Ultrasound scan is one of the most important imaging techniques applied in the field of pediatric medicine. With the assistance of this process we can anatomically and functionally examine the internal organs during their physiological activity. Many defects, like internal injuries, acute abdominal pain – which in the background may involve serious diseases, like appendicitis, bowel obstruction, ileus, lymph node inflammation, all requiring acute intervention – could be well diagnosed by an abdominal ultrasound scan. This examination, executed by a specialist, allows a very rapid, effective and exact diagnosis without harmful effects to the developing physique of the child and consequently could be performed at any age. Further advantage is that ultrasound examination is painless.
What internal organs could be scanned by an ultrasound device?
Most of the soft tissues can be examined by ultrasound (footnote no.1.) It is perfect for scanning thyroid gland (footnote no.2.), breast, heart, liver (footnote no.2.), spleen (footnote no.2.), pancreas, kidney and urinary tracts (footnote no.2.), uterus and ovaries, testicles (footnote no.2.) and large blood vessels. With its assistance we can get a picture about the condition of the bowels and make the defects of the joints, muscles and ligaments visible. Under the age of one year even the brain of the child could be scanned through the fontanel. It is important to distinguish between infant and children ultrasound examinations.
Ultrasonic scan in childhood
- Infants without symptoms
The first important screening type examination (footnote no.2.) could be accomplished at the age of six weeks focusing on abdomen, hip and cranium (footnote no.2.). By the execution of these scans a number of defects could be diagnosed which have not caused any symptoms yet, such as congenital kidney disorders or immaturity of hip joint which may lead to a later hip dislocation. Immature hip joint could be corrected by the appropriate help of a specialist of orthopedy so early diagnosis is very important.
Ultrasonic screening of the cranium may be performed till the fontanel on the surface of the infant’s scull is still open. A device with high resolution for this examination is available at our clinic. Ultrasonic scan of the cranium through the fontanel is mostly applied for premature babies, since their most frequent complication at the perinatal period is stroke. This diagnostic process allows us to detect and follow-up the hemorrhages inside the cranium and also other defects (like ventricular dilatations).
In some cases of certain deviations and developmental anomalies it can be sufficient to follow-up the status by ultrasonic scan alone, but it may happen that further interventions are also needed.
- Infants and children with symptoms
In such cases ultrasonic scan of the cranium could only be applied when the fontanel of the infant is still open.
In case of hip complaints the screening must demonstrate the presence of the abnormal liquid in the hip joint and not the existence of the accidental hip dislocation.
Abdominal ultrasonic scan needs to be performed according to the nature of the complaint (gripes, urinary inflammation, complaints of the lower abdomen etc.).
Important instructions for the parents!
For abdominal ultrasonic scan older children must arrive with empty stomach and moderately full urinary bladder!
Empty stomach means that 4-5 hours before the examination no food could be taken by the child. Upon eating bile liquid is emptied from the gallbladder to the duodenum. It is difficult to scan the empty gallbladder and diagnose the presence of gallstones without a doubt. The other important problem is that when fed the child generally gulps much air, which makes the examination more difficult and less effective. Prior to the examination drinking clean water is allowed, even recommended, while consumption of milk, coffee and other flavored drinks is not advisable since they may reduce the efficiency of the scanning.
Moderately full urinary bladder could be achieved if the child pees two hours before the examination at the latest. It is not a problem if the child cannot retain its urine but in this case a quantity of 2-4 deciliter drink (non-carbonated water or tea) must be drunk 1-1.5 hours before the screening.
For a pelvis scan the patient needs to arrive with full urinary bladder, which is necessary for being able to check up the organs in the pelvis, for example the uterus, ovaries and the prostate gland properly. (Of course this is not relating to the scan of infants.)
In addition to the above mentioned examinations we provide the following screenings:
- ultrasonic scan of the neck to check up the salivary glands and lymph nodes
- screening of soft tissues (footnote no.2.) in order to evaluate the problematic area
- scan of the thyroid gland (footnote no.2.) to check up its structure and size
examination of the testicles (footnote no.2.) to observe their position, size and structure
When is it necessary to take our child to ultrasound examination?
It is definitely recommended to scan the child if a dysfunction of any of the aforementioned organs may be suspected. Also inevitable to perform the screening in case of any abdominal trauma to exclude the presence of internal organs’ damages. If indefinite abdominal complaints and gripes take place ultrasonic scan is also advised to be the first instrumental checkup. In addition, this kind of scanning constitutes an important role among the general screening examinations, which result in the preservation of our children’s health.
The future when CT or MR examinations could be replaced by ultrasonic screening
Appearance of the advanced ultrasonic scanning with the combination of applying contrast agents reflects the start of a new age. This examination is based on the non-toxic marking of one of the body fluids, like blood or urine, in order to follow their movement in the human organism. For example the extent of the urine’s back flow being typical of vesicoureteral reflux disease could be determined with higher accuracy by this method. Further advantage of this combined procedure is that in the course of setting up the diagnosis of certain diseases it may substitute CT and MR screenings. Lately 3-D scans have also become widespread especially in the field of obstetrics. By the implementation of this technique the realistic imagery of the embryo has been facilitated. Its recent development is the 4-D examination which also renders the observation of the embryonic motion possible.