Diagnostic imaging has developed dramatically in recent years. More and more strategies for evaluating and caring for childhood illness include imaging. In many cases the question is no longer, "Is there an imaging study that can help me to care for my patient?," but rather, "Which imaging study will provide the most information at the lowest risk and for the lowest cost?."
Imaging options for the evaluation of children now include at least seven different modalities. Each of these modalities has advantages and disadvantages, and most have risks that must be considered when choosing a study. As new data are acquired, new imaging recommendations are developed. At the same time the modalities continually develop, further impacting imaging strategies. Choosing the appropriate study may be as challenging as interpreting the images. This challenge is shared by the pediatrician and the imager.
In this issue of Pediatric Annals pediatric radiologists from the Cincinnati Children's Hospital Medical Center share their knowledge on using imaging in different areas of pediatric care. Rather than an overview of broad areas in imaging, we have chosen to provide a more indepth understanding of a group of specific topics.
Each of the five articles in this issue addresses imaging from a different perspective. Two address computed tomographic scanning: Dr. Guillerman and I review the radiation risk from diagnostic imaging; Dr. Altes seeks to decrease confusion about technical terms and to increase understanding of the applications of this widely used modality. A specific anatomic area, the central nervous system, is the subject of the article by Drs. Halsted and Jones that emphasizes the advantages and disadvantages of different modalities, and then provides specific imaging recommendations for common clinical situations. A clinical entity, child abuse, is the subject of the article by Dr. Care. The final article by Dr. Guillerman introduces the use of guidelines to develop an imaging strategy. The evaluation of pyloric stenosis provides an example of the development of an evidence-based clinical guideline.
Readers will notice that there are fewer images in these articles than is often the case with articles on imaging. This reflects our belief that the best use of imaging in the health care of children requires a team approach. Our goal in this issue is to provide our pediatric colleagues with information that can help them plan an imaging evaluation, rather than concentrating on the process of interpreting the images. We hope that these articles will benefit the team of clinician and imager and through their care provide the best for our patients and their families.