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

Mcgehee Arianna,  Wu Yen-ying,  Singh Jaspreet,  Mckinney Caleb,  Manalo Carlo

Final Pr. ID: Poster #: SCI-015

Midgut malrotation can lead to significant morbidity and even mortality if complicated by volvulus or obstruction related to Ladd bands. At our institution, it is routine practice to perform fluoroscopic upper gastrointestinal (UGI) exams to assess for intestinal malrotation prior to gastrostomy tube placement. We sought to determine if it is feasible to assess midgut rotation using any previous MRI exams that include the upper abdomen. We hope to remove the need for upper GI exams in patients with previous MRI exams, thus preventing unnecessary radiation exposure and overutilization of resources, prior to gastrostomy tube placement. Read More

Authors:  Mcgehee Arianna , Wu Yen-ying , Singh Jaspreet , Mckinney Caleb , Manalo Carlo

Keywords:  UGI, third portion of duodenum, SMA-aorta axis

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

Burns Madisen,  Cao Joseph,  Carrico Caroline

Final Pr. ID: Poster #: CR-001

Aortic calcifications are an uncommon finding in the pediatric population and when present are often reflective of underlying congenital heart or metabolic disease. Intraluminal polypoid calcified lesions (coral reef aorta) causing flow limiting stenosis are exceedingly rare in even the congenital heart disease population.
A 15-year-old patient with a history of hypoplastic left heart syndrome (HLHS) with mitral and aortic atresia. She was found to have significant flow limiting stenosis of the augmented neo-aorta under catheter hemodynamic assessment. CT angiography was performed showing a 4.4 cm partially calcified mass in the ascending aorta extending into the proximal arch causing an 80% narrowing of the aortic lumen. The intrinsic multi-energy capabilities of the first-generation photon counting CT (PCCT) scanner used permitted retrospective material decomposition and thus more definitive characterization of the mass. The patient underwent open ascending aorta replacement and arch repair where densely calcified ascending aorta and base of the arch were removed en bloc along with a large intraluminal mass component without complication. Pathologic assessment revealed PTFE conduit material, thrombus, and extensive calcification with fibrous incorporation of graft and arterial wall. Read More

Authors:  Burns Madisen , Cao Joseph , Carrico Caroline

Keywords:  Aorta, Calcifications, Stenosis

Saadat Vandad,  Chawla Soni,  Chen Johnathan,  Iskander Paul,  Ghahremani Shahnaz

Final Pr. ID: Poster #: EDU-006

Awareness of abdominal aorta abnormalities in pediatric patients is essential for appropriate diagnosis and management of the patients suffering from these conditions. Due to a nonspecific presentation, and sometimes being asymptomatic earlier in life, imaging has an important role in diagnosis of these abnormalities. Aneurysm and dissection are excluded, as they are not specific to children and with few exceptions mostly present in older patients.
We review the clinical presentation and show imaging findings of mid aortic syndrome, Takayusu arteritis, rare entities such as idiopathic infantile arterial calcification. Also we show imaging of the anatomic variants of the distal aorta such as middle sacral artery, persistent sciatic artery, abdominal aorta coarctation and blind ending aorta, with a short review of embryologic development of abdominal aorta. These anomalies are not common, however if remain undiagnosed might have serious consequences.

-Midaortic syndrome is an uncommon disease with progressive narrowing of the abdominal aorta and its major branches, typically involving interrenal segment of the aorta; it affects mostly children and young adults, the cause is not clear, might be the result of an intrauterine insult to the intima and subintimal tissues. Aside from diagnosis, imaging has a major role in endovascular treatment of mid aortic syndrome.
-Takayusu arteritis, also predominantly involves aorta and its major branches of younger patients, with strong female predominance, and frequently found in Asian patients. Destruction of arterial medi leads to aneurysm formation and uncommonly rupture of the involved artery.



-Idiopathic infantile arterial calcification, a rare entity presenting with extensive calcification and stenosis of large and medium sized arteries, usually leads to early death from coronary artery occlusion.
-The aortoiliac variants are rare and not commonly discussed in the imaging literature. Some anomalies might be asymptomatic in young ages, but might complicate surgeries like heart, renal transplant, or hip surgery and increases the risk of morbidity and mortality. Some of these anomalies such as persistent sciatic artery need long term follow-up, given the possibility of aneurysmal degeneration. Read More

Authors:  Saadat Vandad , Chawla Soni , Chen Johnathan , Iskander Paul , Ghahremani Shahnaz

Keywords:  Aorta, takayusu, midaortic