Pediatric vascular imaging techniques and clinical applications: Vascular Imaging of the Central Nervous System: Physical Principles, Clinical Applications and Emerging Techniques

The prelims comprise: Compared to adults, imaging studies have a more preponderant role in the evaluation of pediatric stroke, due to the higher clinical variability, stroke-like diseases and differential diagnosis. Computed tomography is frequently the first exam performed and allows a rapid differentiation between hemorrhagic and ischemic lesions. Magnetic Resonance Imaging is the modality of choice for imaging evaluation of pediatric neurovascular pathologies. Due to the high frequency of intra and extra-cranial arterial anomalies vascular imaging should be done in all children with stroke. Cranial ultrasound is a very good and noninvasive technique for imaging neonatal brain, mainly useful in preterm newborns, also sensitive but insufficient for an accurate evaluation of focal ischemic infarct. Transcranial Doppler is a noninvasive technique with several applications, most of all in sickle cell disease. Conventional angiography remains the most precise technique for the evaluation of vascular pathology and should be considered in children if cerebral vasculitis is suspected, if there are doubts with therapeutic implications (eg, arterial dissection), in the pre-surgical assessment of collateral blood flow in MoyaMoya and in the evaluation of arterio-venous vascular malformations, dural fistulas and aneurisms. © 2014 by John Wiley & Sons, Inc. All rights reserved.