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Innovative Procedures |
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Here are some examples of the more unique tests and therapies performed at Children's Hospital Boston:
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Most MR machines take highly detailed pictures of internal tissues, so that physicians can see the anatomic structure of the brain and other organs or tissues. Functional MR (fMR) enables physicians to see how the body functions. For example, fMR taken of the brain lets physicians see the cerebral responses to stimulation in real time. When a patient is asked to move in a certain way, fMR enables physicians to see which area of the brain is responsible for performing that function.
At Children's Hospital Boston, fMR scanners are used in the diagnosis and treatment plan of neurological disorders such as epilepsy, stroke, cerebral palsy, brain tumors and brain injury, mental retardation, autism and learning disabilities. In addition, Children's researchers are using this tool to study learning disabilities, epilepsy, and hydrocephalus. See "A Window into the Living Brain", Dream Magazine Research Edition, 2005.
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A mobile MR, the first of its kind, is being used to assist surgeons in one of Children's Hospital's new operating rooms. This mobile "intraoperative MR," which is suspended from the ceiling, lets our surgeons scan patients before completing surgery to obtain the most precise and complete resection.
For example, after surgeons operate on a tumor, they can mobilize the MR unit from its garage where it normally resides, housed safely away from metal instruments. Images of the patient can be obtained and surgeons have the opportunity to reoperate immediately, if required, before the patient awakens. Unlike other intraoperative MR machines, the mobile MR lets surgeons use their usual metal surgical tools because the unit is moved into the shielded garage when surgeons are operating.
Click here to see a slide show taking you behind the scenes of Children's live Webcast from October 25, 2006, which featured the mobile MR.
The purchase of the MR/OR was made possible by a grant from The Klarman Family Foundation.
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Although PET scanning is available throughout the region, Children's Hospital Boston has the only PET scanner in New England devoted exclusively for use in children. The GE Advance NXi PET is particularly configured so that it is sensitive in detecting the tiniest abnormalities, an essential feature when performing studies on children. PET is a unique and highly sensitive imaging tool that generates three dimensional images of biochemical changes that are too subtle to detect by other means. Since these changes precede structural changes seen by traditional anatomic imaging, clinicians can typically diagnose disease earlier with PET. Utilizing materials called radiopharmaceuticals, PET enables visualization and measurement of several crucial processes, including glucose metabolism and blood flow.
Pediatric PET is extremely useful in the detection and treatment of cancer, neurological and cardiovascular conditions. Images obtained through PET can be digitally combined with anatomic images obtained through MRI and CT to provide the most precise information. For example, combining information in this way, a neurologist can see the exact location in the brain where a seizure originates or an oncologist can determine which parts of a tumor are growing most rapidly.
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Children's Hospital Boston performs more pediatric angiograms per year than any children's hospital in the United States. Pediatric angiography, a high-resolution x-ray exam of blood vessels, requires specialized skills and different catheter systems than angiography in adults. The radiologic, technical, nursing, and anesthesiology staff at Children's Hospital Boston is trained and experienced in all aspects of performing this examination and caring for our young patients. The interventional radiological staff is also trained and experienced in the use of advanced angiographic techniques for the treatment of certain disorders of blood vessels in children. Our angiographic equipment is state-of-the-art and capable of supporting the most sophisticated angiographic needs.
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Due to our large Vascular Anomalies Center, Children's Hospital Boston has extensive experience in interventional radiology techniques to treat vascular anomalies, which translates into less need for open surgery in children. Endovascular techniques use catheters and other small devices that can be manipulated within vascular channels for delivery of drugs and other occlusive materials. Our interventional radiologists, anesthesiologists, radiology technologists, and nurses are very familiar with these techniques and with care of patients undergoing these procedures.
One new endovascular technique used to treat some types of vascular malformations is endovenous laser ablation. This procedure enables our specially trained interventional radiologists to reduce the size of some vascular malformations and ease symptoms such as pain, swelling and disfigurement through a small incision. A diode laser fiber, introduced into the malformed veins through a catheter, creates energy that is absorbed by the blood within the abnormal blood vessels comprising the vascular malformation. This energy then generates steam bubbles within the blood. The steam bubbles transfer heat to the cells that line the walls of the blood vessel. This heat damages the abnormal blood vessel. Over several months following the procedure, the abnormal blood vessel eventually shrinks in size. Endovenous laser ablation is believed to result in a lower rate of formation of blood clots compared with other treatments currently in use for vascular malformations.
Sclerotherapy is another endovascular technique we specialize in. For this procedure, a medicine called a sclerosant, is directly injected into an abnormal blood vessel to cause clotting and shrinkage of the blood vessel. For more information about these procedures, see our interventional radiology division.
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