Neonatal Radiology

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Neonatal Radiology
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Different X-ray views
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AP chest best view for heart and lung
pathology, ETT placement, pneumothorax, line
placement
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Normal AP chest
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Lateral chest useful for pneumothorax, UAC
placement
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Lateral decubitus best view for small
pneumothorax,
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AP of abdomen best view for abdominal
disorders, line placement
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Left lateral decubitus infant is placed right
side up best view to look for perforation
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X-ray pearls
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Hyaline membrane disease

• Fine, reticulogranular pattern with associated
  air bronchograms, low lung volume

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Meconium Aspiration Syndrome

• Bilateral patchy coarse infiltrates with
  hyperinflation

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Severe MAS
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Pneumonia

• Alveolar or interstitial disease which is usually
  asymmetric and localized

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Transient Tachypnea of the Newborn

• Hyperinflation with symetrical perihilar
  infiltrates, sometimes fluid in the fissures

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Pneumomediastinum

• Rim of air which may displace the thymus on the
  AP view
• Air collection substerally

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Pneumothorax

• Lung is displaced away from the chest, lack of
  lung markings

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Tension pneumothorax

• Pneumothorax with associated shift

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Atelectasis

• Volume loss or collapse, shift towards the
  affected side

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Intestinal obstruction

• Air fluid levels, lack of gas in the colon

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Meconium Ileus
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pneumoperitoneum

• Free air in the abdomen

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pneumatosis

• Intraluminal gas which looks like a string of
  bubbles

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Intraportal air

• Air in the portal veins

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Cardiomegaly
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Increased Pulmonary Vascularity
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Diaphragmatic Hernia
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Lines and tubes
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x-ray for placement

• ET tube placement, should be halfway between the
  thoracic inlet and the carina
• UVC, should be placed with the tip above the
  diaphram but below the heart.
• UAV, high placement is T6 - T8 low placement
  between L3 L4

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