/Spectrum
				8.3.1.5	 Corpus Callosum Malformations
				8.3.1.6	 Lipoma
			8.3.2	 Migration and Gyration Alterations and Disturbances
				8.3.2.1	 Lissencephaly, Pachygyria, Macro- or Polygyria and Colpocephaly
				8.3.2.2	 Megalencephaly
				8.3.2.3	 Schizencephaly
				8.3.2.4	 Holoprosencephaly
					Alobar Holoprosencephaly
					Semilobar Holoprosencephaly
					Lobar Holoprosencephaly
					De Morsier Syndrome: Septo-Optic Dysplasia
					Agenesis of the Septum Pellucidum
				8.3.2.5	 Hydranencephaly
			8.3.3	 Phakomatoses
			8.3.4	 Cerebral Cysts
			8.3.5	 Ischemic Encephalopathy
				8.3.5.1	 Preterm Infant
				8.3.5.2	 Global or Diffuse Brain Oedema
				8.3.5.3	 Focal Hypoxemia and Ischemia
				8.3.5.4	 (C)DS in Brain Hypoxia
			8.3.6	 Other applications of (C)DS:
			8.3.7	 Inflammation
				8.3.7.1	 Prenatal Intrauterine Infections and Residuals
				8.3.7.2	 Postnatal Inflammation
			8.3.8	 Dilatation of CSF Spaces: Hydrocephalus
			8.3.9	 Cerebral Haemorrhage
				8.3.9.1	 Haemorrhage in Preterm Babies: IVH Grades I–III, PVH (Fig. 8.37)
				8.3.9.2	 Haemorrhage in Term Infants
				8.3.9.3	 Role of CDS in Neonatal Haemorrhage
				8.3.9.4	 Haemorrhage in Infants and Older Children
			8.3.10	 Tumours and Space-Occupying Lesions
				8.3.10.1	 Vascular Malformations
			8.3.11	 Cerebral Calcifications
				8.3.11.1	 Non-calcifying Vasculopathy (Lenticulostriate Vasculopathy)
		8.4	 Ultrasound of the Skull
			8.4.1	 Introduction
			8.4.2	 Haematoma
			8.4.3	 Space-Occupying Lesions and Tumours
			8.4.4	 Skull Fracture
		8.5	 Additional Imaging
			8.5.1	 Plain Film
			8.5.2	 CT
			8.5.3	 MRI
			8.5.4	 Catheter Angiography
			8.5.5	 Additional Supporting Procedures
		8.6	 Ultrasound of the Eye and the Orbit
			8.6.1	 Introduction
			8.6.2	 Normal Findings
			8.6.3	 Sonographically Depictable Pathology
	9: US of the Neonatal Spinal Canal and Cord
		9.1	 Introduction
		9.2	 Requisites
		9.3	 Transducers and Technique
		9.4	 Indications
		9.5	 Normal Findings
		9.6	 Pathologic Findings of the Spinal Cord
			9.6.1	 Dysraphism
			9.6.2	 Other Associated Pathology
			9.6.3	 Other “Occult” Dysraphisms
		9.7	 Trauma
		9.8	 Tumours and Miscellaneous Others
		9.9	 Other Spinal and Vertebral Pathology
		9.10	 Additional Imaging
		9.11	 Value of US
	10: Ultrasound of the Neck in Childhood
		10.1	 Indications, Requisites and Techniques
			10.1.1	 Transducers
			10.1.2	 Positioning and Handling
			10.1.3	 Typical Examinations
				10.1.3.1	 Cervical Lymph Nodes
				10.1.3.2	 Glands
				10.1.3.3	 Cervical Arteries
				10.1.3.4	 Cervical Veins
				10.1.3.5	 Intervention
		10.2	 Normal Findings
			10.2.1	 Lymph Nodes
			10.2.2	 Cervical Glands
				10.2.2.1	 Thyroid Gland
				10.2.2.2	 Parotid, Submandibular and Sublingual Glands
			10.2.3	 Other Cervical Soft Tissues
				10.2.3.1	 Muscles
				10.2.3.2	 Tonsils
				10.2.3.3	 Tongue
				10.2.3.4	 Para- and Retropharyngeal Spaces
				10.2.3.5	 Larynx
			10.2.4	 Cervical Vessels
		10.3	 Pathologic Findings
			10.3.1	 Lymph Nodes
			10.3.2	 Pathology of Cervical Soft Tissue
				10.3.2.1	 Malformations
					Cervical Cyst
