Editorial Reviews. Review. “This is the sixth edition of a well-known comprehensive book on pediatric neuroimaging. The intent is to provide a comprehensive. The thoroughly updated Fifth Edition ofPediatric Neuroimagingis a highly illustrated text-reference that describes and illustrates the full range of pediatric. Pediatric Neuroimaging by A. James. Barkovich has long been the most comprehensive text available for neuroimaging in infants and children. The latest edition.
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BOOK REVIEW. Pediatric Neuroimaging, 4th ed. A. James Barkovich, ed. Philadelphia: Lippincott Williams &. Wilkins: pages, illustrations, $ Barkovich Pediatric Neuroimaging 4th Fourth Edition [PDF] [EPUB] Foundations of Orientation and. Mobility Third Edition Volume II Instructional. This newest addition of the comprehensive Pediatric Neuroimaging combines thousands of images Author(s): A. James Barkovich MD, Charles Raybaud MD.
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Board Review Series. Washington Manual Step Up Series. Recall Series. This necessitates the creative modification of pulse sequence parameters in order to optimize the soft-tissue contrast between anatomical and pathological structures. During the process of myelination on T1-W images the signal from white matter goes from dark to bright. For a variable period the subcortical white matter becomes isointense with grey matter. We prefer this sequence to the more conventional T2-W fast or turbo spin-echo sequences, for reasons of increased lesion conspicuity.
However, we recognize that similar tissue contrast may be achieved if such fast spin-echo sequences are modified using increased TR and TE to compensate for the increased water content in this age group. The additional brain water is difficult to suppress and we do not find the fluid-attenuated inversion recovery FLAIR technique useful in this age group as lesion conspicuity is poor. Open image in new window Fig.
The most dramatic decrease in ADC values occurs within the first few months of life and the greatest changes are seen in the frontal and parietal white matter [ 8 ]. Failure to appreciate the normal changes with age of the ADC will result in the erroneous reporting of white matter abnormality particularly in the neonatal period. Factors influencing sequence choice For any imaging protocol, it is the specific combination of sequences that determines the diagnostic efficacy of the examination.
It is clear that imaging protocols vary between institutions. This is largely because rapid advances in imaging technology and variations between manufacturers, applied in the context of investigating relatively rare disorders, precludes an effective evidence-based approach to sequence choice.
The main advantages that MRI offers over alternative imaging modalities is the ability to demonstrate different tissue contrasts principally T1-W, T2-W and spin density, but also flow and diffusion in multiple imaging planes principally sagittal, coronal and axial. The disadvantage of MRI is the artefacts that it generates in almost every image. The choice of sequence combination should reflect the multicontrast and multiplanar capabilities of MRI. We have found that applying the generic principle of combining T2-W images in two planes, supported by T1-W imaging in two planes, as the basis of our imaging protocols, serves to optimize the benefits of MRI whilst minimizing the impact of artefacts.
Sagittal T1-W images allow the assessment of the midline structures, particularly the corpus callosum and cerebellum, which are frequently abnormal in congenital abnormalities.
Coronal T1-W images are valuable in the diagnosis of abnormalities of the anterior visual pathway, schizencephaly and holoprosencephaly. DWI is acquired in all children unless artefacts from, for example, dental braces or a ventriculoperitoneal shunt, preclude it, and an ADC is calculated using automated computer software and provided for reporting.
The sequence is particularly useful in trauma and vascular malformations such as multiple cavernomas.
Spine MRI is the modality of choice for imaging the intraspinal components of the paediatric spine.