Chern Joshua,  Urbine Jaqueline,  Mallon Mea,  Kazmi Faaiza,  Malik Archana,  Poletto Erica,  Faerber Eric

Final Pr. ID: Poster #: EDU-110

Sickle cell disease is a common inherited disorder due to a structural abnormality in hemoglobin affecting the shape of the red blood cells. There are a variety of manifestations of this disease affecting a multitude of different organ systems. Some of the complications with the highest morbidity are those involving the central nervous system, and thus, the radiologist plays a pivotal role in the clinical management of these patients. It is important for the radiologist to understand the disease process, the radiologic manifestations, and the screening modalities available. Read More

Authors:  Chern Joshua , Urbine Jaqueline , Mallon Mea , Kazmi Faaiza , Malik Archana , Poletto Erica , Faerber Eric

Keywords:  Moya moya, Aneurysm, CVA, Stroke, Infarction

Acosta-izquierdo Laura

Final Pr. ID: Poster #: EDU-006

Abdominal aortic pathology is uncommon in the pediatric population. It is a complex clinical condition that can range from aneurysms to stenosis and can present in the emergency department as a life-threatening condition or as an incidental finding in elective studies. As radiologists, knowing the underlying conditions of abdominal aortic pathology can help clinicians narrow the differential diagnosis and provide early and focused treatment, as most of these cases represent a therapeutic dilemma. The purpose of this educational exhibit is to overview the embryology and normal anatomy of the abdominal aorta and to provide a comprehensive review, through cases, of the different causes of abdominal aortic aneurysms and middle aortic syndrome. Read More

Authors:  Acosta-izquierdo Laura

Keywords:  Aneurysm, Stenosis, Aorta

Wallace Andrew,  Raptis Demetrios,  Bhalla Sanjeev

Final Pr. ID: Poster #: EDU-001

This case-based, pictorial, educational exhibit will:
1. Examine the predisposing conditions of thoracic aortic aneurysm (TAA) in children
2. Illustrate the histopathologic and imaging features of these conditions
3. Demonstrate proper technique for measuring and reporting aortic dimensions in children
4. Review treatment options for TAA and how treatment depnds on the underlying disease and imaging findings Read More

Authors:  Wallace Andrew , Raptis Demetrios , Bhalla Sanjeev

Keywords:  Aneurysm, Aorta, Thoracic

Tan Timothy Shao Ern,  Woon Tian Kai,  Fortier Marielle

Final Pr. ID: Poster #: EDU-007

Congenital coronary artery (CA) anomalies can be classified into abnormalities pertaining to origin, course and termination, which can serve as important prognostic factors. Some of these anomalies are asymptomatic with a benign clinical course, while others can give rise to symptoms of chest pain and even sudden death (e.g. malignant interarterial CA course). Acquired CA abnormalities such as coronary arterial aneurysms associated with Kawasaki disease may result in thrombi development, necessitating a change in patient management. Early and accurate diagnosis of these abnormalities is therefore crucial but can be technically challenging owing to the small size of the coronary arteries, rapid heart rate, and limited cooperation of children. Whilst the proximal aspect of the coronary arteries can be visualized with echocardiography, computed tomography angiography (CTA) provides a more comprehensive assessment of the coronary arteries even without ECG-triggering. Moreover, CTA offers the flexibility of customizing acquisition parameters for the individual patient. As such, CTA is rapidly becoming the imaging modality of choice for evaluating complex congenital and acquired CA abnormalities in children.

The aims of this educational exhibit are to review the embryology of coronary arteries, outline congenital and acquired CA abnormalities, and discuss the utility of optimizing low-dose CTA to evaluate these abnormalities in children. Determining the origin and course of CAs is key for pre-operative planning in some types of congenital heart disease, for example, the arterial switch procedure for transposition of great arteries and in Taussig Bing anomaly. Identifying the malignant interarterial intramural CA course can be lifesaving. Evaluating for co-existing abnormalities, such as CPAM, is also an integral part of these studies. Read More

