For an MRI, a patient lies on a table that is rolled into a machine. The machine surrounds them on all sides, like a tube. (Open MRI machines exist for people who are very anxious in a regular MRI machine.) The MRI is painless, but the machine makes loud noises. Your child may use earplugs or a headset during the MRI. They must be able to lie completely still, and some children require sedation to do this. The MRI usually takes 1-2 hours. Often, a dye is injected into a vein to improve the MRI images. Because they use strong magnets, MRI machines cannot have metal objects inside them. Before an MRI, your child will be asked to remove all metal objects such as jewelry and clothes with metal snaps or zippers. An MRI does not expose your child to any form of radiation.
ULTRASOUND Ultrasound is a technique that uses the echoes from high- frequency sound waves to produce a picture of internal organs or tumors. It has many uses, including finding tumors in the belly, checking the health of the kidneys and bladder, and measuring the size of some organs (like the liver, gall bladder, and spleen). A type of ultrasound that looks at the way blood flows and the condition of the blood vessels, Doppler , can be used to diagnose clots in blood vessels. An ultrasound is a painless test that does not use radiation. The child lies on a table for a short time, and a clear jelly is smeared on the area being examined. (The jelly wipes off easily after the test.) A small, round handle is moved around on the jelly to get a clear picture of the tissue or organ being examined. Depending on the location of the ultrasound, the child may not be allowed to eat or drink for several hours or may need to have a full bladder before the test.
TESTICULAR BIOPSY This test will be done if your doctor thinks that leukemia may be in the testicles. Typically, testicular involvement is suspected if there is a painless enlargement of the testicle. If there is not an enlargement of the testicle and the child has not yet entered puberty, a biopsy likely will not be performed. To obtain the biopsy, a needle is inserted into the testes to remove a small sample of tissue that will be examined under a microscope to look for leukemia cells. This is done in the operating room while your child is asleep. Only a small percentage of boys have testicular disease at initial diagnosis. If your child is diagnosed with testicular disease, your healthcare team will discuss fertility preservation options (like sperm banking) with you.
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