Imaging procedures in pediatrics.

To demonstrate the use of these multiple techniques, one might consider algorithms that are available for various disorders. It is worth pointing out that for imaging of specific abnormalities, they must be evaluated in light of the skill and interest of available personnel and on the equipment that is available. For example, in acute upper abdominal trauma in children the following is one diagnostic route: With no substantial suspicion of brain injury and after evaluation by an attending surgeon; With upper abdominal injury limited reasonably clearly to the kidneys, renal vessels, and ureters: Intravenous sonography; With upper abdominal injury limited reasonably clearly to the liver, spleen, or both: Liver/spleen scintigraphy; With substantial suspicion that the injury is not limited to the kidneys or the liver and spleen: Enhanced CT of upper abdomen; With a suspicion of brain injury sufficient to require CT of the head: CT scan, and if there is abdominal injury as well, contrast enhanced CT of the upper abdomen; Again it is to be emphasized that this diagnostic route (as well as the ones in Figures 1 and 2) represents an approach and is used in the context of this chapter to illustrate the role of the various imaging techniques that are available to the diagnosis of one pediatric problem.