Paediatric MR imaging--current clinical applications.

Abstract

ABSTRACTEighty four MRI examinations of 69 paediatric patients referred to the RNSH MRI unit were retrospectively reviewed with clinical notes to establish the role of MRI scanning in clinical practice to date. In view of the limited scanning time presently available, this study aims to identify those children for whom MRI provided the most useful diagnostic information and most assisted subsequent management.For intra‐cranial examinations, the most useful applications were as follows:— Pre‐operative localization of primary brain tumours to assist selection of surgical approach and demonstrate involvement of adjacent structures or unsuspected distant CNS spread. Surveillance of known tumours to determine the need for chemotherapy, radiotherapy or further surgery and to differentiate recur rent tumour from haemorrhage or cyst formation. Demonstrate congenital or neoplastic lesions in the pituitary region. Identify the presence and extent of disease in suspected demyelinating and ischaemic conditions. Exclude the presence of lowgrade glioma associated with known cyst formation. In the spine, MRI was most useful in the demonstration of syrinx cavities including size, extent and loculation. A number of these patients presented with scoliosis. Assessment of cord tumours and spinal dysraphism including tethered cord also proved useful.Significant problems in paediatric scanning included movement artifact, most common in children under six years of age with psychomotor retardation, and sometimes nescessitating general anaesthesia.