Epelman Monica,  Dinan David,  Ngo Thang,  Johnson Craig,  Weber-guzman Fabiola,  Chandra Tushar,  Podberesky Daniel

Final Pr. ID: Poster #: EDU-046

The purpose of this exhibit is:
-To discuss the role of DWIBS (diffusion-weighted whole body imaging with background body signal suppression) in the evaluation of pediatric body imaging pathology and to identify common indications for its use
-To review normal DWIBS findings in various body organs and to understand imaging pitfalls
-To provide examples of pathological conditions seen on DWIBS Read More

Authors:  Epelman Monica , Dinan David , Ngo Thang , Johnson Craig , Weber-guzman Fabiola , Chandra Tushar , Podberesky Daniel

Keywords:  DWIBS, DWI, Body, MRI

Law Emily,  Luo Yu

Final Pr. ID: Poster #: CR-025

Ultrasound is the first line of study of radiolucent foreign bodies, such as wooden or organic foreign bodies. The reported sensitivity is up to 90-100%. However, the orientation, location, and size of such foreign bodies can pose challenges for accurate detection.

Case Presentation: We present a case of a 16-year-old girl who stepped on a small wooden stick, leading to a foreign body penetrating between her fourth and fifth toes, which was removed in the emergency room. Post-removal X-ray and ultrasound failed to identify any residual foreign body, and the patient was discharged home with antibiotics. However, persistent pain and progressive foot swelling prompted a return to the Emergency Room two weeks later. A repeat ultrasound showed increased soft tissue swelling, and hyperemia centered around the webspace of the fourth and fifth digits but failed to detect the foreign body. Subsequent MRI revealed a vertically oriented 1.7 cm long cylindrical structure with a diameter of 0.3cm, demonstrating a hypointense signal in all sequences and hyperintense signal and enhancement in the surrounding tissue compatible with the foreign body. In retrospect, a tiny echogenic focus corresponding to the end of the foreign body is present in a similar location on some of the images of both sonographic exams. The foreign body was surgically removed, and the patient completely recovered within a week.

Discussion: This case highlights the limitations of ultrasound in detecting wooden foreign bodies, particularly when they have a unique orientation, location, and small dimensions; in this case, the foreign body was found vertically oriented (thus perpendicular to the ultrasound probe surface) and between the toes. The ultrasound can only detect the tiny end of the foreign body, which can be easily missed or misinterpreted. With its excellent tissue characterization capabilities, MRI proved to be a valuable tool in this challenging scenario. While ultrasound remains a highly sensitive and specific tool, clinicians should consider additional imaging modalities when faced with challenging cases to avoid missed diagnoses and unnecessary complications. Read More

Authors:  Law Emily , Luo Yu

Keywords:  foreign body, MRI, US

Zhang Zhongwei,  Barhaghi Krystle,  Tao Ting,  Murray Kari

Final Pr. ID: Poster #: EDU-017

Pediatric body MRI is a highly effective imaging modality that enables precise characterization of diverse medical conditions. However, it comes with daily challenges, including accommodating variations in patient size, managing breath-hold difficulties, potential sedation needs, addressing patient comfort and anxiety, and the importance of minimizing RF energy deposition and contrast agent use. To become proficient in interpreting body MRI, it is essential to understand the techniques and clinical applications of each pulse sequence and learn how to use them for accurate tissue characterization.

In this ABC guide, we employ the structured approach of “clinical images - techniques – physics” to bridge the gap between practical application and the theoretical foundation of pediatric body MRI. It serves as a comprehensive roadmap, helping learners gain a profound understanding of not only what they are observing in the images but also the underlying reasons and mechanisms that give rise to these images.

We will present body MRI techniques in 4 categories: qualitative MRI sequences, quantitative MRI sequences, artifact recognition, and “how to”. In each category, our approach will encompass data acquisition, fundamental physical principles, imaging characteristics, and the essential groundwork for interpretation. These teachings are firmly grounded in our institutional MRI protocol for pediatric body MRI, providing a comprehensive and practical understanding of the subject.
The education poster will be divided as follows:
1. Qualitative MRI Sequences:
- T2-Weighted and Heavy T2-Weighted Imaging
- Pre- and Post-Contrast T1-Weighted Imaging
- Mixed T2/T1 Contrast Imaging:
- Cartesian, Radial, or Spiral-based k-space data acquisition: Detailed explanations of various k-space sampling methods will be provided.
- The Role of Magnetization Preparation Techniques
- The Role of Physiological Control
2. Quantitative MRI Sequences:
- Measurement of T1 and T2 Relaxation Times
- Measurement of ADC and Diffusion MRI Techniques
- Measurement of Stiffness of Liver and MR Elastography Techniques
- Liver Iron Quantification
3. Common Body MRI Artifacts in Pediatric Patients: A wide array of artifacts, including motion artifacts, susceptibility artifacts, and aliasing artifacts, among others, will be thoroughly covered.
4. How to…
- Address Body MRI Image Quality Issues
- Safely Scan Pediatric Patients with Implants Read More

