State of the Art: Body and Fetal Imaging
description
Transcript of State of the Art: Body and Fetal Imaging
![Page 1: State of the Art: Body and Fetal Imaging](https://reader035.fdocuments.us/reader035/viewer/2022081514/5681658f550346895dd85cdf/html5/thumbnails/1.jpg)
State of the Art:Body and Fetal Imaging
Kristin Fickenscher, MDAssistant Professor RadiologyChildren’s Mercy Hospital and
University of Missouri, Kansas City
![Page 2: State of the Art: Body and Fetal Imaging](https://reader035.fdocuments.us/reader035/viewer/2022081514/5681658f550346895dd85cdf/html5/thumbnails/2.jpg)
What’s new in body imaging?
• PET/CT• MR Enterography• MRI of the liver• MR Urography• MR Angiography
![Page 3: State of the Art: Body and Fetal Imaging](https://reader035.fdocuments.us/reader035/viewer/2022081514/5681658f550346895dd85cdf/html5/thumbnails/3.jpg)
PET/CT• Measures the metabolic
activity of lesion • Superimposed on
anatomic CT image• Guide surgical biopsy,
staging, metastasis, response to therapy, recurrent lesions Coronal post contrast
CT: enlarged mediastinal lymph nodes
Coronal FDG PET: abnormal activity in mediastinum and left supraclavicular nodes
Nodular Sclerosing Hodgkins Lymphoma
![Page 4: State of the Art: Body and Fetal Imaging](https://reader035.fdocuments.us/reader035/viewer/2022081514/5681658f550346895dd85cdf/html5/thumbnails/4.jpg)
Imaging Inflammatory Bowel Disease
• IBD previously imaged with small bowel follow through, enema, and CT
• High cumulative radiation dose
Small bowel follow through: jejunal stricture secondary to Crohn
Axial post contrast CT: distal ileal bowel wall thickening and inflammation secondary to Crohn
![Page 5: State of the Art: Body and Fetal Imaging](https://reader035.fdocuments.us/reader035/viewer/2022081514/5681658f550346895dd85cdf/html5/thumbnails/5.jpg)
Imaging InflammatoryBowel Disease
• MR Enterography– Lack of ionizing
radiation– Easy to identify
multifocal disease– DWI and cine give real
information regarding disease activity
– Superior depiction of perirectal disease
![Page 6: State of the Art: Body and Fetal Imaging](https://reader035.fdocuments.us/reader035/viewer/2022081514/5681658f550346895dd85cdf/html5/thumbnails/6.jpg)
Imaging Inflammatory Bowel Disease
• Ulcerative Colitis: contigous colitis– Lead pipe colon
• Complications after colon resection and ileoanal anastomosis – pouchitis
![Page 7: State of the Art: Body and Fetal Imaging](https://reader035.fdocuments.us/reader035/viewer/2022081514/5681658f550346895dd85cdf/html5/thumbnails/7.jpg)
Imaging Inflammatory Bowel Disease
• Crohn Disease:– Wall thickening
and inflammation– Messenteric
changes– Disease activity
• Restricted diffusion– Dysmotility– Perianal disease
![Page 8: State of the Art: Body and Fetal Imaging](https://reader035.fdocuments.us/reader035/viewer/2022081514/5681658f550346895dd85cdf/html5/thumbnails/8.jpg)
MRI of the liver• EOVIST: gadolinium
based contrast agent– Dynamic phase for
morphologic and vascular information
– Hepatocyte specific uptake gives additional information about lesion composition
EOVIST (gadoxetate disodium)
Portal venous
10 minute delay
20 minute delay
10 minute delay
20 minute delay
Focal Nodular Hyperplasia
![Page 9: State of the Art: Body and Fetal Imaging](https://reader035.fdocuments.us/reader035/viewer/2022081514/5681658f550346895dd85cdf/html5/thumbnails/9.jpg)
MR Urogoraphy
•Provides excellent anatomic and functional information•Suspected urinary tract obstruction, hematuria, and congenital anomalies, surgically altered anatomy
![Page 10: State of the Art: Body and Fetal Imaging](https://reader035.fdocuments.us/reader035/viewer/2022081514/5681658f550346895dd85cdf/html5/thumbnails/10.jpg)
MR Angiography• Time resolved dynamic
contrast enhanced angiography
• Excellent temporal and spatial resolution
• Vascular dynamics and physiology as well as pathology
![Page 11: State of the Art: Body and Fetal Imaging](https://reader035.fdocuments.us/reader035/viewer/2022081514/5681658f550346895dd85cdf/html5/thumbnails/11.jpg)
NATIVE• Contrast free MR
angiography• Contraindication to
gadolinium• Arterial or venous
![Page 12: State of the Art: Body and Fetal Imaging](https://reader035.fdocuments.us/reader035/viewer/2022081514/5681658f550346895dd85cdf/html5/thumbnails/12.jpg)
Fetal MRI• Important adjunct to fetal
sonography• Inconclusive sonographic
findings• Technically limited
ultrasound• Additional/ associated
anomalies not visible on ultrasound
![Page 13: State of the Art: Body and Fetal Imaging](https://reader035.fdocuments.us/reader035/viewer/2022081514/5681658f550346895dd85cdf/html5/thumbnails/13.jpg)
Fetal MRI: CNS
• CNS anomalies most common indication
• Further evaluation of ventriculomegaly
• Associated abnormalities
• Delivery and surgical plan
Coronal: bilateral open lip schizencephaly
Sagittal: agenesis of the corpus callosum, midline cyst
Sagittal: Dandy Walker malformation, agenesis of corpus callosum
Sagittal: Large facial teratoma
![Page 14: State of the Art: Body and Fetal Imaging](https://reader035.fdocuments.us/reader035/viewer/2022081514/5681658f550346895dd85cdf/html5/thumbnails/14.jpg)
Fetal MRI: Body
• Evaluation of chest masses– CPAM, sequestration,
diaphragmatic hernia– Lung volumes
• Chest and abdominal wall defects– Contents in hernia
• Abdominal/pelvic masses
Congenital Pulmonary Adenomatoid Malformation
Congenital Diaphragm Hernia
Omphalocele
Extrapulmonary sequestration
![Page 15: State of the Art: Body and Fetal Imaging](https://reader035.fdocuments.us/reader035/viewer/2022081514/5681658f550346895dd85cdf/html5/thumbnails/15.jpg)
Thank you!