RADIOLOGY The Department of Radiology provides a full spectrum of imaging services as well as minimally invasive image-guided procedures to all clinical divisions at Connecticut Children’s. The department participates in the Image Gently Alliance, seeking to minimize radiation while utilizing best practice standards and American College of Radiology (ACR) Appropriateness Criteria® to provide optimal diagnostic imaging for children. Imaging modalities range from digital radiography to complex magnetic resonance imaging. The department is accredited through the American College of Radiology in Ultrasound, CT and MRI. Image-guided procedures are performed on site at Connecticut Children’s with support from the divisions of Anesthesia and Sedation improving delivery of care in a pediatric-friendly environment. Interventional radiologists perform these diagnostic and interventional services on a 24/7 basis, providing uninterrupted care to the children we treat. Covid-19 presented challenges to hospital systems throughout the country. The division of Radiology at Connecticut Children’s in conjunction with the divisions of Infectious Diseases and Quality and Safety proactively followed best practices to keep our Imaging Department safe and accessible to our patients. Radiology was able to seamlessly transition without interruption from only urgent elective imaging back to elective imaging. Our priority is always focused on balancing optimal image quality with dose reduction strategies throughout the department. Digital radiography and low-dose imaging equipment, such as the EOS scoliosis technology in our Orthopaedic department, help us achieve these goals. This year we were able to retrofit our last analog radiographic room, which is located in Glastonbury, to digital technology with a marked improvement in reducing dose.
The Ultrasound division offers extended appointments at our Hartford campus on weekdays and on the weekends to meet the needs of our patients and their families. Ultrasound imaging by our subspecialty-trained sonographers is also available at our Farmington and Danbury locations, allowing the community greater access to these expertly performed examinations. Contrast-enhanced ultrasound using microsphere bubbles assists our radiologists in the evaluation of vesicoureteral reflux or characterization of lesions in the liver without the need for radiation or sedation.
imaging and vascular imaging and specialized imaging of the bowel and urinary tract (MR enterography and urography) have been optimized for our pediatric patients. Child friendly movies allow children to undergo their MRI study comfortably without sedation whenever possible and decrease the need for sedation or anesthesia. For more technically challenging or lengthy studies and procedures, the Sedation Service, Department of Anesthesia, and the Child Life Team offer outstanding resources to help our children undergo MRI or CT examinations.
Fluoroscopy is an important modality used in radiology to assist pediatric providers in the assessment of their patients. This examination is performed at the Hartford campus using a Siemens flat-panel fluoroscopy unit with pulsed fluoroscopy, allowing for significant radiation dose reduction with improved image quality. This equipment is in alignment with our philosophy to “Image Gently and Step Lightly” to allow our team to provide appropriate imaging while reducing as much as possible the patient’s exposure to ionizing radiation. This year allowed us to add dose metrics for fluoroscopy exams to our dose monitoring software, Radimetrics.
Education is a major component of the activities of the Division of Pediatric Radiology. Residents from the Hartford Hospital, University of Connecticut, and St. Vincent’s Hospital Bridgeport radiology residency programs receive pediatric radiology training in our department. We also host elective rotations for UConn pediatric residents and pediatric subspecialty fellows as well as UConn and Quinnipiac University medical students. Additionally, the department engages in the education of sonography and radiography technology students. Didactic lectures and case presentations provide teaching to our residents, medical students, and radiology staff. Clinical care and teaching conferences are held in collaboration with the divisions of Pulmonary Medicine, Gastroenterology, Endocrinology, General Surgery, Hematology-Oncology, Orthopaedic Surgery, Rheumatology, Urology/Nephrology, and Critical Care. Through these activities, the Department of Radiology seeks to deliver optimized, patient- and family-centered care to the children we serve.
Computed Tomography continues to have a significant role in children with orthopaedic, neurologic, pulmonary or abdominal conditions. Every child is different and our CT scanning techniques are monitored to ensure dose optimization for children of all sizes. When feasible, the techniques are modified to allow imaging without the need for sedation or general anesthesia. We continue to participate in the American College of Radiology Dose Index Registry, which enables us to benchmark our CT doses with other facilities. The MRI department offers state-of-the-art facilities with both 1.5T and 3T field strength units at Connecticut Children’s Hartford campus. The availability of a 3T MRI system provides advanced cardiac imaging and neuroimaging (functional imaging, diffusion tensor imaging, and perfusion imaging of the brain). Liver fat and iron quantification and stiffness assessment (elastography) as well as advances in whole body
PUBLICATIONS Lepus CA, Karasik MS, Moote D, Hyams J. Electrocautery incisional therapy for an atypical esophageal stricture in a previously healthy patient. J Pediatri Gastroenterol Nutrit. 2020 Oct. Epub ahead of print. doi: 10.1097/MPG.0000000000002971. Sharma I, Moote D, Campbell BT. Concussion of the colon: paediatric patient with traumatic cecal haematoma. BMJ Case Rep. 2020 Dec; 13(12):e236066, doi: 10.1136/bcr-2020-236066.
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