Newborn Imaging

Our intent is to provide a central resource for SPR members who seek information to help establish or grow their involvement in newborn imaging in their communities. We hope to provide additional support to radiologists without subspecialty training in Pediatrics, who may practice in adult facilities with obstetric services, making newborns their only pediatric patients. Content is offered in a downloadable format for your use and modification. To offer suggestions on ways to improve the page or add other useful components, please contact the Newborn Imaging Committee members through the SPR office at spr@acr.org.

Resources

General

   

Radiographs (Chest, KUB, Babygram, Skeletal)

  1. Overview 
  2. Indications and Limitations 
  3. Guidelines /Views  
  4. Requirements and near-requirements 
  5. Risks and Benefits 
  6. Biometry references 
  7. Resources 
    1. Websites 
    2. Recommended texts/ articles

Ultrasound

1. Guidelines/Indications              

Ultrasound should be the first line imaging modality for many indications in the infant. For example, pyloric stenosis, sacral dimple, hip dysplasia until proximal femoral epiphyses are ossified (approximately 4 months postnatal age), soft tissue lesions, head ultrasound for germinal matrix hemorrhage and macrocrania, fluid collections, evaluation of intraabdominal pathology and urinary tract pathology.

 

Ultrasound is tolerable by most patients in various circumstances. It can help answer many questions and should be readily available and utilized for broad indications in pediatrics as first line study.


2. Limitations

•Small field of view

•Operator dependence

•Ultrasound does not perform well for bone evaluation, however some institutions still utilize ultrasound as an adjunct for fracture evaluation. 

•UGI remains the gold standard for evaluation of malrotation. 

3. Safety

Safety profile of ultrasound is extremely favorable. In fact, ultrasound is the preferred modality in children due to lack of ionizing radiation. The AIUM states” Diagnostic ultrasound has been in use since the late 1950s. Given its known benefits and recognized efficacy for medical diagnosis, including use during human pregnancy, the American Institute of Ultrasound in Medicine herein addresses the clinical safety of such use: No independently confirmed adverse effects caused by exposure from present diagnostic ultrasound instruments have been reported in human patients in the absence of contrast agents. Biological effects (such as localized pulmonary bleeding) have been reported in mammalian systems at diagnostically relevant exposures but the clinical significance of such effects is not yet known. Ultrasound should be used by qualified health professionals to provide medical benefit to the patient.     

Ultrasound exposures during examinations should be as low as reasonably achievable (ALARA).”

http://www.aium.org/officialStatements/34

 

There is a small risk of cell damage due to heating in certain settings, this would require prolonged duration of scanning.

http://www.aium.org/officialStatements/17

https://www.bmus.org/static/uploads/resources/BMUS-Safety-Guidelines-2009-revision-FINAL-Nov-2009.pdf

  

 Use of ultrasound by licensed technologists and physicians with manufacturer and physicist oversight in the medical setting assures the patient of the safest and most reasonable study for diagnostic purposes. It is the responsibility of all involved; manufacturer, technologists and radiologists, to optimize parameters and techniques to minimize any potential risk, particularly in neonatal population. 

 

As with any imaging, ALARA principle is applied, as low as reasonably achievable.

http://www.aium.org/officialStatements/39

 

 

4. Resources
•American Institute of Ultrasound in Medicine (AIUM): 

http://www.aium.org/

 
•AIUM includes practice parameters, guidelines for performance and documentation of images per study (includes hip, spine, head).

http://www.aium.org/resources/guidelines.aspx

 

 •American College of Radiology (ACR): 

http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Ultrasound

  

•Hip dysplasia
http://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/US_Hip_Dysplasia.pdf


•Spine

http://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/US_Neonatal_Spine.pdf

 

 •Head

http://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/US_Neurosonography.pdf

 

•ACR Appropriateness Guidelines- Suspected appendicitis

https://acsearch.acr.org/docs/69357/Narrative/

 

•ACR Appropriateness Guidelines-Urinary Tract Infection Child

https://acsearch.acr.org/docs/69444/Narrative/

 

http://www.imagegently.org/Procedures/Ultrasound

 

 

 

MR

  1. Overview - Head, head & neck, chest, abdomen, spine, extremities 
  2. Indications and Limitations 
  3. Guidelines / Views 
    1.  ACR–SPR Practice Guideline for the Performance and Interpretation of Pediatric Magnetic Resonance Imaging (MRI) Res. 23 – 2011
    2. ACOG guidelines for Head MRI for HIE 
  4. Requirements and near-requirements 
  5. Risks and Benefits 
  6. Biometry references 
  7. Imaging sequence parameters 
    1. GE 
    2. Siemens 
    3. Philips 
  8. References 
    1. Links 
      1.  MRI of the Neonatal Brain, by Mary Rutherford  
    2. Recommended texts/ articles

CT

  1. Overview 
  2. Indications and Limitations 
  3. Guidelines /Views- 
  4. Pediatric CT Protocol Guidance and worksheet
  5.  ACR–SPR Practice Guideline for the Performance of Pediatric Computed Tomography (CT) Res. 22 – 2008  
  6. Requirements and near-requirements 
  7. Risks and Benefits 
  8. Biometry reference tables 
  9. Resources 
    1. Websites 
    2. Recommended texts/ articles

Interventional

Other (GI contrast, Nuclear Medicine)

  1. Overview
  2. Indications and Limitations 
  3. Guidelines /Views 
  4. Requirements and near-requirements 
  5. Risks and Benefits 
  6. Biometry references 
  7. Resources 
    1. Websites 
    2. Recommended texts/ articles 

Radiation Safety

 

Environment

  1. General 
  2. Specific - Gestational age specific guidelines (preterm, term)
  3. NICU 
  4. Well Baby Nursery
  5. ED

Guidelines

 

Reporting Templates

 

Organ System Imaging Overviews

Newborn Unknown Case

Coming soon.

Find an Expert

Until this section can be built, we suggest you contact your local children's hospital or search the map found on the Parents and Patients page

Fetal & Newborn Imaging Committee

Roster

Beth M. Kline-Fath, MD, Chair
Teresa Victoria, MD, Vice Chair
Evelyn Y. Anthony, MD
Rama S. Ayyala, MD
Karen Blumberg, MD, FACR
Thangamadhan Bosemani, MD
John A. Cassese, MD
Kimberly A. Dannull, MD
Pamela M.Deaver, MD
Nilesh Desai, MD
Luis Goncalves, MD
Katrina S. Hughes, MD
Emily M. Janitz, DO
Sabiha Pinar Karakas, MD
Paggie Kim, MD
David W. McDonald, MD
Gaurav Saigal, MD
Chetan C. Shah, MD
Gayathri Sreedher, MD
Kalyan C. Tatineny, MD

ADVISORY Members
Dorothy I. Bulas, MD, FACR
Lucia Carpineta, MD, CM
Judy Ann Estroff, MD
Mariana L Meyers, MD
Richard Parad, MD
Erika Rubesova, MD