Clinical Utility of Magnetic Resonance Imaging in Pediatrics

Focal Bacterial Infections

“…Ultrasonography should be the initial imaging study in newborns with clinical evidence of a hepatic abscess [83][84][85][86]. If ultrasound is negative, and the diagnosis is still strongly suspected, more sensitive techniques such as computed tomography (CT) or magnetic resonance imaging (MRI) should be performed [83][84][85][86][87][88]. Enhancement with contrast agents may increase the definition of smaller abscesses.…”

“…In the past, recommended management has been incision and drainage or resection of the abscess [134,138,141,144,150]. Needle aspiration under ultrasound guidance, combined with placement of a catheter for drainage and irrigation, has proved to be a useful alternative method [88,130,131,143] and is likely to supplant open drainage as the preferred method. Antibiotic therapy should be based on Gram stain, culture, and susceptibility studies of abscess fluid and should be continued for 10 to 14 days, provided that drainage can be established.…”

Sacrococcygeal teratoma in the perinatal period

“…The following investigations are recommended before surgery: x rays of spine, abdomen, chest, and pelvis to detect evidence of tumour or metastasis33 34; ultrasound to define the extent, nature (cystic or solid) of the mass, the presence and size of solid elements or calcification, and to recognise intrapelvic extension35; computed tomography to delineate the bony pelvic structures and to identify small areas of intrapelvic extension, but this involves radiation of the gonads; it is best performed following administration of a contrast agent8 35; magnetic resonance imaging (MRI) also delineates bony and muscular pelvic structures and can characterise the nature of the mass and detect intrapelvic extension8 36; Hata et al reported facilitation of antenatal diagnosis of sacrococcygeal teratoma by combined use of Doppler sonography and MRI37; angiography to demonstrate the main blood vessels supplying sacrococcygeal teratomas—the middle and lateral sacral and gluteal branches of the internal iliac artery and a branch from the profundus femoris artery; as hypervascularity, irregularly encased vessels, arteriovenous shunting, and serpentine dilated veins may be seen in malignant as well as in benign tumours, angiography is not conclusive in distinguishing benign from malignant disease8; Gross et al have discussed the role of myelography in evaluating the intraspinal extension of sacrococcygeal teratomas 38 …”

“…magnetic resonance imaging (MRI) also delineates bony and muscular pelvic structures and can characterise the nature of the mass and detect intrapelvic extension8 36; Hata et al reported facilitation of antenatal diagnosis of sacrococcygeal teratoma by combined use of Doppler sonography and MRI37;…”