Diagnostic and Interventional Radiology

Radiology, both diagnostic and interventional, plays a key role in the management of diseases involving a native liver or a graft, contributing to the diagnosis, treatment, and follow-up of pediatric patients with liver diseases. The diagnostic radiology can provide indirect information on the staging and complications of chronic disease and the detection of benign and malignant focal liver lesions and can offer a detailed preoperative planning, revealing the vascular and biliary anatomy of the patient. It is important that radiologists are adequately prepared in the management of pediatric patient both for the specific knowledge and for the adequate interaction required by these patients. Children, often very young, have a low compliance during examinations, and if for CT, MRI, and interventional procedures anesthesia is provided, during the ultrasound they are awake and afraid. For this reason it is necessary to have adequate time to reassure them and make the environment comfortable with heated rooms and sonographic gel, to allow the examination be the most appropriate. The second important skill is “ad hoc” specialization, since children are not small adults. Furthermore, in pediatric liver transplantation centers, the presence of interventional radiology is fundamental, which allows less invasive approach in cases once considered of exclusive surgical relevance, such as biliary complications after transplantation. Nowadays, these cases can be treated by interventional radiologists with less risk, less pain, and faster recovery time, improving patient’s care and outcome.