Clinical application of "black bone" imaging in paediatric craniofacial disorders
Xi Zhen Low1, Mei Chin Lim1, Vincent Nga2
1Department of Diagnostic Imaging, National University Hospital, Singapore, Singapore.
Insights
Black bone MRI offers a promising alternative to CT scans for diagnosing paediatric craniofacial disorders, reducing radiation exposure. This technique aids in evaluating conditions like craniosynostosis and fibrous dysplasia in children.
Area of Science:
- Medical Imaging
- Paediatric Radiology
- Craniofacial Disorders
Background:
- Computed tomography (CT) is the standard for diagnosing and monitoring paediatric craniofacial disorders.
- Concerns exist regarding the long-term effects of ionizing radiation, particularly in children's head and neck regions.
- Sensitive organs in the head and neck have limited soft tissue protection, increasing radiation risks.
Purpose of the Study:
- To review the utility of "black bone" MRI sequences in paediatric craniofacial pathologies.
- To highlight the potential of "black bone" MRI to reduce ionizing radiation exposure in children.
- To discuss the technical aspects, advantages, and limitations of this imaging technique.
Main Methods:
- Review of clinical experience utilizing "black bone" MRI sequences.
- Application in children with diverse craniofacial conditions, including trauma, craniosynostosis, fibrous dysplasia, and Langerhans cell histiocytosis (LCH).
- Detailed technical discussion of "black bone" sequence parameters, including low flip angles and short echo time (TE).
Main Results:
- "Black bone" MRI demonstrates significant promise as an alternative to CT for craniofacial imaging.
- The technique is effective in visualizing various osseous and fibro-osseous lesions.
- Potential pitfalls and limitations of the "black bone" sequence are identified and discussed.
Conclusions:
- "Black bone" MRI is a valuable tool for evaluating paediatric craniofacial disorders, offering reduced radiation exposure.
- This technique provides a viable alternative to CT, especially in radiosensitive paediatric populations.
- Further understanding of technical aspects and limitations will optimize its clinical application.
Abstract:
For decades, CT has been the primary imaging modality for the diagnosis and surveillance of paediatric craniofacial disorders. However, the deleterious effects of ionising radiation in the paediatric population are well established and remain an ongoing concern. This is especially so in the head and neck region, which has relatively poor soft tissue shielding with many radiosensitive organs. The development of "black bone" imaging utilising low flip angles and short echo time (TE) has shown considerable promise in alleviating the use of ionising radiation in many cases of craniofacial disorders. In this review article, we share our experience of utilising "black bone" sequence in children with craniofacial pathologies, ranging from traumatic injuries to craniosynostosis and focal osseous/fibro-osseous lesions such as fibrous dysplasia and Langerhans cell histiocytosis (LCH). A detailed discussion on the technical aspects of "black bone" sequence, including its potential pitfalls and limitations, will also be included.
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