Interactive Transcript
0:01
So MRI can have limitations,
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which are important to keep in mind.
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They are very sensitive to motion.
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You may need occasional anesthesia or
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some sort of sedation if the child is
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young enough and can't stay still for it.
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MRI is limited in evaluating for free air.
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So just things to keep in mind.
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But it is often still quite diagnostic
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and maybe better than a CT scan.
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So in this case, another child,
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you can follow that colon down.
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In this case, it's a bit harder to identify
0:32
the appendix versus the terminal ileum.
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You do have this.
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It's a thick-walled structure that has
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what looks like bowel signature that
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does appear to attach here to the cecum.
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I find it hard in this particular case to
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tell exactly where the terminal ileum is to
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prove that this is the appendix, but we do
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have these T2 dark structures within this
0:51
loop of bowel here that could be air, you
0:54
know, or they certainly could be appendicoliths.
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The structure, however, when you
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follow it, it does look blind-ending.
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It just stops here in the right lower quadrant.
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You see some T2 bright free fluid here,
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and then what's more importantly here, you
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didn't just diagnose acute appendicitis,
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but you're looking for the complications.
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So here we have an example of an abscess
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from an acute appendicitis on MRI.
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So this is the bladder anteriorly, it's being
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squished by this volume of fluid right here.
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This is not just free fluid, it's
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pushing on the structures nearby.
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This is an abscess.
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It is thick-walled.
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It has an air-fluid level right here.
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Here's a little bit of air.
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That's rising on the pus,
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basically sitting back here.
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It's a little bit heterogeneous because
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remember it is purulent material.
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And then you have a little bit of,
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sorry, rectum back here behind it.
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Thick-walled back here as well.
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And that's reactive in this case because
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there's a large abscess sitting upon it.
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So in these cases, you do not need contrast.
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This is a relatively quick exam.
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It's just several coronal and
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axial T2-weighted imaging.
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No contrast is necessary for these.
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And you can diagnose acute appendicitis and
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an abscess, both in the same examination,
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relatively quick for these kids.
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So they don't have to be under
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anesthesia very long if they need it.
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And if they're older and don't need
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it, they can tolerate the exam quite
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well, given that it's relatively short.
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