Abdominal MRI - techniques, common applications and findings in paediatric MR enterography and hepatobiliary MR imaging
01 Apr 2014
Aims:
1. Knowledge of MR technique and protocols in paediatric MR enterography (MRE) and hepatobiliary MR.
2. Understanding of the common indications for paediatric MRE and hepatobiliary MRI.
3. Recognition of signs of inflammatory bowel disease on MRE.
4. Knowledge of the characteristic MR findings of common paediatric liver masses and understanding of the use of liver specific contrast agents in hepatobiliary MR.
5. Recognition of the common biliary pathologies in paediatric MR.
Learning points:
MRE
The commonest indication for MRE in children is the investigation of Crohn’s disease although MRE also has an emerging role in the assessment of small bowel tumours and sub acute obstruction. MRE has largely replaced conventional barium studies of the small bowel due to the lack of ionising radiation and comparable diagnostic capabilities for Crohn’s disease aside from more subtle apthous ulceration. MRE assesses extent of disease, disease activity, treatment response and extraintestinal complications. MR findings can be classified as active inflammatory disease, penetrating and fistulating disease, fibrostenotic and reparative and regenerative. There is emerging use of DWI to assess activity of disease with potential to replace the use of contrast.
Hepatobiliary MRI
Indications for hepatobiliary MRI in paediatrics include characterisation of focal liver masses, staging of malignant disease, vascular assessment, evaluation of the biliary tree and assessment of diffuse parenchymal disease. MR is often able to characterise focal liver lesions with the use of appropriate sequences avoiding the need for biopsy or further investigation.
The use of hepatocyte specific agents further increases diagnostic accuracy distinguishing hepatocellular lesions from non-hepatocellular lesions and also improves delineation of tumour margins and the relationship to the biliary tree. MR of the biliary tract accurately detects the level and cause of obstruction; including stones, tumours, inflammatory lesions and choledochal abnormalities. Hepatocyte specific agents are excreted via the biliary system and have an emerging role in functional imaging with potential application for congenital abnormalities, post-operative complications and differentiation of biliary from extra-biliary lesions.
1 CPD credit.
Watch the video and complete the online self-reflection form. Go to "My events" to download your certificate. You must login to watch the video and receive CPD.
1. Knowledge of MR technique and protocols in paediatric MR enterography (MRE) and hepatobiliary MR.
2. Understanding of the common indications for paediatric MRE and hepatobiliary MRI.
3. Recognition of signs of inflammatory bowel disease on MRE.
4. Knowledge of the characteristic MR findings of common paediatric liver masses and understanding of the use of liver specific contrast agents in hepatobiliary MR.
5. Recognition of the common biliary pathologies in paediatric MR.
Learning points:
MRE
The commonest indication for MRE in children is the investigation of Crohn’s disease although MRE also has an emerging role in the assessment of small bowel tumours and sub acute obstruction. MRE has largely replaced conventional barium studies of the small bowel due to the lack of ionising radiation and comparable diagnostic capabilities for Crohn’s disease aside from more subtle apthous ulceration. MRE assesses extent of disease, disease activity, treatment response and extraintestinal complications. MR findings can be classified as active inflammatory disease, penetrating and fistulating disease, fibrostenotic and reparative and regenerative. There is emerging use of DWI to assess activity of disease with potential to replace the use of contrast.
Hepatobiliary MRI
Indications for hepatobiliary MRI in paediatrics include characterisation of focal liver masses, staging of malignant disease, vascular assessment, evaluation of the biliary tree and assessment of diffuse parenchymal disease. MR is often able to characterise focal liver lesions with the use of appropriate sequences avoiding the need for biopsy or further investigation.
The use of hepatocyte specific agents further increases diagnostic accuracy distinguishing hepatocellular lesions from non-hepatocellular lesions and also improves delineation of tumour margins and the relationship to the biliary tree. MR of the biliary tract accurately detects the level and cause of obstruction; including stones, tumours, inflammatory lesions and choledochal abnormalities. Hepatocyte specific agents are excreted via the biliary system and have an emerging role in functional imaging with potential application for congenital abnormalities, post-operative complications and differentiation of biliary from extra-biliary lesions.
1 CPD credit.
Watch the video and complete the online self-reflection form. Go to "My events" to download your certificate. You must login to watch the video and receive CPD.
Duration:50 mins
Speaker info
Helen Woodley
Dr Woodley undertook undergraduate training at Cambridge University and The Royal London Hospital. Following house jobs in London she headed north to Leeds for a medical SHO rotation followed by a place on the Yorkshire Radiology Registrar Rotation. Following a fellowship year in paediatric radiology at the Women and Children’s Hospital, Adelaide, Australia, she took up her current post as Consultant Paediatric Radiologist in Leeds Teaching Hospitals Trusts (LTHT) in 2000. LTHT became the 3rd centre in the UK for paediatric liver transplantation at the time of her appointment and as well as performing the full range of paediatric imaging in her consultant post she has developed a specialist interest in paediatric hepatobiliary imaging.