					Dermoid Cyst
					Duplication Cysts
					Thymic Cyst
					Cervical Ectopic Thymus
				10.3.2.2	 Tumours
					Haemangioma
					Lymphatic Malformation
					Other Mesenchymal Tumours
					Neuroblastoma, (Ganglio-)Neuroma, Neurofibroma and Other Nerve (Sheath) Tumours
					Teratoma
					Other Malignant Tumours
					Role of US
				10.3.2.3	 Abscess Formations
				10.3.2.4	 Traumatic Changes
					Haematoma (Including Sternocleidomastoid Muscle “Haematoma”)
			10.3.3	 Thyroid Gland
				10.3.3.1	 Cystic Changes
				10.3.3.2	 Malformations
				10.3.3.3	 Inflammation
				10.3.3.4	 Other Conditions
					Hypothyroidism/Struma Diffusa/Colloides (Fig. 10.17)
					Nodular Goitre
					Amyloid Goitre
					Adenoma/Carcinoma
			10.3.4	 Salivary Glands (Parotid, Sublingual, Submandibular Gland)
				10.3.4.1	 Inflammation
				10.3.4.2	 Cysts
				10.3.4.3	 Calcifications/Sialolithiasis
				10.3.4.4	 Tumours
			10.3.5	 Cervical Vessels
				10.3.5.1	 Arteriosclerosis
				10.3.5.2	 Dissection
				10.3.5.3	 Stenosis
				10.3.5.4	 Other Vascular Anomalies
				10.3.5.5	 Thrombosis and Occlusion
	11: Basics of Paediatric Echocardiography
		11.1	 Introduction
		11.2	 Equipment Needs and Specific Considerations
			11.2.1	 Transducers
			11.2.2	 Standard US Techniques
			11.2.3	 Patient Position
			11.2.4	 Sedation
		11.3	 Standard Planes and Standardised Course of Examination
		11.4	 Normal 2D Echocardiogram Findings
			11.4.1	 Parasternal Views
				11.4.1.1	 Parasternal Long Axis View (Fig. 11.2)
				11.4.1.2	 Parasternal Short Axis Views (Figs. 11.3 and 11.4)
				11.4.1.3	 Apical Views
			11.4.2	 Subcostal Views
				11.4.2.1	 Sagittal Subcostal View
				11.4.2.2	 Subcostal Four-Chamber View (Fig. 11.6)
			11.4.3	 Suprasternal View (Fig. 11.7)
		11.5	 Other Techniques
			11.5.1	 M (Motion)-Mode Echocardiography
			11.5.2	 Doppler Sonography in Echocardiography
				11.5.2.1	 CDS with 2DUS
				11.5.2.2	 PW- and CW-Doppler
				11.5.2.3	 Calculation of Pressure (P) Gradients (P1 Minus P2)
			11.5.3	 Assessment of LV and RV Function
		11.6	 Special Echocardiographic Techniques
			11.6.1	 Transoesophageal Echocardiography (TEE)
			11.6.2	 Three-/Four-Dimensional (3D/4D) Echocardiography
			11.6.3	 Tissue Doppler Imaging (TDI)
			11.6.4	 Contrast-Enhanced US (ce-US/CEUS)
		11.7	 Normal Values
		11.8	 Pathologic Findings
			11.8.1	 Congenital Heart Defects with Left-to-Right Shunt
				11.8.1.1	 Atrial Septal Defect (ASD)
				11.8.1.2	 Atrioventricular Septal Defects (AVSD)
				11.8.1.3	 Ventricular Septal Defects (VSD)
				11.8.1.4	 Patent Ductus Arteriosus of Botalli (PDA)
				11.8.1.5	 Persistent Truncus Arteriosus (Truncus Arteriosus Communis)
			11.8.2	 Obstructions of Left Ventricular Outflow
				11.8.2.1	 Aortic Valve Stenosis (AS)
				11.8.2.2	 Subaortic Stenosis (Sub-AS)
				11.8.2.3	 Supravalvular Aortic Stenosis
				11.8.2.4	 Aortic Coarctation (CoA)
				11.8.2.5	 Interrupted Aortic Arch
			11.8.3	 Obstructions of the Right Ventricular Outflow
				11.8.3.1	 Isolated Pulmonary Valve Stenosis (PS)
				11.8.3.2	 Subvalvular Pulmonary Stenosis
