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Pediatric Brain and Spine

An Atlas of MRI and Spectroscopy

Ketonen · Hiwatashi · Sidhu · Westesson

III

L. M. Ketonen

A. Hiwatashi

R. Sidhu

P.-L. Westesson

Pediatric Brain

An Atlas of MRI

and Spectroscopy

With 1427 Figures

123

and Spine

ISBN 3-540-21340-6

Springer Berlin Heidelberg New York

Library of Congress Control Number: 2004111251

This work is subject to copyright. All rights are reserved,

whether the whole or part of the material is concerned, specif-

ically the rights of translation, reprinting, reuse of illustrations,

recitation, broadcasting, reproduction on microﬁlm or in any

other way, and storage in data banks. Duplication of this pub-

lication or parts thereof is permitted only under the provisions

of the German Copyright Law of September 9, 1965, in its cur-

rent version, and permission for use must always be obtained

from Springer. Violations are liable for prosecution under the

German Copyright Law.

Springer is a part of Springer Science + Business Media

springeronline.com

Printed in Germany

The use of general descriptive names, registered names, trade-

marks, etc. in this publication does not imply, even in the

absence of a speciﬁc statement, that such names are exempt

from the relevant protective laws and regulations and therefore

free for general use.

Product liability: The publishers cannot guarantee the accu-

racy of any information about dosage and application con-

tained in this book. In every individual case the user must

check such information by consulting the relevant literature.

Editor: Dr. Ute Heilmann, Heidelberg

Desk editor: Dörthe Mennecke-Bühler, Heidelberg

Production editor: Bernd Wieland, Heidelberg

Cover design: F. Steinen, e Studio Calamar, Spain

Reproduction and Typesetting: AM-productions, Wiesloch

Printing and bookbinding: Stürtz AG, Würzburg

21/3150 – 5 43210

Printed on acid-free paper

Preface

This is an atlas on contemporary MR imaging of the

pediatric central nervous system. We have concen-

trated on brain imaging, but have an extensive chap-

ter on the spine and a smaller chapter on the head

and neck.

The book starts with a chapter on the normal

myelinization and normal variance. We are including

chapters on malformations, inherited conditions, in-

fection, tumors, trauma, vascular abnormalities, and

spine abnormalities. The last chapter of the book is a

miscellaneous chapter that includes all those cases

that did not ﬁt well in other categories. The chapter

on trauma and brain damage includes an extensive

section on CNS manifestations of nonaccidental pe-

diatric trauma. There is an also an exciting chapter

on fetal MR imaging describing some of the more

common abnormalities seen in prenatal imaging. We

have intentionally avoided discussing some of the

ethical aspects of fetal imaging.

Cases in this book range from those commonly

seen in clinical practice to many exceedingly rare

conditions. The book format has allowed us to illus-

trate these unusual cases generously, and in many we

have been able to include MR proton spectroscopy

and diffusion images. We included a few CT images

when they were an essential part of the diagnosis,

classic presentations or showed the abnormalities the

best. It was not our intention to publish a textbook,

but rather an atlas-type book on pediatric neuro-MR

imaging. We have concentrated on multiple high-

quality images, which will allow the clinician to iden-

tify an unknown case relatively quickly by simply

comparing the images of his patient with the images

in the book. A short discussion is associated with

each case, but for more detailed and in-depth infor-

mation we refer to existing textbooks.

The book is a collaboration between four authors

and three collaborators all with different back-

grounds, training from different parts of the world

and with different clinical experiences. Dr. Leena Ke-

tonen is the lead author and has a long-term interest

in pediatric neuro-imaging. During her 20-year ca-

reer in neuroradiology she has continuously gathered

interesting cases. When Dr. Ketonen moved from

Massachusetts General Hospital in Boston to the Uni-

versity of Rochester it was quite obvious, looking into

her new ofﬁce, that she had a very extensive collec-

tion of such cases. She would have needed a much

larger ofﬁce than the one we were able to offer her

just to store her enormous teaching ﬁle. Seeing her

phenomenal collection of cases and pairing that with

our positive experience writing our previous book,

Diffusion-Weighted MR Imaging of the Brain , it was

obvious that we had both an idea and the material for

another neuro-imaging book. We decided on the top-

ic of pediatric neuro-imaging with Dr. Ketonen as the

lead author. We started out with the intention of hav-

ing ten cases per chapter, but it soon became obvious

that the number of cases would double for many of

the chapters. The book is based mainly on Dr. Keto-

nen’s collected cases, backed up by the University of

Rochester’s teaching ﬁle, started many years ago by

Dr. Numaguchi. We have incorporated cases of fetal

MR imaging (Chap. 11) that we borrowed from Dr.

Susan Blaser of the Children’s Hospital in Toronto.

Dr. Akio Hiwatashi has been instrumental in cor-

recting, manipulating and formatting the images for

this book. Dr. Ravinder Sidhu has been the lead per-

son for looking up background information and

making sure we have the most appropriate and up-to-

date references. Dr. Westesson has been the leader of

the project and has kept it moving forward while

writing the head and neck chapter. The contribution

of Susan Blaser has been instrumental. Her outstand-

ing collection of prenatal MR cases constitutes the

bulk of Chap. 11. In addition we have enjoyed the help

of Drs Lawrence Buadu and Sudhir Kathuria for the

chapters on miscellaneous conditions and nonacci-

dental trauma (child abuse).

Our experience from working with Springer on

our earlier book was totally positive from the begin-

ning to the end. The printing, editing and image qual-

ity along with the layout of the book were ﬁrst quali-

ty and the publisher proved to be able to produce this

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