Authors:  Zhang Zhongwei , Barhaghi Krystle , Tao Ting , Murray Kari

Keywords:  Body MRI, Physics, Pediatric Imaging

Kato Kambrie,  Mackenzie John,  Phelps Andrew,  Courtier Jesse,  Behr Spencer,  Zapala Matthew

Final Pr. ID: Poster #: SCI-033

Determine the incidence of occult malignancy detected by ¹⁸F-FDG PET-CT and whole body (WB) MRI in children. Read More

Authors:  Kato Kambrie , Mackenzie John , Phelps Andrew , Courtier Jesse , Behr Spencer , Zapala Matthew

Keywords:  whole body MRI, PET CT, paraneoplastic syndrome

Hughes Nicole,  Phelps Andrew,  Meyer Anna,  Courtier Jesse,  Mackenzie John,  Zapala Matthew

Final Pr. ID: Poster #: EDU-042

Accurate diagnosis of venous malformations can be challenging, and confidently diagnosing them is important for accurate treatment. A thorough understanding of the etiology, imaging appearance, and important mimickers of venous malformations is critical for the radiologist to provide an accurate assessment for the clinician. Read More

Authors:  Hughes Nicole , Phelps Andrew , Meyer Anna , Courtier Jesse , Mackenzie John , Zapala Matthew

Keywords:  MRI, venous malformation, Whole body MRI, Blood pool MRI contrast agent

Nichat Vaibhav,  Matzinger Mary Ann

Final Pr. ID: Poster #: EDU-052

Bones are frequent targets of various neoplastic and non-neoplastic disorders, which often present with focal bone pain. Clinicians should be familiar with the workup of a challenging symptom such as focal bone pain, in order to make appropriate referrals to various specialists, order appropriate investigations and tissue sampling workup, and avoid unnecessary prolonged antibiotics course, thereby preventing delay in diagnosis and antibiotics resistance.

Sometimes, results of various investigations are not always discriminatory among infectious, inflammatory, neoplastic and non-neoplastic etiologies. Some of these disorders can be a source of important morbidity and mortality in infants and children. In order to optimize diagnostic accuracy, early detection of diseases, detection of clinically silent lesions, and disease management, it is imperative for radiologists to be familiar with the imaging characteristics of each entity and the proper methods employed in their evaluation. In light of this, whole body imaging may be performed to get highest yield and cost effectiveness.

The purpose of this exhibit is:

■ To discuss the indications and highlight the role of Whole body MRI and Whole Body Bone Scan
■ To describe scan protocols of Whole body MRI and Whole Body Bone Scan
■ To describe the imaging appearance of some of the oncologic and non-oncologic diseases presenting as bone pain
■ To briefly compare Whole body MRI and Whole Body Bone Scan

Illustrative cases from our Radiology Department will be used to demonstrate various entities such as chronic recurrent multifocal osteomyelitis, infections, Langerhans cell histiocytosis, hematological malignancies, and bony metastases. Read More

Authors:  Nichat Vaibhav , Matzinger Mary Ann

Keywords:  Whole Body MRI, Whole Body Bone Scan, Bone Pain

Sato T Shawn,  Bajaj Manish,  Ferguson Polly

Final Pr. ID: Poster #: EDU-058

Chronic Recurrent Multifocal Osteomyelitis (CRMO) is an auto-inflammatory disease that can affect multiple locations. Whole body MRI is an important tool to help identify subclinical multifocal disease and help monitor disease. As a referral center for CRMO, we have developed a successful CRMO whole body MRI imaging protocol which maximizes diagnostic information while minimizing scanner time. Read More

Authors:  Sato T Shawn , Bajaj Manish , Ferguson Polly

Keywords:  Rheumatology, CRMO, Whole Body MRI