				11.8.3.3	 Supravalvular Pulmonary Stenosis
				11.8.3.4	 Tetralogy of Fallot (TOF) and Pulmonary Atresia (PA) with VSD
			11.8.4	 Miscellaneous Congenital Heart Defects
				11.8.4.1	 Transposition of Great Arteries (TGA)
				11.8.4.2	 Total Anomalous Pulmonary Venous Return (TAPVR)
				11.8.4.3	 Univentricular Heart (UVH)
				11.8.4.4	 Double Outlet Right Ventricle (DORV)
				11.8.4.5	 Ebstein Anomaly
				11.8.4.6	 Cor Triatriatum
		11.9	 Acquired Paediatric Heart Diseases
			11.9.1	 Cardiomyopathies (CMP)
				11.9.1.1	 Hypertrophic CMP
				11.9.1.2	 Hypertrophic Obstructive CMP (HOCMP)
				11.9.1.3	 Dilated (Congestive) CMP
				11.9.1.4	 Restrictive CMP
			11.9.2	 Acute Myocarditis
			11.9.3	 Acute (Infective) Endocarditis
			11.9.4	 Pericarditis/Pericardial Effusion
			11.9.5	 Kawasaki Disease
			11.9.6	 Intracardiac Thrombi
			11.9.7	 Cardiac Tumours
		11.10	 Modern Approaches, Peri-interventional and Postoperatrive Applications
		11.11	 Complementing Investigations
			11.11.1	 Cardiac Catheterisation and Angiography
			11.11.2	 Cardiac MRI and CT
		11.12	 When to Do What
			11.12.1	 Imaging in Typical Clinical Scenarios
				11.12.1.1	 Typical Orientating Examination
				11.12.1.2	 Typical Clinical Queries
			11.12.2	 Trauma and Emergency
	12: Ultrasound of the Chest
		12.1	 Requisites
			12.1.1	 Transducers
			12.1.2	 Positioning
			12.1.3	 Indications
			12.1.4	 How to Perform Chest US
		12.2	 Normal Findings
			12.2.1	 Chest Wall
			12.2.2	 Breast
			12.2.3	 Pleural Space
			12.2.4	 Diaphragm
			12.2.5	 Lung
			12.2.6	 Mediastinum
				12.2.6.1	 Anterior Mediastinum/Thymus
				12.2.6.2	 Middle Mediastinum
				12.2.6.3	 Posterior Mediastinum
			12.2.7	 (Colour) Doppler Sonography
			12.2.8	 Contrast Enhanced US (ce-US)
		12.3	 Pathology of Chest Wall
			12.3.1	 Aplasia: Variations of Ribs
			12.3.2	 Congenital Malformations
			12.3.3	 Traumatic Changes
			12.3.4	 Chest Wall Tumours
				12.3.4.1	 Lymphangioma (Venolymphatic Vascular Malformation)
				12.3.4.2	 Lipoma
				12.3.4.3	 Fibroma/Neurofibroma
				12.3.4.4	 Other Tumours
			12.3.5	 Breast
			12.3.6	 Miscellaneous Other Applications
			12.3.7	 Role of US and Additional Imaging
		12.4	 Pathology of Pleural Space
			12.4.1	 Pneumothorax
			12.4.2	 Pleural Effusion
				12.4.2.1	 Empyema
			12.4.3	 Other Pleural Pathology
				12.4.3.1	 Role of Imaging
		12.5	 Pathology of Diaphragm
			12.5.1	 Diaphragmatic Hernia
			12.5.2	 Diaphragmatic Motion Disturbance
			12.5.3	 Role and Potential of Imaging
		12.6	 Lung Pathology
			12.6.1	 Pneumonia
			12.6.2	 Lung Abscess
			12.6.3	 Atelectasis
			12.6.4	 Respiratory Distress Syndrome (RDS)/Hyaline Membrane Syndrome, Wet lung, Alveolo-interstitial syndrome
			12.6.5	 Sequestration
			12.6.6	 Congenital Cystic Adenomatoid Malformation (CCAM)
			12.6.7	 Cysts
			12.6.8	 Infarction
			12.6.9	 Tumours and Space-Occupying Lesions
		12.7	 Other Miscellaneous and Rare Applications
			12.7.1	 US for Interstitial Lung Disease/Alveolar-Interstitial Syndrome
		12.8	 Additional Imaging
	13: Upper Abdominal US in Neonates, Infants and Children: (Excluding the Kidneys)
