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Society for Pediatric Radiology – Poster Archive

Showing 26 Abstracts.

Karuppiah Viswanathan Ashok Mithra,  Wilson Nagwa

Final Pr. ID: Poster #: EDU-064

A number of acquired non-traumatic diseases of myriad aetiologies involve the temporal bone in children. While some of these are also noted in adults, many diseases are specific to the pediatric age group. These can be grouped into infectious/inflammatory, neoplastic, vascular and other miscellaneous disorders.

Anatomy of the temporal bone is complex. It forms the lateral aspect of skull base and comprises of five osseous parts viz. squamous, mastoid, petrous, tympanic and styloid segments. Specific disease processes afflict each part of the temporal bone, largely dictated by its anatomy and constituent structures. Hence a structured approach to image interpretation and reporting is especially useful in this region to localise the lesion and subsequently generate differential diagnoses.

Traditionally CT has been the imaging modality of choice in assessing temporal bone lesions. However, currently, CT and MRI are deemed complimentary. CT provides exquisite details of anatomy, characterises osseous lesions, determines bony involvement/destruction and extension while MRI is highly useful in assessing intrinsic lesion characteristics due to its superior contrast resolution. In certain aetiologies such as cholesteatoma MRI is diagnostic.

This poster aims to review the anatomy of temporal bone and various common, uncommon acquired non traumatic temporal bone lesions in children.

The lesions that will be discussed in this poster are listed below:
Infectious / Inflammatory:
1. Otitis externa
2. Otitis media
3. Coalescent mastoiditis with orbital involvement
4. Bell’s Palsy
5. Guillain-Barre’ syndrome with facial palsy
Neoplastic Lesions:
1. Vestibular schwannoma
2. Rhabdomyosarcoma
3. Ewing’s sarcoma
4. Langerhan’s cell histiocytosis
5. Osteoblastoma
6. Osteoma
7. Aggressive Myofibromatosis
1. Carotid vasculitis secondary to petrous abscess
Miscellaneous Lesions:
1. Cholesteatoma (congenital and acquired)
2. Cholesterol granuloma
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Authors:  Karuppiah Viswanathan Ashok Mithra , Wilson Nagwa

Keywords:  Temporal Bone, Children, Acquired lesions

Mahomed Nasreen

Final Pr. ID: Poster #: EDU-022

Pancreatic tumours are a rare and unusual entity in pediatric patients accounting for less than 0.2% of malignant paediatric deaths. The limited number of cases and the diversity of histopathologic subtypes have made it difficult to predict prognosis which differs significantly from adults. In general, pancreatic tumours that occur in children are well circumscribed and partially encapsulated. Their relatively soft nature and encapsulated rather than infiltrative growth pattern allow them to become large prior to clinical presentation. Owing to their large size, central necrosis is common.

Causes of pancreatic masses in children are usually benign and include pancreatic pseudocyst, congenital pancreatic cyst, dermoid cyst, hydatid cyst, islet cell tumours, lymphangioma, pancreatic hemangioendothelioma and cystadenomas. Causes of malignant pancreatic masses in children (which are rare) include pancreatoblastoma, lymphoma, neuroblastoma, solid-pseudopapillary tumour and rhabdomyosarcoma.

We present an algorithmic approach to a pancreatic mass in a child, describing the common imaging features in each of the benign and malignant causes of pancreatic mass in a child with radiologic cases. We also report a very rare case of a pancreatic kaposiform hemangioendothelioma in an 8 month old boy who presented with Kasabach Merritt syndrome.
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Authors:  Mahomed Nasreen

Keywords:  pancreatic tumours, pancreatic kaposiform hemangioendothelioma, benign, malignant, children

Lulkin Solange,  Sancho Cano Julieta,  Lipsich Jose

Final Pr. ID: Poster #: SCI-002 (S)

The lower GI study with water soluble contrast, is used to evaluate the remnant colon. The population to study includes patient with anorectal malformation, stenosis due to necrotizing enterocolitis, bowel resections or to plan the ostomy closure.
There are scarce adverse effects reported in the literature.

