THE HOSPITAL FOR
SICK CHILDREN
Pediatric Cardiac Imaging Fellowship – Goals and Objectives
DEFINITION OF PEDIATRIC CARDIAC IMAGING
Pediatric cardiac imaging is the organ/system-based subspecialty of Diagnostic
Radiology dedicated to diagnosis of disorders and diseases of the heart in children
utilizing different imaging techniques.
TRAINING YEAR SPECIFIC OBJECTIVES
General Goals and Objectives Pediatric Cardiac Imaging Training:
1) Medical Expert:
1.1) Understand normal cardiovascular anatomy on chest radiograms,
angiocardiograms, echocardiograms and MR images.
1.2) Learn how to customize angiocardiographic views and MR and CT
techniques, and to supervise technologists.
1.3) Learn the concept of sequential segmental approach to congenital heart
diseases.
1.4) Learn a general classification of congenital cardiac malformations.
1.5) Learn lesions causing high output congestive heart failure and an approach
to their evaluation.
1.6) Understand the basics of acquired heart diseases in children, including
cardiomyopathies, arrhthmogenic right ventricular dysplasia, pericarditis,
Kawasaki disease, and Takayasu arteritis.
1.7) Learn the general principles of medical and surgical management of the
pediatric cardiovascular patients.
1.8) Develop the ability to determine if chest radiograms are technically adequate.
1.9) Learn a systematic approach to chest radiograms of patients with pediatric
cardiovascular disease.
1.10) Learn a general approach to chest radiograms of PICU patients.
1.11) Learn the more pertinent radiologic features of the more common anomalies.
1.12) Develop an ability to recognize major emergency cardiothoracic problems on
chest radiograms, including heart failure, pulmonary edema, total or partial
lung collapse, pulmonary thromboembolism, air trapping, pulmonary
interstitial emphysema, pleural effusion, pneumothorax, and abnormal
placement of various lines and tubes.
1.13) Learn the major palliative and corrective surgeries and postoperative
radiologic signs.
The Hospital for Sick Children
555 University Ave, Toronto, Ontario
Canada M5G 1X8
www.sickkids.ca
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1.14) Develop the ability to direct technologists to correct problems with chest
radiograms.
1.15) Understand the advantages and disadvantages of conventional
angiocardiography, echocardiography, CT and MR in evaluation of
cardiovascular diseases in children.
1.16) Identify the proper indications of computed tomography in pediatric
cardiology.
1.17) Develop the aility to prescribe CT imaging and contrast enhancement
protocols in various discease conditions using least amount of radiation.
1.18) Identify the proper indications of cardiovascular magnetic resonance imaging
in pediatric cardiology.
1.19) Identify the contraindications to magnetic resonance imaging.
1.20) Understand the utility of the basic magnetic resonance sequences including:
cine white blood pool, double inversion recovery black blood, phase-contrast
velocity mapping, myocardial delayed enhancement and myocardial tagging
sequences.
1.21) Understand pathology and imaging of ventricular septal defects.
1.22) Learn the diagnosis and differentiation of vascular rings and the pulmonary
sling complex.
1.23) Develop the ability to analyze abnormalities on MR and CT in sequential
segmental manner.
1.24) Learn the cardiac associations with types of situs.
1.25) Understand the anatomy and physiology of the single ventricle and the role of
MRI both pre and post operatively.
1.26) Develop the ability to correlate abnormal findings seen on imaging with
clinical and surgical features and significances.
1.27) Consolidate skills for conferences and consultations.
1.28) Begin to present cases in the clinical conferences and to develop consultation
skills.
1.29) Develop the ability to teach pediatric cardiovascular imaging to residents and
junior fellows.
1.30) Develop clinical research skills and present / publish a paper on pediatric
cardioivascular imaging.
2) Communicator:
2.1) Trainees will be responsible for explaining the procedure to the patient/family,
including the risks of possible complications and answering questions.
3) Collaborator:
3.1) Gain experience in reviewing pediatric cardiac cases brought to attention by
clinicians on a daily basis.
3.2) Enhanced through obtaining the appropriate history to guide decisions
regarding the best imaging modality to pursue imaging investigation.
The Hospital for Sick Children
555 University Ave, Toronto, Ontario
Canada M5G 1X8
www.sickkids.ca
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3.3)
Responsible for communicating requests for further imaging to imaging
technologists.
4) Manager:
4.1) Gain experience in screening and protocoling of CTs and MRIs in the
pediatric cardiac context.
4.2) Learn how to prioritize studies.
4.3) Gain expertise in the proper steps in imaging investigation of pediatric cardiac
pathologies.
4.4) Develop skills to become increasingly responsible for cardiac imaging,
including proper delegation of authority to residents and technologists.
5) Health Advocate:
5.1) Gain expertise in the selection of appropriate tests or follow-up studies from
discussion with referring doctors and consultants.
5.2) Take into consolidation the benefits/risks of procedures, in consultation with
referring doctors.
5.3) Gain expertise in guiding referring clinicians to the imaging study or studies
most appropriate for their patients.
6) Scholar:
6.1) One academic day is assigned per week for trainees to pursue research
projects.
6.2) Research activity done at The Hospital for Sick Children.
6.3) Publish scientific papers.
6.4) Present work at Radiology meetings.
6.5) It is expected that the resident will prepare at least one manuscript for
presentation and/or publication, and will actively participate in the teaching of
radiology residents and residents from other clinical services.
6.6) Attend and present at various clinical rounds, including:
6.6.1) Normal cardiovascular anatomy for imaging: 2 sessions.
6.6.2) Concept of sequential segmental approach to congenital heart
disease: 2 sessions.
6.6.3) Plain film interpretation of congenital heart disease: 2 sessions.
6.6.4) Plain film interpretation of congenital heart disease in neonates.
6.6.5) Interpretation of PICU chest radiograms.
6.6.6) Ventricular septal defects: pathology and imaging.
6.6.7) Cardioivascular MR in children: 2 sessions.
6.6.8) Imaging of cyanotic congenital heart disease: 2 sessions.
6.6.9) Vascular rings, slings and things.
6.6.10) Cardiomyopathies and cardiac tumors.
6.6.11) Weekely presurgical conference
7) Professional:
The Hospital for Sick Children
555 University Ave, Toronto, Ontario
Canada M5G 1X8
www.sickkids.ca
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7.1)
Incorporate ethical practice, professional regulation and high personal
standards of behaviour.
The Hospital for Sick Children
555 University Ave, Toronto, Ontario
Canada M5G 1X8
www.sickkids.ca
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