		13.1	 Introduction
		13.2	 Requisites and Investigation
			13.2.1	 Preparation
			13.2.2	 Positioning
			13.2.3	 Transducers
		13.3	 Liver
			13.3.1	 Course of Investigation
			13.3.2	 Standard Planes
			13.3.3	 Normal Findings
				13.3.3.1	 Structure
				13.3.3.2	 Ligaments
				13.3.3.3	 Hepatic Veins (HV)
				13.3.3.4	 Portal Vein (PV)
				13.3.3.5	 Hepatic Artery (HA)
				13.3.3.6	 Gall Bladder
				13.3.3.7	 Common Bile Duct
				13.3.3.8	 Intrahepatic Bile Ducts
				13.3.3.9	 Doppler Findings
				13.3.3.10	 Special Aspects of Newborns and Infants
			13.3.4	 Pathology of the Liver
				13.3.4.1	 Congenital Changes and Normal Variance
					Situs Inversus (Abdominalis)
					Butterfly or Midline Liver
					Hypoplasia/Atrophy of Left Liver Lobe and Other Variations
				13.3.4.2	 Inflammatory Conditions
					Hepatitis
					Liver Abscess
					Granulomatous Disease
					Role of US
				13.3.4.3	 Other Parenchymal Liver Disease
					Hepatopathy
					Fatty Liver/Steatosis
					Liver Congestion
					Liver Fibrosis
					Cirrhotic Liver
					Liver Involvement in Systemic Disease
					Role of US
				13.3.4.4	 Portal Hypertension and Vascular Problems
					Portal Hypertension
					Vascular Malformations
					Portal Vein and Hepatic Artery Stenosis
					Congenital Agenesis or Variants of Portal Vein/Congenital Portocaval Anastomosis/Abernethy Malformations
					Hepatic Vein Thrombosis/Occlusion/Stenosis
					Portosystemic Shunts
				13.3.4.5	 Liver Trauma
					Liver Haematoma
					Contusion
					Laceration
					Haemobilia
					Associated Diaphragmatic Injury
					Liver Infarction
					Role of US in Liver Trauma
					Additional Imaging
				13.3.4.6	 Space-Occupying Liver Lesions
					Simple Cysts
					Complicated Cysts
					Liver Calcifications
					Intrahepatic Gas
					Haemangioma
					Mesenchymal Hamartoma
					Focal Nodular Hyperplasia (FNH)
					Hepatic Adenoma
					Fatty Tumours
					Hepatoblastoma
					Hepatocellular Carcinoma
					Hepatic Sarcomas
					Metastasis
					Proliferative Disorders
					Role of US
					Additional Imaging
		13.4	 Biliary Tract and Gall Bladder
			13.4.1	 General Findings
			13.4.2	 Congenital Conditions and Normal Variants of Biliary Tract
				13.4.2.1	 Intrahepatic Gall Bladder
				13.4.2.2	 Hypo-/Aplasia of Gall Bladder/Biliary Atresia/Neonatal Hepatitis Syndrome
				13.4.2.3	 Choledochal Cyst
			13.4.3	 Biliary Tract Diseases
				13.4.3.1	 Aerobilia
				13.4.3.2	 Cholestatic Changes/Inspissated Bile/Gallstone
				13.4.3.3	 Sclerosing Cholangitis
				13.4.3.4	 Other Forms of Cholangitis and Cholecystitis
				13.4.3.5	 Tumour-like Conditions
					Polyps
					Tumours
				13.4.3.6	 Role of US
				13.4.3.7	 Additional Imaging
		13.5	 US in Liver Transplantation
			13.5.1	 Pretransplant US
				13.5.1.1	 Recipient Evaluation
				13.5.1.2	 Donor US (Split Liver Transplant, Related Living Donor—Deceased Donor)
			13.5.2	 Intraoperative US
			13.5.3	 Postoperative Assessment
			13.5.4	 Typical Complications
		13.6	 Spleen
			13.6.1	 Requisites
			13.6.2	 Positioning
			13.6.3	 Indications
			13.6.4	 Course of Investigation
