Neonatal Chest

Diffuse patchy opacities

White dots on a black background:
High lung volumes (left image)

• Transient tachypnea of the newborn:
• Meconium aspiration: Risk of pneumothorax
• Neonatal pneumonia:

Low lung volumes (right image)

• Hyaline membrane disease: Premature, 32-36 weeks. At risk for pulmonary interstitial emphysema, pneumothorax, bronchopulmonary dysplasia.
• Neonatal pneumonia:

Diffuse cystic disease

Black dots on a white background:

• Week 1: Pulmonary interstitial emphysema
• Weeks 2-3: Wilson-Mikity syndrome (no prior positive pressure ventilation)
• Week 4: Bronchopulmonary dysplasia (prior positive pressure ventilation)

Cardiac

Acyanotic, increased vascularity:

• Hypoplastic left heart:
• Coarctation:
• Peripheral shunts: Vein of galen malformation, infantile hemangiomas.
• Sepsis

Cyanotic, increased vascularity:

• Normal heart size: Total anomalous pulmonary venous return
• Enlarged heart: D-transposition of the great vessels (right arch), persistent truncus arteriosus (right arch), tricuspid atresia with a large ventricular septal defect, single ventricle.

Cyanotic, normal or decreased vascularity:

• Normal heart size: Tetralogy of Fallot.
• Enlarged heart: Ebstein anomaly, tricuspid atresia with small ventricular septal defect, pulmonary atresia with intact ventricular septal defect.

References

Hoepker A, Seear M, Petrocheilou A, Hayes D Jr, Nair A, Deodhar J, Kadam S, O'Toole J. Wilson-Mikity syndrome: updated diagnostic criteria based on nine cases and a review of the literature. Pediatr Pulmonol. 2008 Oct;43(10):1004-12.