Imaging Modalities 1021 Ultrasonography

Ultrasonography is the most commonly performed screening examination for abdominal and pelvic problems in pediatric patients. Unlike many other imaging studies, sedation is not needed for ultrasonography and there is no exposure to ionizing radiation. The location of the primary tumor, the presence of vascular encasement, and metastasis to the liver may be detected by ultrasonography. Calcifications are demon-

strated as focal areas of increased echogenicity, sometimes associated with acoustical shadowing. The aorta and inferior vena cava are usually anteriorly displaced by the retroperitoneal mass. Tumor invasion of the liver or kidney can be assessed by visualization of planes between the mass and the liver or kidney. Doppler may be used to demonstrate flow in vessels compressed by tumor; however, evaluation of the full extent of the disease is not possible with ultrasonography.

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