			13.6.5	 Normal Anatomy
			13.6.6	 Normal Variants
				13.6.6.1	 Splenunculus (Accessory Spleen)
				13.6.6.2	 Splenic Lobulations and Clefts
			13.6.7	 Malformations
				13.6.7.1	 Asplenia
				13.6.7.2	 Polysplenia Syndrome
				13.6.7.3	 Wandering Spleen
			13.6.8	 Splenomegaly
			13.6.9	 Trauma
			13.6.10	 Splenic Infarction
			13.6.11	 Space-Occupying Lesions of the Spleen
				13.6.11.1	 Cysts
				13.6.11.2	 Inflammation and Abscess
				13.6.11.3	 Tumours and Space-Occupying Lesions
				13.6.11.4	 Role of US
		13.7	 Pancreas
			13.7.1	 Requisites
			13.7.2	 Indication
			13.7.3	 Course of Investigation
			13.7.4	 Normal Findings
			13.7.5	 Variations and Malformations
				13.7.5.1	 Annular Pancreas
				13.7.5.2	 Pancreas Divisum
			13.7.6	 Inflammation: Pancreatitis
				13.7.6.1	 Oedematous or Reactive Pancreatitis
				13.7.6.2	 Haemorrhagic or Necrotising Pancreatitis
				13.7.6.3	 Chronic Pancreatitis
			13.7.7	 Trauma
			13.7.8	 Space-Occupying Lesions
				13.7.8.1	 Cysts/Pseudocysts
				13.7.8.2	 Tumours
			13.7.9	 Role of US
			13.7.10	 Additional Imaging
		13.8	 Retroperitoneum and Retroperitoneal Structures: Abdominal Vessels and Abdominal Wall
			13.8.1	 Abdominal Vessels
				13.8.1.1	 Positioning
				13.8.1.2	 Transducers
				13.8.1.3	 How to Investigate
				13.8.1.4	 US Findings
				13.8.1.5	 Important Variants and Malformations
			13.8.2	 Vascular Pathology
				13.8.2.1	 Thrombosis/Occlusion
				13.8.2.2	 Pelvic Congestion Syndrome
				13.8.2.3	 Mid-Aortic Syndrome
				13.8.2.4	 Retroaortic Left Renal Vein: Nutcracker Syndrome
				13.8.2.5	 Compression by Superior Mesenteric Artery (Also Called Nutcracker or SMA Syndrome)
				13.8.2.6	 Arteriosclerotic Changes and Aneurysms
				13.8.2.7	 Embolic Thrombus to Abdominal Aorta
				13.8.2.8	 Role of US
				13.8.2.9	 Complementing Imaging
			13.8.3	 Retroperitoneal Soft Tissues
				13.8.3.1	 Lymph Nodes
				13.8.3.2	 Retroperitoneal Tumours
				13.8.3.3	 Abdominal Wall
	14: US of the Gastrointestinal (GI) Tract
		14.1	 Stomach
			14.1.1	 Requisites
			14.1.2	 How to Investigate
				14.1.2.1	 Access
				14.1.2.2	 Functional Assessment of Bowel and Stomach
			14.1.3	 Normal Findings
			14.1.4	 Normal Variants
			14.1.5	 Malformations
				14.1.5.1	 Microgastria
				14.1.5.2	 Pyloric Atresia
				14.1.5.3	 Congenital Hiatal Hernia
			14.1.6	 Pathologic Findings
				14.1.6.1	 Gastro-Oesophageal Reflux (GOER)
				14.1.6.2	 Hypertrophic Pyloric Stenosis (HPSt)
				14.1.6.3	 Other Stomach Conditions
			14.1.7	 Role of US
		14.2	 Bowel
			14.2.1	 Preparation and Requisites
			14.2.2	 Course of Investigation
			14.2.3	 Normal US Findings
			14.2.4	 Pathology
				14.2.4.1	 Congenital Anomalies
			14.2.5	 Acquired Obstructive Pathology
				14.2.5.1	 Meconium Ileus
				14.2.5.2	 Midgut Volvulus
				14.2.5.3	 Sigma Volvulus
				14.2.5.4	 Hernia
				14.2.5.5	 Intussusception
				14.2.5.6	 Masses and Tumours
			14.2.6	 Inflammatory Conditions
				14.2.6.1	 Necrotising Enterocolitis (NEC)
				14.2.6.2	 Gastroenteritis
				14.2.6.3	 Henoch–Schönlein Purpura
				14.2.6.4	 Appendicitis
				14.2.6.5	 Crohn’s Disease
