Infante Juan

Final Pr. ID: Poster #: CR-014

Urinary bladder injuries are classified based on intraperitoneal versus extraperitoneal location. Intraperitoneal lacerations are associated with a higher risk of sepsis and tend to be large and are therefore treated with prompt surgical exploration and repair. In contrast, extraperitoneal bladder ruptures are commonly managed conservatively via simple catheter drainage with healing commonly achieved between 10 days and 3 weeks. However, lower urinary tract injuries are an exception to the rule which also require emergent intervention.

The subject of this case report is an 8-year old girl that suffered lacerations to the bladder neck, bladder trigone, and pelvic floor during a motor vehicle collision. The initial contrast-enhanced phase demonstrated bladder wall thickening and intraluminal blood clot. Bladder rupture was not directly apparent until the patient was called back for a delayed scan of the pelvis which showed contrast extravasation from the trigone pooling around retroperitoneal spaces including the mesorectal fascia surrounding the rectum and the presacral space. Although these are not intraperitoneal locations, the radiologist should be aware that lacerations involving the bladder neck and lower urinary tract warrant immediate surgical consultation.

Lower urinary tract injuries are sufficiently uncommon that an experienced urologist may encounter only a handful during their career. This case report highlights the anatomic spaces in the pelvis that are necessary to troubleshoot the likely location of a bladder injury and that the lack of intraperitoneal pooling of contrast should not distract from the emergent nature of this rare injury. The common association of lower urinary tract injury with pelvic floor disruption is also highlighted in this case as the patient had lacerations and pooling of contrast extending along the vagina and into the labia. Finally, the importance of delayed excretory phase imaging in the setting of pelvic trauma is emphasized to allow for the prompt diagnosis of bladder trauma. Read More

Authors:  Infante Juan

Keywords:  trauma, bladder, pelvic anatomy

Fuortes Michaelangelo,  Vijapura Charmi,  Dennhardt Joel,  Policeni Bruno,  Sato Yutaka,  Sato T Shawn

Final Pr. ID: Poster #: EDU-104

1) Review the normal development and anatomy of the middle cranial fossa.
2) Describe the variety of pathologies affecting the middle cranial fossa in the pediatric age group with a focus on the typical computed tomography (CT) and magnetic resonance imaging (MRI) characteristics.
3) Discuss clinical management and imaging follow up of middle cranial fossa pathology. Read More

Authors:  Fuortes Michaelangelo , Vijapura Charmi , Dennhardt Joel , Policeni Bruno , Sato Yutaka , Sato T Shawn

Keywords:  skull base anatomy, skull base pathology, middle cranial fossa

Lacroix Caroline,  Ahyad Rayan,  Manson David

Final Pr. ID: Poster #: EDU-107

Pulmonary haemorrhage in children is a non-specific response to a number of varying insults. Many of these insults favour particular anatomic foci along the pulmonary and bronchial arterial trees respectively. Although recent years have seen an emerging interest in the understanding and classification of pulmonary vasculitides, this pathophysiology represents only one subset of the causes of pulmonary haemorrhage in children. Our purpose is to review the imaging and pathophysiologic manifestations of varying causes of pulmonary haemorrhage according to the anatomic region of susceptibilities in the pulmonary arterial and bronchial artery trees.

We aim to provide a perspective of imaging manifestations of the pathophysiologies of pulmonary haemorrhage displayed schematically according to their relative anatomic areas of susceptibility. We aim to focus on useful constellations or associated findings that will serve to help the reader differentiate amongst entities that often have otherwise similar imaging presentation. Read More

Authors:  Lacroix Caroline , Ahyad Rayan , Manson David

Keywords:  haemorrhage, vasculitides, anatomy, pathophysiology, pulmonary

Southard Richard,  Ellsworth Erik,  Moe Tabitha,  Augustyn Robyn,  Thorkelson Marrit,  Bardo Dianna

Final Pr. ID: Poster #: EDU-090

The structure of the heart is more complex than 4 major chambers, 4 major valves, venous inflow and arterial outflow.

Muscular and soft tissue ridges, perforated membranes, tissue flaps, electrical pathways, external grooves, endocardial surface characteristics, and a core architecture structured of fibrous tissue and embryonic tissue remnants form distinguishing anatomic landmarks. These structures provide insight into cardiac development, serve physiologic purpose, define structural and functional elements, as well as offer prognostic information.

