Magnetic Resonance Imaging of Pediatric Patients

Abstract

The lack of radiation exposure, the possibility of multiplanar imaging, and the wide range of tissue contrast have made magnetic resonance imaging (MRI) an important tool in the evaluation of pediatric diseases. Unfortunately, majority of the radiologists are not as familiar as necessary with normal variations, developmental anomalies, and the variety of illnesses that are often unique in children. Therefore, a spectrum of uneasiness or discomfort to frank anxiety is encountered when it comes to pediatric radiology. The purpose of this chapter is to provide some basic information about the most common pediatric entities that differ from diseases in the adult population and will be sent to MRI for evaluation. There may be some overlap between this chapter and others in this book, but it is worthwhile to study the information given from different authors. In pediatric radiology, imaging studies like ultrasonography, conventional radiography, and fluoroscopy remain the primary imaging modalities for the majority of clinical requests. If there is a need for further evaluation and the diagnostic information from both CT and MRI is comparable, then MRI should be the next step, to avoid radiation exposure. However, CT is a widely available and comparably quick method to evaluate a variety of diseases in a superb manner. A good quality CT may provide more information than a substandard MRI study. A good deal of a pediatric radiologist’s daily work consists of reviewing imaging studies from different referral centers and deciding whether these studies are good enough to base clinical decisions on them. A poor CT or MRI study may have to be repeated, which leads to increasing costs, unnecessary radiation exposure, or additional sedation or general anesthesia. Therefore, it is of vital interest for pediatric radiologists to share their knowledge with other radiologists. In many institutions, majority of the children with diseases involving the airways and chest are evaluated by CT. Some diseases of the chest (i.e., tumors) occurring in other locations that require an MRI evaluation are covered in the abdominal and musculoskeletal section of this chapter. This chapter mainly focuses on brain, spine, abdominal, and musculoskeletal diseases in children. Some information about congenital heart disease is provided in Chap. 10.