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State of the Art Pediatric Musculoskeletal Imaging

State of the Art Pediatric Musculoskeletal Imaging. Brenton Reading MD Assistant Professor, Univ of MO-Kansas City Pediatric Radiologist, Children’s Mercy Hospitals & Clinics. Learning Objectives. After this talk, learner should be able to:

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State of the Art Pediatric Musculoskeletal Imaging

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  1. State of the Art Pediatric Musculoskeletal Imaging Brenton Reading MD Assistant Professor, Univ of MO-Kansas City Pediatric Radiologist, Children’s Mercy Hospitals & Clinics

  2. Learning Objectives After this talk, learner should be able to: • Describe the modalities used in musculoskeletal imaging • Understand the basic utility and benefit of advanced imaging techniques

  3. Outline • Radiographs • CT • MRI • Ultrasound • PET/CT

  4. Radiographs • Rapid • Excellent spatial resolution • CR/DR • Low dose ionizing radiation

  5. Radiographs Tibia Fibula Tibia Fibula 10 yo female with trauma 1 yo female with antalgic gait

  6. Computed Tomography • Volumetric acquisition • Post Processing • Good contrast resolution • Bone detail • Higher dose ionizing radiation

  7. Computed Tomography Med. Cuneiform 2nd Metatarsal 4th Metatarsal Med. Cuneiform 2nd Metatarsal Lat. Cuneiform Lat. Cuneiform 4th Metatarsal 14 yo male with trauma

  8. Computed Tomography Right hip Axial Right Hip Anterior Right Hip Posterior Right hip Coronal 10 yo male with history of trauma to right hip and acetabular dysplasia

  9. Magnetic Resonance Imaging • Volumetric acquisition • Excellent contrast resolution • Soft tissue detail • No ionizing radiation

  10. Magnetic Resonance Imaging Femur Femur Patella Patella Tibia Tibia Sagittal T2 Sagittal T2 1.5 Tesla 3 Tesla Source: J MacKenzie and S Vasanawala. State-of-the-Art in Pediatric Body and Musculoskeletal Magnetic Resonance Imaging. Seminars in Ultrasound, CT, and MRI. 2010.

  11. Magnetic Resonance Imaging Femur Femur Patella Patella Tibia Tibia Sagittal PD Sagittal T2 Femur Femur Patella Black Box Tibia Tibia Sagittal PD 14 yo old male with knee injury and pain

  12. Magnetic Resonance Imaging Femur Femur Femur Patella Patella Patella Femur Femur Patella Patella 14 yo male with increasing knee pain and osteochondral lesion

  13. Magnetic Resonance Imaging 13 yo female with left wrist mass

  14. Ultrasound • Real time dynamic imaging • Lower resolution • No ionizing radiation

  15. Ultrasound Fibula Fibula Fibula Marker Marker Marker Sagittal T1 Sagittal T2 Sagittal T1 Gad Marker Marker Marker Fibula Fibula Fibula AxialT1 Axial T2 Axial T1 Gad 16 yo male with anterior lower leg mass

  16. Ultrasound 16 yo male with anterior lower leg mass

  17. Positron Emission Tomography • Functional imaging • CT for anatomical correlation • Higher dose ionizing radiation

  18. Positron Emission Tomography 2/19/2009 1/20/2011 Coronal T1 Gad Coronal T1 Gad 2/19/2009 2/19/2009 10/28/2010 1/27/2011 1/27/2011 Sagittal T2 Coronal T1 Coronal T1 Gad 3D Volume PET Coronal PET/CT 5 yo female with rhabdomyosarcoma of the right thigh

  19. Thank you for your attention

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