NEONATAL KIDNEY --USG

1.The sonographic appearance of the kidneys in the neonate differs from that in older children in respect of  

a.more lobulation

b.much less renal sinus echogenicity

c..very echogenic cortex

d.CM differentiation extremely well

e.cortex thicker relative to the size of  pyramid

ans 1.e

 Neo­nates have much less renal sinus fat than in older children, and the central renal sinus echogenicity is uncommonly appreciated at this age.

The immature neonatal cortex is very echo­genic; in contrast to that in older children, it is hyperechoic relative to the liver—even more so in premature neonates. Because of this, sonography depicts corticomedullary differen­tiation extremely well .Postnatally, the echogenicity of the cortex gradually decreases, and it is usually hypoechoic relative to the liver by 4 months of age, but occasionally this process takes until 6 months.

 Normal renal pyramids are hypoechoic relative to the renal cortex, indepen­dent of patient age, and are more echogenic than normal urine in the collecting system, which is anechoic .

Compared with the cortex in older children, the immature cortex in the neonate is thinner relative to the size of the pyramids. Therefore, the pyramids appear relatively large .

To those unfamiliar with this normal neonatal ap­pearance, the relatively large, normal, hypoechoic pyramids may be misinterpreted as dilated calices or renal cystic disease and the relatively thinner hyperechoic cortex may be misinterpreted as cortical scarring or even ischemic changes.

Figure . Normal sonographic appearance of the renal pyramids in young infants. (a) Transverse sonogram of a neonatal kidney shows good corticomedullary differentiation. The hypoechoic pyramids normally appear

relatively large at this age. (b) Focused longitudinal sonogram of a kidney, obtained with a linear-array transducer,

shows striations of the parenchyma, which are better appreciated in the cortex than in the pyramids.

The echogenic structures (arrows) represent the collapsed fornices of the calices (which are not distended with urine) together with some renal sinus fat. 

REF --RADIOGRAPHICS

Mcq Brain tumour

All are true regarding bain tumour except
1.increased  emphasis on molecular and genetic data in updated  2016 WHOCNS tumour classification
2.Sonic hedgehog activated medulloblastoma generally have good prognosis
3.diffuse leptomeningeal glioneuronal tumour
and multinodular and vacuolating tumour of cerebrum added as new entities
4. 2 hydroxy glutarate spectroscopy in infiltrating glioma may be useful
5.1p/19q codeletion is seen in astrocytoma
And -- 5
1p/29q codeletion is seen in oligodendroglioma 

Hydroxyglutarate imaging role

Q.
Brain tumor may harbor mutations in the genes for the isocitrate dehydrogenases (IDH) 
and produce 2 - hydroxyglutarate which may be identified by imaging and help in characterization of tumor . Identify the tumor 
1.Infiltrating gloms 
2.infiltrating meningioma
3.infiltrating medulloblastoma
4.infiltrating teratoma
5.infiltrating ependymoma 

Ans ——- 1 .

For the WHO 2016 revision, IDH mutation has become definitional for infiltrating gliomas in adults, with 1p/19q codeletion further characterizing the type .Oligodendroglioma is an infiltrating glioma that carries both IDH mutation and 1p/19q codeletion (which does not occur in the absence of IDH mutation). Astrocytoma is an infiltrating glioma that is subdivided in the classification by the presence of IDH mutation and never contains 1p/19q codeletion.
REF —- Radiographics