				14.2.6.6	 Colitis
				14.2.6.7	 Other Inflammatory Bowel Conditions
				14.2.6.8	 Bowel Trauma
			14.2.7	 Mesentery
				14.2.7.1	 Mesenteric (Peritoneal) Masses
				14.2.7.2	 Abscesses
				14.2.7.3	 Twisted Appendices Epiploica
			14.2.8	 Mesenteric Lymph Nodes
			14.2.9	 Free Intraperitoneal Air
			14.2.10	 Free Intraperitoneal Fluid: Ascites
			14.2.11	 Mesenteric Vessels
	15: Ultrasound of the Urogenital Tract in Neonates, Infants, and Children
		15.1	 Requisites
			15.1.1	 Indications
			15.1.2	 Preparation
			15.1.3	 Transducers
			15.1.4	 Positioning
			15.1.5	 How to Investigate
				15.1.5.1	 Diuretic US
			15.1.6	 Contrast-Enhanced Voiding Urosonography (ce-VUS)
		15.2	 Normal Findings
			15.2.1	 Bladder
			15.2.2	 Kidney
				15.2.2.1	 Normal Variants
					Duplex Kidney
					Ectopic Kidneys
					Renal Agenesis
					Fusion Anomalies and Other Rare Findings
		15.3	 Pathology of the Kidney
			15.3.1	 Congenital Conditions
				15.3.1.1	 Dysplasia/Hypoplasia
				15.3.1.2	 Cystic Renal Disease
					Inherited/Congenital Cystic Disease
					Acquired Cystic Kidney Disease
				15.3.1.3	 Alteration of Urinary Drainage
					Urinary Tract Dilatation (UTD) or Pelvicalyceal Dilatation/Distention (PCD)
					Pelvi-ureteric Junction Obstruction (PUJO)
					Uretero-Vesical Junction Obstruction (UVJO)/Obstructive Megaureter (POM/MU)
					Posterior Urethral Valve (PUV)
					Vesico-Ureteric Reflux (VUR)
					Secondary Obstruction
			15.3.2	 Inflammatory Renal Parenchymal Conditions
				15.3.2.1	 Pyelitis
				15.3.2.2	 Acute Pyelonephritis (aPN)/Interstitial Nephritis
				15.3.2.3	 Necrosis and Abscess Formation
				15.3.2.4	 Scarring
				15.3.2.5	 Tuberculosis
				15.3.2.6	 Xanthogranulomatous Pyelonephritis
				15.3.2.7	 Glomerulonephritis/Nephrotic Syndrome
			15.3.3	 Vascular Conditions
				15.3.3.1	 Renal Artery Stenosis
				15.3.3.2	 Arteriovenous Fistula (AVF)
				15.3.3.3	 Infarction
				15.3.3.4	 Renal Vein Thrombosis
			15.3.4	 Nephrocalcinosis
			15.3.5	 Urolithiasis
			15.3.6	 Other Important Renal Parenchymal Disease
				15.3.6.1	 Haemolytic Uremic Syndrome (HUS)
				15.3.6.2	 Glomerulonephritis/Nephrotic Syndrome
				15.3.6.3	 Scars, Cirrhotic Kidney
			15.3.7	 Renal Failure (RF)
			15.3.8	 Renal/Urinary Tract Trauma
			15.3.9	 Renal Tumours
				15.3.9.1	 Benign Tumours
				15.3.9.2	 Pre- or Semi-Malignant Tumours
				15.3.9.3	 Malignant Tumours
		15.4	 Renal Biopsy and Interventions
			15.4.1	 Renal Biopsy
			15.4.2	 Drainage/Nephrostomy
			15.4.3	 Postoperative Imaging
				15.4.3.1	 After VUR Treatment
					Cystoscopic Treatment
					Antireflux Surgery
				15.4.3.2	 Findings after Pyeloplasty
				15.4.3.3	 After Various Interventions
		15.5	 Renal Transplant
			15.5.1	 Normal US Findings in Renal Transplant
			15.5.2	 Pathologic US Findings
		15.6	 Adrenal Glands and Pararenal Space
			15.6.1	 General Remarks
			15.6.2	 Typical Normal US Finding
			15.6.3	 Pathologic Findings
				15.6.3.1	 Adrenal Gland Haemorrhage
				15.6.3.2	 Inflammatory Condition
				15.6.3.3	 Tumours
					Adrenal Cysts
					Adrenal Adenoma
