CONTRIBUTION OF COMPUTED-TOMOGRAPHY AND M AGNETIC-RESONANCE-IMAGING OF THE CHEST TO THE MANAGEMENT OF PEDIATRIC INTENSIVE-CARE PATIENTS

Although the plain chest film remains the pivotal investigation in int ensive care patients, the diagnostic and topographic information provi ded by computed tomography and magnetic resonance imaging warrants tra nsportation to the radiology unit of some patients with complex condit ions. Computed tomography is useful in infections involving the lung p arenchyma, pleural cavities, and mediastinum; mediastinal space-occupy ing lesions with compression of the airways; poorly tolerated congenit al pulmonary defects amenable to limited surgical treatment (e.g., ade nomatoid malformations); and multiple injuries in which prompt evaluat ion of lesions is essential. The main indications for magnetic resonan ce imaging include aortic arch compression, congenital cardiovascular defects, and poorly tolerated space-occupying lesions of the cardiac c hambers or pericardium (m combination with echocardiography). In patie nts with compression due to a mediastinal space-occupying lesion, the topography of the lesion in the three dimensions can be accurately eva luated.