Authors:  Tan Timothy Shao Ern , Woon Tian Kai , Fortier Marielle

Keywords:  Coronary artery, Computed tomography, Aneurysm

Gagnon Marie-helene,  Richer Edward,  Alazraki Adina

Final Pr. ID: Poster #: CR-030

A 16 year old previously healthymale patient who initially presented with daily recurrent fevers and chills lasting 5-10 minutes. His parents brought him to a tertiary care hospital after developing vomiting and weight loss in the setting of progressively worsening fevers. Initial work up was remarkable for elevated CRP and a negative infectious workup. An MR enterography ordered to evaluate for a cause of weight loss demonstrated incidental lung base lesions. Follow up CTA revealed a lesion within the right ventricle and multiple lung nodules, concerning for endocarditis and septic emboli. He underwent two surgical resections over two months for the ventricular mass. Pathology revealed findings consistent with necrotizing endocarditis. During his hospital course, he was found to have a left cephalic venous thrombosis and was placed on Xarelto, later developing a right subclavian vein thrombus while on anticoagulation. He was readmitted 1 month later after presenting for right chest and right upper quadrant pain. Initial chest X-ray revealed right lower lobe mass and follow up CTA revealed two large right pulmonary artery pseudo-aneurysms. He underwent cardiac catheterization for pre-operative coiling of the pseudo-aneurysms and subsequent right lower lobectomy. Pathology revealed necrotizing arteritis and pulmonary artery pseudo-aneurysms. Based on clinical presentation and further work up, he was diagnosed with Hughes Stovin Syndrome and started on Cytoxan and Apixaban. While not yet considered in remission, his symptoms have improved since initiating treatment.

Hughes Stovin Syndrome (HSS) is a rare disorder characterized by thrombophlebitis as well as multiple pulmonary and/or bronchial aneurysms. There is a male predilection, usually presenting between 12-48 years. There have been less than 40 cases published in the English literature. HSS is thought to be a variant of Bechet’s but does not present with oral or genital ulcers. The lack oral and genital ulcers in this patient excluded a diagnosis of Bechet’s. The underlying cause of HSS is unclear but is believed to be due to angiodysplasia or infection. Since there is no formally described diagnostic criteria, the clinical presentation of thrombophlebitis with pulmonary artery aneurysms characterize the disease.

We present this case to illustrate the clinical presentation of a rare and possibly under recognized syndrome. Read More

Authors:  Gagnon Marie-helene , Richer Edward , Alazraki Adina

Keywords:  Vasculitis, Aneurysm, Thrombophlebitis

Molloy Christopher,  Merchant Michelle,  Chiang Michael,  Peng Lauryn,  Lew Wesley,  Shaul Donald

Final Pr. ID: Poster #: EDU-094

-Review causes of pediatric abdominal aortic aneurysm (AAA)
-Optimize imaging in evaluation of pediatric AAA, including imaging of complications
-Discuss medical management and definitive treatment of pediatric AAA Read More

Authors:  Molloy Christopher , Merchant Michelle , Chiang Michael , Peng Lauryn , Lew Wesley , Shaul Donald

Keywords:  Aneurysm, Aorta, Vascular

Stein Nina,  Ahmed Fahran

Final Pr. ID: Poster #: CR-066

We present a radiologic case of a teenager with portal, inferior mesenteric, superior mesenteric, and splenic vein thromboses presenting with acute abdominal pain and treated conservatively with anticoagulation therapy. Ultrasound and computed tomography were done at the acute presentation and follow up magnetic resonance images were performed. One year of anticoagulation therapy correlated with almost complete resolution of splanchnic thrombosis; however, the superior mesenteric vein continues to remain severely dilated close to the confluence on subsequent annual imaging. The initial imaging also diagnosed multiple phlebolith in the pelvis. We suspect this is a congenital malformation of the porto-splanchnic circulation presenting with acute thrombosis. Differential is variceal dilatation as sequela of extensive thrombosis. Read More

Authors:  Stein Nina , Ahmed Fahran

Keywords:  Splanchnic Venous Thrombosis, Portal Venous Aneurysm, Mesenteric Vein Thrombosis, Portal Vein Thrombosis, Anticoagulation