					Neuroblastoma
					Ganglioneuroma
					Phaeochromocytoma
					Adrenal Carcinoma
					Role of US
		15.7	 US of Urinary Bladder
			15.7.1	 Requisites
			15.7.2	 Pathologic Findings
				15.7.2.1	 Atypical Shape (Neurogenic Bladder, “Valve Bladder”)
				15.7.2.2	 Polyps
				15.7.2.3	 Bladder Tumours
				15.7.2.4	 Calcification in/of Bladder
				15.7.2.5	 Ureterocele
				15.7.2.6	 Persisting Urachus
				15.7.2.7	 Megaureter
				15.7.2.8	 Infravesical Obstruction and Urethra
				15.7.2.9	 Inflammation
				15.7.2.10	 Traumatic Changes
				15.7.2.11	 Vesico-Ureteric Reflux
			15.7.3	 Paravesical Changes
				15.7.3.1	 Abscess Formations
				15.7.3.2	 Tumours of Paravesical Region
				15.7.3.3	 Cystic Perivesical Structures
			15.7.4	 Role of US
		15.8	 US of Male Genitals
			15.8.1	 US Technique
			15.8.2	 Normal Findings
			15.8.3	 Common Pathologic Findings
				15.8.3.1	 Hydrocele
				15.8.3.2	 Undescended Testes
				15.8.3.3	 Varicocele
				15.8.3.4	 Cystic Dysplasia of Rete Testis and Seminal Vesicles
				15.8.3.5	 Testicular and Paratesticular/Epididymal Cysts/Spermatocele
				15.8.3.6	 Microlithiasis
			15.8.4	 Inflammation—Orchitis, Ependymitis
			15.8.5	 Scrotal Trauma
			15.8.6	 Torsion
				15.8.6.1	 Torsion of Appendages
				15.8.6.2	 Inguinal Hernia
			15.8.7	 Testicular Tumours
			15.8.8	 Role of US and Additional Imaging
		15.9	 Female Genitals
			15.9.1	 Indications
			15.9.2	 Requisites
			15.9.3	 Transducers
			15.9.4	 How to Perform Investigation
			15.9.5	 Normal Findings
				15.9.5.1	 Sonogenitography
			15.9.6	 Pathologic Findings
				15.9.6.1	 Congenital Malformations
					Vaginal Septum and Duplications
					Vaginal Atresia
					Vaginal Fistula
					Other Vaginal Malformations
					Vaginal Aplasia
					Uterine Malformations
					Ovarian Malformations
				15.9.6.2	 Inflammatory Conditions of Female Genitalia
				15.9.6.3	 Genital Tumours and Space Occupying Lesions
					Cysts
					Teratoma
					Other Genital Tumours
					Rhabdomyosarcoma
				15.9.6.4	 Traumatic Changes
				15.9.6.5	 Other Specific Important Entities of Female Genitalia in Childhood
					Ovarian Torsion
					Pregnancy
				15.9.6.6	 Role of US/Additional Investigations
	16: Neonatal and Paediatric Hip US
		16.1	 General Remarks
		16.2	 Examination Technique
			16.2.1	 Hip US According to Graf
			16.2.2	 Modified Graf Classification (Rosendahl)
			16.2.3	 Hip US According to Harcke
			16.2.4	 Femoral Head Coverage According to Morin (and Modified Morin-Terjesen)
			16.2.5	 3DUS for DDH Assessment
			16.2.6	 Assessment of Joint Effusion, Capsular Thickening, Perthes, Arthritis and Others
		16.3	 Normal Anatomy
			16.3.1	 US Criteria in Graf
			16.3.2	 Rosendahl Modification
			16.3.3	 Normal Findings During Harcke Investigation
			16.3.4	 Anatomic Landmarks and Normal Limits for Measuring Femoral Coverage
		16.4	 Hip US in Older Children
		16.5	 Pathologic Findings
			16.5.1	 Developmental Dysplasia of the Hip (DDH)
		16.6	 Other Conditions of Hip Joint
			16.6.1	 Arthritis and Inflammation of Hip Joint
				16.6.1.1	 Capsular Thickening
				16.6.1.2	 Joint Fluid/Effusion
