Imaging the Pediatric Patient: Specific Pathologies: Specific Imaging Protocols

The application of MR imaging in the pediatric patient has increased dramatically in the recent years and undoubtedly, its role will continue to expand. In this presentation, we will discuss the following aspects of imaging the pediatric patient: • Sedation • Specific Imaging protocols which are advantageous for imaging the pediatric patient • Specific pathologies with focus on oncological imaging, and emerging applications of advanced MR imaging techniques Sedation (1-9) • Sedation is generally required for infants and children up to 6-7 years of age. • Maybe pediatric anesthesiologist-led, radiologist-led or specialist nurse-led. • Debate between use of general anesthesia and deep sedation: o Advantage of GA: less failure rate and therefore faster turn around. Failure rate for deep sedation ranges from 1-7%. ? Safer. o Disadvantage of GA: need for dedicated anesthetic equipment and pediatric anesthetists. • Safety guidelines have been issued by the American Society of Anesthesiologists (ASA), American Academy of Pediatrics (AAP) and American College of Radiology (ACR). Deep sedation should be performed by someone: o Who is working to an accepted guideline o With sole responsibility for the sedation o Trained to an acceptable level for life support o Familiar with drugs, dosages, monitoring equipment, and requirements of the procedure o Support from other skilled staff e.g. pediatric nurse • Pre-procedural evaluation: o Thorough patient assessment, including history and physical examination to screen patients and exclude contraindications to sedation. History taking should include history of respiratory illness, e.g. asthma, obstructive sleep apnea. Physical examination with evaluation of airway, range of neck motion, size of mandible and tongue, any craniofacial abnormalities. o Current medication and allergies