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My son now 8 months old was diagnosed as a possible case of…

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My son now 8 months...
My son now 8 months old was diagnosed as a possible case of BPS(Bronchopulmonary Sequestration) since his heart was more pushed towards the center. Through out the pregnancy we are frequently subjected to ultra-sound to monitor this. The size of this possible BPC was reducing after 27 weeks, after sometime was not visible in ultrasound. He was fine during the birth and after. Doctors did an ultra sound immediately after birth and did not find anything concrete and suggested there is no immediate problem, it is advisable to do a scan after 7 - 10 months. Now Doctors are suggesting he should be subjected to CT scan to further understand his issue. We are worried about subjecting this little baby to CT scan because of radiation risks. We want to understand whether it is advisable to do MRI, I can see MRI might take longer to complete. We are also worried about General anesthesia risks. Please suggest your recommendation for CT vs MRI and GA Risks. Also your advise on the timing of taking these scans whether it too early or can we delay it.
Submitted: 10 months ago.Category: Pediatrics
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Answered in 31 minutes by:
10/5/2017
Pediatrician: Richard Han, Board Certified Pediatrician replied 10 months ago
Richard Han
Richard Han, Board Certified Pediatrician
Category: Pediatrics
Satisfied Customers: 1,132
Experience: Pediatrician with over 15 years experience
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Pediatrician: Richard Han, Board Certified Pediatrician replied 10 months ago
Thank you for waiting and the meticulous details of your baby’s condition. To address the question of imaging modality, currently CT scan is the preferred method. For infants, radiation levels can be lowered compared to adult exposures and CT provides enhanced images particularly when it comes to thin walled cysts and emphesematous or “air bubbly” changes. MRI can image BPS and does avoid radiation but it can miss the above, takes longer, is much louder and may require deeper sedation and is very sensitive to even slight movements which can distort the image. CT is faster, quieter, a little more preciseand shouldn’t require full general anesthesia. Babies your child’s age usually are put under “conscious sedation” which is a lesser level of anesthesia where they are essentially in a deep sleep and breathing on their own. Timing of the imaging is classically done between 6-12 months which is right where your baby is at now. If he is completely asymptomatic, in other words, feeding and growing well with no respiratory difficulties, an argument can be made to wait until 12 months but then conscious sedation is less effective and a deeper form of anesthesia would be necessary. All in all, I tend to agree with your current medical team as to the timing and method of evaluation your son’s BPS.
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