Week 7 - Jada

 Jada Okaikoi | Clinician Mentor: Dr. Jiwon Kim 

This week, I continued working on my research project by segmenting CT scans of the right ventricular wall of the heart. This process has required careful attention to anatomical detail, as each scan presents its own challenges depending on image quality and patient-specific variation.

Outside of research, I had the opportunity to shadow Dr. Arzu Kovanlikaya in pediatric radiology. I observed a wide range of cases, primarily using ultrasound imaging. These included cranial ultrasounds to identify intraventricular hemorrhage in infants, pelvic and sacral ultrasounds to evaluate the spinal cord, and abdominal ultrasounds to assess for conditions such as fatty liver disease. One case that stood out was a hip ultrasound performed to screen for developmental dysplasia of the hip. Screening is performed within the first few weeks to months of life because an infant's hip is still largely made of cartilage and can often be guided into normal development with a brace, such as a Pavlik harness, if instability is detected early. As a child grows, the hip becomes more ossified, making ultrasound less useful. Older children are instead evaluated with X-rays, and untreated dysplasia may require closed or open surgical reduction and, in some cases, corrective osteotomies rather than simple bracing.

I also observed a voiding cystourethrogram, a fluoroscopic imaging study used to evaluate the bladder and urethra. During the procedure, a small catheter is inserted into the bladder through the urethra, and contrast material is instilled to fill the bladder. Real-time X-ray images are obtained while the bladder fills and again as the patient urinates. This allows physicians to determine whether urine is flowing backward from the bladder into the ureters or kidneys, a condition known as vesicoureteral reflux, and to identify structural abnormalities or urethral obstruction. Watching the study emphasized how dynamic imaging can reveal functional problems that would not be apparent on static images alone.

Overall, this experience broadened my appreciation for pediatric imaging and highlighted how imaging strategies are tailored not only to the organ being evaluated but also to a patient's age and stage of development. 

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