Specific details of cardiac anatomy may not be recognized on cardiac MR and CT examinations. Structural anomalies that affect cardiac function and anatomic or physiologic relationships may be abnormal in hearts with congenital malformations. The fine structural details of the heart are typically not part of an imagers search pattern and are therefore overlooked or underreported. Each minute structure and anatomic characteristic provides clues to errors in cardiac formation and may provide clinically relevant diagnostic information. After palliation of CHD defining anatomic structure may be lost, displaced, interrupted or even restored.

Important processes, corresponding anatomic landmarks, and effects of malformation in defining congenital heart disease anatomy, physiology and functional variation from normal include basal structures such as the central fibrous body of the heart, atrial structures including the crista terminalis, the sinus venarum, and eustacian valve, and ventricular structures such as the crista supraventricularis.

Each structure is described along with its normal location, anatomy functional and physiologic importance, the effect of congenital malformation, and imaging findings as in the example of the central fibrous body (table 1).

Minute cardiac anatomy will be shown in illustration as well as in CT and MR images (figure 1). Read More

Authors:  Southard Richard , Ellsworth Erik , Moe Tabitha , Augustyn Robyn , Thorkelson Marrit , Bardo Dianna

Keywords:  Cardiac anatomy, Cardiac MR, Cardiac CT, Congenital heart disease, Embryology

Malkawi Ibraheem,  Bloom David,  Hryhorczuk Anastasia

Final Pr. ID: Poster #: EDU-036

Describe the normal anatomic appearance and anatomic variants of the pediatric coracoid process with representative images.
Evaluate the radiologic fracture patterns and fracture mimics of the pediatric coracoid process with representative images.
Review additional pathology of the pediatric coracoid process that can present incidentally after trauma

Included topics :
I Coracoid process anatomy
Normal pediatric development/ossification
Developmental variations
Associated anatomic structures

II. Sequelae of coracoid process trauma
Multimodality imaging—radiography, CT, MRI
Pediatric fracture patterns
Mimics of fractures

III. Incidental findings of the coracoid process
Neoplasm
Other Read More

Authors:  Malkawi Ibraheem , Bloom David , Hryhorczuk Anastasia

Keywords:  shoulder anatomy, coracoid process, trauma

Acosta-izquierdo Laura,  Dien-esquivel Maria,  Miller Elka,  Ferretti Emanuela,  Martinez-rios Claudia

Final Pr. ID: Poster #: EDU-017 (S)

Extremely low gestational age (ELGA) infants are those born before 23 + 6 weeks of gestation. Continued advances on therapy and supportive care in the neonatal intensive units have allowed for an improved survival of these infants. Transfontanellar brain ultrasound (US) is the standard of care imaging modality to assess the integrity of the brain during the first weeks of postnatal life, as it provides a closer direct look to the brain. The purpose of this exhibit is to illustrate detailed US characteristics of the normal development and complications of the evolving premature brain of ELGA infants. Read More

Authors:  Acosta-izquierdo Laura , Dien-esquivel Maria , Miller Elka , Ferretti Emanuela , Martinez-rios Claudia

Keywords:  Brain anatomy, Prematurity, Neurodevelopment

Cheeseman George,  Mack Marie,  Hook Marcus

Final Pr. ID: Poster #: EDU-100

The breadth of heterotaxy syndromes is a topic commonly covered in the education of radiology providers, however is often neglected in graduate medical education and in the scope of general pediatric practice. Although some heterotaxy syndromes are discovered incidentally, others can lead to severe morbidity and mortality secondary to congenital abnormalities including heart defects and intestinal malrotation. Early recognition of heterotaxy syndromes associated with severe congenital defects such as right-sided isomerism can help to reduce negative patient outcomes and lead to appropriate referral from an outpatient basis to the appropriate medical subspecialists. Conversely, knowledge of heterotaxy syndromes and associated clinical manifestations can aid in identifying which syndromes which are incidental and avoid further imaging work up or costly examinations for patients when not indicated. This exhibit aims to educate providers about the different classifications of heterotaxy syndromes with a focus on clinical features and recommended follow-up based on multidisciplinary guidelines. Read More

Authors:  Cheeseman George , Mack Marie , Hook Marcus

Keywords:  Heterotaxy, Isomerism, Anatomy