There are hardly any limits to the possibilities of ultrasound diagnosis in childhood.
Skull sonography, abdominal ultrasound and the various soft tissue examinations can answer many diagnostic questions. Thanks to the latest technical developments, diagnostic areas that used to be thought of as inaccessible (such as transcranial Doppler sonography) are opening up.
Skull sonography is the “classic” pediatric ultrasound method. As long as the fontanelle is open, there is a possibility of an almost complete image of the brain. The non-visible areas can be observed through the thin temporal bone. The large cerebral arteries can also be extensively examined for anatomic and functional changes by Doppler sonography. With this method, we can detect slowly progressive changes in a timely manner and thus prevent permanent damage, e.g. hydrocephalus – big head, vascular changes, etc.). After severe illnesses, e.g. after inflammation or lack of oxygen after birth, it is possible to plan further therapy modalities optimally by close monitoring. In rarer cases, cranial ultrasonography can provide valuable information for diagnosis and therapy even in systemic diseases.
Transcranial Doppler Sonography
A very specific examination method is transcranial Doppler sonography (TCD). Here the main arteries running at the brain base can be depicted. The examination is carried out age- through the temporal bone, independent of age. The thin bone (“echo window”) almost always allows a detailed examination. Using this method, we can get a good overview even without anesthesia and, if necessary, continue with targeted examinations (CT, MRI).
The abdominal ultrasound is a very complex examination – it contains several well-circumscribed examination modalities. A very bloated gastrointestinal system can cause significant limitations in the examination, so it is recommended to not take a heavy, flatulent meal the day before. A full bladder is the prerequisite for optimal examination of the urinary tract. Of course, these criteria are sometimes difficult to fulfill in the case of a toddler or infant.
The most frequent issue leading to a stomach sonography is acute, or chronic recurrent abdominal pain. If there is a pathological cause, we can find it in a detailed examination with great certainty.
Soft Tissue Sonography
Soft tissue sonography can be used with the superficial organs, e.g. in the thyroid, lymph nodes, testes, bone surface, joints, etc. A specific, very sensitive Doppler method allows the assessment of tissue perfusion and thereby the early detection of e.g. inflammatory processes. The search for undescended testicles can sometimes take a long time.