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Introduction to Pediatric Imaging
Introduction to Pediatric Imaging
Introduction to Pediatric Imaging
Introduction to Pediatric Imaging
Introduction to Pediatric Imaging
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Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?
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Introduction to Pediatric Imaging
INTRODUCTION TO PEDIATRIC IMAGING
Dr Priya Chudgar.
Lecturer in Radiology,
Department of Radiology,
KEM Hospital,
Mumbai.
 

  • Contrast Studies :

    • Barium studies for G. I. Tract :- Oral suspension of Barium sulphate is given & double contrast procedures are performed with serial x-rays or under fluoroscopic guidance. Laxatives are given one day prior to the procedure. Simple enema is given to the patient (to prepare the colon) before Barium enema. Ideally the patient should have an overnight fast. Except in suspected case of perforation, there are no other contra-indications for Barium Studies.

      Following procedures may be performed with Barium:

    Procedure Indication
    Barium Swallow (esophagus) Dysphagia,Odynophagia, Tracheo-esophageal fistula
    Barium Meal(stomach/Duodenum) Gastro-esophageal reflux, Gastritis, Peptic ulcers
    Barium Meal Follow through (small bowel) Recurrent abdominal pain, Koch's abdomen
    Barium enema Bleeding per rectum, diarrhea

  • Urographic studies for urinary tract :- They are performed with intravenous injection of water-soluble contrast media containing iodine. Different protocols are used for different procedures. Though Ultrasonography has decreased the utility of IVP (Intravenous Pyelography); MCU (Micturating Cystourethrogram) is still commonly used for detecting PU valves (Posterior urethral valves).

    Newer, low osmotic, non-ionic contrast media are less painful than the older hyperosmolar ionic contrast medium. All contrast media are safe up to dose of 300 mg/ml of iodine concentration.

    Ideally, all examinations that require intravenous contrast demand an empty stomach, yet a hungry, dehydrated child is unhappy & uncooperative. Thus it is recommended that the examination is performed immediately before the next scheduled feed (in babies, it is usually 2- 3 hours after last light feed). This means that child undergoing IVP at 9:00 a.m. should have light breakfast at 6:30 a.m.

    • Angiography :- This technique comprises of introduction of an arterial catheter & injecting the contrast through the same.
    • DSA - Digital subtraction Angiography :- It is much quicker & requires less contrast. This procedure requires sedation/anesthesia as even slight movement of the patient will hamper the procedure.

      Major indications for DSA in the pediatric age group include:

      • Hypertension - To rule out renal artery stenosis.
      • Hepatic masses.
      • CNS vascular malformations.
      • GI Bleeding.
      • Preoperatively in Plastic Surgery cases

 
 
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