AIM: Brant: Ch 65: Imaging Children

Question 1

In children, if inspiratory/expiratory chest radiographs are required for assessment of air trapping, these are best performed using what position/s:
a. Upright
b. Lateral
c. Lateral decubitus (bilateral)
d. Cross-table lateral

Answer 1

c. Lateral decubitus (bilateral)

Question 2

In infants, this position is considered possible for all but the sickest of infants when evaluating for pneumothorax:
a. Upright
b. Decubitus
c. Cross-table lateral
d. None of the above

Answer 2

b. Decubitus

Question 3

In children, two-view abdominal radiographs are better performed with supine and decubitus views (vs. upright in adults). ____ views require less cooperation and have the benefit of increasing the amount of gas in the right lower quadrant which is helpful when appendicitis is a consideration (a common occurrence)

Answer 3

Left lateral decubitus views

Question 4

At least how many separate radiographs are required for a skeletal survey for child abuse (radiation risk is not even a consideration here due to the risk to the child from missed abuse and the benefit of diagnosis)?
a. 10
b. 15
c. 20
d. 25

Answer 4

c. 20

Question 5

Imaging modality that is considered workhorse of pediatric imaging
a. Radiography
b. Fluoroscopy
c. Ultrasound
d. MRI

Answer 5

c. Ultrasound

Question 6

At all ages, ____ is probably the most important factor in obtaining high-quality images
a. Ultrasound technologist
b. Sedation
c. Distraction techniques
d. Ultrasound machine

Answer 6

a. Ultrasound technologist

Question 7

This is an examination that is almost unique to pediatrics and is still extensively used for the diagnosis, staging, and follow-up of neuroblastoma
a. HIDA scan
b. 123I- MIBG scan
c. Cystograms
d. 18-F FDG-PET

Answer 7

b. 123I- MIBG scan

a. HIDA scan: hepatobiliary scan for biliary atresia
c. Cystograms: VUR
d. 18-F FDG-PET: lymphoma and sarcomas

Question 8

True about CT techniques used in the pediatric population, except:
a. HRCTs should be acquired using volume acquisition in both inspiration and expiration
b. One millimeter every 10-mm interval scanning for high-resolution chest CT has little or no dose savings compared to a scan of the entire chest and only serves to hide portions of the lung from view.
c. It is probably better to deal with large areas of atelectasis rather than motion
d. With the exception of CTPA and dedicated cardiac CT, routine contrast chest technique usually provides all the information needed even when evaluation of the vessels is required

Answer 8

c. It is probably better to deal with large areas of atelectasis rather than motion

True: It is probably better to deal with motion rather than large areas of atelectasis.

Other notes:
-Oral contrast material can help by separating bowel from other structures but is not necessary when evaluating for appendicitis or trauma.
-Intravenous contrast material is required for the vast majority of abdominopelvic CT examinations except for CTs done for renal stone