chapter  17
60 Pages

Pediatric Applications

WithMarilyn J. Siegel, Ellen M. Chung

Magnetic resonance imaging (MRI) is an important imaging technique in nearly every part of the pediatric body. It offers superb soft tissue contrast without exposure to ionizing radiation, which is important in a pediatric population. The introduction of 3.0 T magnets,

faster sequences, multichannel coils, and parallel imaging techniques allows for increased resolution and shorter image acquisition times [1,2]. MRI is increasingly utilized as the primary study to evaluate soft tissue masses as well as joint abnormalities, and its use for evaluating thoracic, abdominal and pelvic masses is increasing [3-14]. It also plays an important role in the staging and monitoring of tumor response. This chapter

17.4.6 Pancreatic Masses ....................................................................................................................................... 393 17.4.7 Splenic Masses ............................................................................................................................................ 394 17.4.8 Gastrointestinal and Peritoneal Masses .................................................................................................. 395 17.4.9 Urinary Tract: Hydronephrosis and Congenital Anomalies ................................................................ 396 17.4.10 Chronic Diffuse Liver Diseases ............................................................................................................... 396

17.4.10.1 MR Techniques ........................................................................................................................ 397 17.4.10.2 Cirrhosis ................................................................................................................................... 397 17.4.10.3 Hepatic Hemochromatosis .................................................................................................... 398 17.4.10.4 Steatosis .................................................................................................................................... 398

17.4.11 Biliary Diseases .......................................................................................................................................... 398 17.4.12 Bowel Diseases ........................................................................................................................................... 398

17.4.12.1 MR Techniques ........................................................................................................................ 398 17.4.12.2 Congenital Anomalies ............................................................................................................ 399 17.4.12.3 Inflammation ........................................................................................................................... 399

17.4.13 Vascular Lesions ......................................................................................................................................... 400 17.5 Pelvis ............................................................................................................................................................................. 401

17.5.1 Functional Cysts ......................................................................................................................................... 401 17.5.2 Benign Ovarian Neoplasms ..................................................................................................................... 401

17.5.2.1 Cystic Teratoma ....................................................................................................................... 401 17.5.3 Malignant Ovarian Lesions ...................................................................................................................... 402

17.5.3.1 Germ Cell Tumors ................................................................................................................... 402 17.5.3.2 Sex Cord-Stromal Tumors ...................................................................................................... 402 17.5.3.3 Ovarian Cancer........................................................................................................................ 402

17.5.4 Vaginal/Uterine Masses ........................................................................................................................... 403 17.5.5 Bladder and Prostate Masses .................................................................................................................... 404 17.5.6 Presacral Masses ........................................................................................................................................ 405 17.5.7 Impalpable Testes ....................................................................................................................................... 406

17.6 Musculoskeletal System ............................................................................................................................................. 407 17.6.1 Bone Marrow .............................................................................................................................................. 407 17.6.2 Malignant Osseous Neoplasms ............................................................................................................... 407

17.6.2.1 Osteosarcoma and Ewing Sarcoma ...................................................................................... 407 17.6.2.2 Langerhans Cell Histiocytosis ............................................................................................... 408

17.6.3 Benign Tumors ........................................................................................................................................... 409 17.6.4 Soft Tissue Neoplasms .............................................................................................................................. 410

17.6.4.1 Congenital Vascular Lesions ..................................................................................................411 17.6.4.2 Hemangioma ........................................................................................................................... 412 17.6.4.3 Vascular Malformations ......................................................................................................... 412

17.6.5 Infection ........................................................................................................................................................414 17.6.5.1 Chronic Recurrent Multifocal Osteomyelitis .......................................................................414