Best Practices in Pediatric Radiology - Part 1

Choosing the right test when imaging children

Dr. Ravi Bhargava is a Professor of Radiology at the University of Alberta and Pediatric Radiologist at Stollery Children’s Hospital. In this presentation, Dr. Bhargava shares his experience and thoughts on best practices in pediatric MR protocoling. The first video in this series provides an introduction to imaging children, considerations for choosing the right imaging modality and selecting the right MRI protocol that may or may require contrast.

Children have a different set of diseases than adults, as well as different pathology that varies with the age of the child. Performing effective examinations is critical, especially in young children who are unable to accurately describe their symptoms. While there are many tools available to radiologists, the risks and benefits of each test need to be considered for each child. When choosing whether or not to give contrast, the practice at Stollery Children’s Hospital is to not routinely give contrast to every patient. Based on experience and published literature, if patients have a normal pre-contrast MRI, then administration of contrast is believed not to add much to the diagnostic yield of the test. There are exceptions that are important to know about (e.g. Sturge-Weber syndrome), where the pre-contrast brain MRI can be normal, but abnormalities can be visualized after administration of contrast.

In the upcoming second part of this video series, Dr. Bhargava continues with a discussion of optimization of MR protocols for children, hardware choices and further considerations when choosing between different contrast agents.