			16.6.2	 Hip Osteoarthritis
			16.6.3	 (Femoral Head) Epiphysiolysis/Slipped (Capital Femoral) Epiphysis
			16.6.4	 Perthes Disease
	17: Musculoskeletal and Other Small Part US in Childhood
		17.1	 Investigation of Bones, Joints, Tendons
			17.1.1	 Requisites and Technique
			17.1.2	 Typical Normal Findings
			17.1.3	 Pathologic Findings
				17.1.3.1	 Fracture
				17.1.3.2	 Joint Effusion
				17.1.3.3	 Arthritis
				17.1.3.4	 Trauma
				17.1.3.5	 Cysts
				17.1.3.6	 Inflammation
				17.1.3.7	 Neoplasia
		17.2	 Other Small Part Applications
			17.2.1	 General Remarks
			17.2.2	 Foreign Bodies
			17.2.3	 US of “Lumps and Bumps”
			17.2.4	 US for Peripheral Vessels
			17.2.5	 US of the Paediatric Breast
			17.2.6	 US of Muscles
				17.2.6.1	 Traumatic Changes: Haematoma/Tear/Rupture
				17.2.6.2	 Inflammatory Myositis
				17.2.6.3	 Other Structural Changes: Fibro-Dystrophic or Atrophic Muscles
			17.2.7	 Miscellaneous Other Applications
	18: US of Peripheral Nerves in Childhood
		18.1	 General Remarks
		18.2	 US Technique
		18.3	 Nerve Anatomy/Structure
			18.3.1	 Normal US Findings
			18.3.2	 Most Important Clinical Questions in Children
		18.4	 Cranial Nerve US
			18.4.1	 Optic Nerve (Cranial Nerve II)
			18.4.2	 Facial Nerve (Cranial Nerve VII)
			18.4.3	 Vagal Nerve (Cranial Nerve X)
		18.5	 Cervical and Brachial Plexus
		18.6	 US of Peripheral Nerves of Extremities
			18.6.1	 Median Nerve
			18.6.2	 Ulnar Nerve
			18.6.3	 Radial Nerve
			18.6.4	 Femoral Nerve
			18.6.5	 Sciatic Nerve
		18.7	 Nerve Trauma
		18.8	 Peripheral Nerve Tumors
			18.8.1	 Neur(in-)oma
			18.8.2	 Benign Peripheral Nerve Tumors
			18.8.3	 Schwannoma
			18.8.4	 Neurofibroma
			18.8.5	 Nerve Sheath Ganglion
			18.8.6	 Malignant Peripheral Nerve Tumors
Part IV: Miscellaneous
	19: US-Guided Interventions and Invasive US Procedures and Respective Follow-Up
		19.1	 General Aspects
			19.1.1	 Requisites
			19.1.2	 Other Important Needs
			19.1.3	 Precautions and Preparations
		19.2	 US-Guided Filling of Structures for Diagnostic or Therapeutic Purpose
			19.2.1	 General Remarks for Assessing Physiologic Cavities (For Example, Bladder, Vagina, Intestines, Stomach, etc.)
			19.2.2	 Diagnostic Sonographic Enema
			19.2.3	 Therapeutic Sonographic Enema
			19.2.4	 US Genitography
			19.2.5	 Contrast-Enhanced Voiding Urosonography (ce-VUS)
			19.2.6	 Other Intracavitary Contrast Applications
			19.2.7	 Intravenous ce-US
		19.3	 Biopsies and Punctures
		19.4	 Drainage
		19.5	 Vascular Access
		19.6	 Lumbar Puncture
		19.7	 Foreign Body Removal
		19.8	 US Guidance for Local Anaesthesia
	20: Normal Values as Relevant for Paediatric US
		20.1	 Introduction
		20.2	 Normal Values in Paediatric Neurosonography
		20.3	 Normal Values in US of the Paediatric Neck, Including Also Lymph Nodes
		20.4	 Normal Values in Paediatric Echocardiology
		20.5	 5. Normal Values in the Paediatric Abdomen (Excluding Urogenital Tract)
		20.6	 Normal Values in the Paediatric Urogenital System
		20.7	 Normal Values for US of Paediatric Small Parts and Musculoskeletal System
		20.8	 Additional Reading