This document discusses the use of MRI in pediatrics. It outlines how MRI can help solve problems when CT and ultrasound are equivocal. Some advantages of MRI over other imaging include its multiplanar capabilities and superior soft tissue contrast without radiation exposure. Special considerations for pediatric MRI include adjusting protocols for faster sequences and lower radiofrequency energy. The document then covers various indications for pediatric MRI of the brain, spine and other areas. It provides examples of how MRI appears for various pediatric infections, tumors, congenital anomalies and other conditions.

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Slide 1
Tool for DNB Practical
examination in pediatrics
MRI in
pediatrics

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Slide 2
MRI-A problem
solving tool!
 CT and USG initial INVG
 MRI helps in cases where both are
equivocal
 Initially MRI – only for Brain and Spine
(longer imaging times)

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Slide 3
ADVANTAGES OF MRI
• MULTIPLANAR CAPABILITIES
• BETTER INTRINSIC SOFT TISSUE
CONTRAST
• NO RADIATION
• NO IODINATED CONTRAST
DISADVANTAGES OF MRI
• COST
• CLAUSTROPHOBIA
• CALCIFICATION NOT WELL SEEN

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MRI IN PEDIATRICS
SPECIAL ISSUES
 NORMAL VARIANTS AND APPEARANCES
 SPECIAL SCAN PROTOCOLS
– FASTER SEQUENCES
– LOW RF ENERGY
 SEDATION

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MRI IN PEDIATRICS - INDICATIONS
BRAIN MRI
– Seizures including infections and Neoplasms
– Perinatal vascular insult (HIE)
– Congenital Anomalies and Neuroregression
SPINE MRI
– Congenital Abnormalities
– Scoliosis
OTHER INDICATIONS
– Musculoskeletal system
– Chest
– Abdomen and Pelvis
– Miscellaneous

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Slide 6
Infection

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Slide 7
TUBERCULOMA

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NEUROCYSTICERCOSIS

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Slide 9
NEUROCYSTICERCOSIS

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Slide 10
Tuberculomas Vs Neurocysticercosis
Hypointense
on T2WI
Hyperintense
on T2WI

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Slide 11
Meningitis

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Slide 12
Herpes encephalitis

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Slide 13
Japanese B
Encephalitis

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Slide 14
ADEM(acute disseminated
encephalomyelitis)
Infective

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Slide 15
TORCH(CMV)

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Slide 16
BRAIN TUMORS

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Slide 17

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Pilocytic
astrocytoma
post contrast
Tumors

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Slide 19
CRANIO
PHARYNGIOMA

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CONGENITAL ANOMALIES
PHAKOMATOSIS &
NEUROREGRSSION

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Slide 21
Neuronal migration anomalies
Agyria/pachygyria

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Slide 22
Polymicrogyria

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Slide 23
Heterotopia

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Slide 24
Schizencephaly

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Tuberous sclerosis
Phakomatosis

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Slide 26
Sturge Weber Syndrome
Phakomatosis

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Slide 27
Leukodystrophies

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DISTINCTIVE FEATURES OF
LEUKODYSTROPHIES
COMPLETE OR NEAR LACK OF MYELINATION
Canavan Disease
Pelizaeus-Merzbacher Disease
FRONTAL WHITE MATTER MOST INVOLVED
Alexander Disease
OCCIPITAL WHITE MATTER MOST INVOLVED
Adrenoleukodystrophy
THICK MENINGES
Hurler Syndrome

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Slide 29
Normal head circumference
Central to peripheral pattern
Metachromatic leukodystrophy (onset: 4 to 8 years)
Krabbe's disease (onset: before 4 years)
Pelizaeus-Merzbacher disease (onset: 4 to 8 years, boys)
Dorsal to ventral pattern
Adrenoleukodystrophy* (onset: 4 to 8 years)
Increased head circumference
Peripheral to central pattern
Canavan's disease (onset: infancy)
Ventral to dorsal pattern
Alexander's disease* (onset: infancy)
*Enhances with gadolinium.

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Slide 30
Canavan’s disease

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Adrenal Leukodystrophy

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Vascular Insults

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Hypoxic ischaemic
encephalopathy
Perinatal insult

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Slide 34
PVL

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Slide 35
Acute Infarct

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Slide 36
MOYA MOYA