Case: We present a 7-month-old boy with operated cardiopathy and the prior story of necrotizing enterocolitis with bowel perforation a few days after the birth, with surgical intervention resolution. By the time of the study, our patient had ileostomy and colostomy in plan of reconnection, for that reason, the GI study was planned.
The patient was lying down face up in the table. Plane X Ray of the abdomen was taken as a first move of the examination (normal air distribution, no abnormal radiopacities). Then a probe with a balloon was introduced in to the distal ostomy and the balloon was inflated with 5 ml of air to prevent the loose of the probe. A syringe of 20 ml was connected, and the solution was injected (1/3 ml Triyosom GI* and 2/3 ml water) with a moderated hydrostatic pressure. During the injection fluoroscopy was given and images of the distal colon were seen. No fistulas or loose of contrast was evidenced, neither contrast out of anus was seen, as a result of stenosis in that point. We emptied the distal colon by taking out the contrast.
3 hours after the practice the patient started vomiting, abdominal distention and signs of sepsis. He was admitted at the emergency. Finally, he died 6 hours after the GI study had been performed. Analytic results of the blood: 2/2 positive to Gram Negative. Autopsy informed: no GI signs of bacterial translocation.

*Meglumina diatrizoato-diatrizoico acido.
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Authors:  Lulkin Solange , Sancho Cano Julieta , Lipsich Jose

Keywords:  Lower GI study, children, Adverse Effects

Ugas Charcape Carlos,  Matos-rojas Irma,  Sanchez-navarro Juan P.,  Fernández-ochoa Diana,  Conilla-arispe José M.

Final Pr. ID: Paper #: 001 (S)

Describir los hallazgos más frecuentes en tomografía computarizada del anillo vascular en un centro de referencia nacional y proponer un algoritmo lógico de diagnóstico para ayudar a los informes del radiólogo pediátrico. Read More

Authors:  Ugas Charcape Carlos , Matos-rojas Irma , Sanchez-navarro Juan P. , Fernández-ochoa Diana , Conilla-arispe José M.

Keywords:  vascular ring, children, ct

Raubenheimer Lauren,  Andronikou Savvas,  Kilborn Tracy

Final Pr. ID: Poster #: SCI-053

There is little published research on the wide variation of corpus callosum (CC) morphology in children, the assessment of which is made difficult by the complex alteration of its appearance in childhood. The purpose of our study was to assess the morphology of the CC on mid-sagittal T1-weighted magnetic resonance imaging (MRI) in a large number of children and correlate the findings with demographic and clinical criteria. Read More

Authors:  Raubenheimer Lauren , Andronikou Savvas , Kilborn Tracy

Keywords:  children, magnetic resonance imaging, corpus callous morphology

Stott Samantha,  Wu Yujie,  Hosseinpour Shahob,  Chen Chaojun,  Namdar Khashayar,  Amirabadi Afsaneh,  Shroff Manohar,  Khalvati Farzad,  Doria Andrea

Final Pr. ID: Poster #: SCI-001

Scoliosis is a complex spine deformity with direct functional and cosmetic impacts on the individual. The reference standard for assessing scoliosis severity is the Cobb angle which is measured on radiographs by human specialists, carrying interobserver variability and inaccuracy of measurements. These limitations may result in lack of timely referral for management at a time the scoliotic deformity progression can be saved from surgery.
We aimed to create a machine learning (ML) model for automatic calculation of Cobb angles on 3-foot standing spine radiographs of children and adolescents with clinical suspicion of scoliosis (AIS) across two clinical scenarios (idiopathic, group 1 and congenital scoliosis, group 2).
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Authors:  Stott Samantha , Wu Yujie , Hosseinpour Shahob , Chen Chaojun , Namdar Khashayar , Amirabadi Afsaneh , Shroff Manohar , Khalvati Farzad , Doria Andrea

Keywords:  Radiograph, Children

Iles Benjamin,  Samora Julie,  Singh Satbir,  Ruess Lynne

Final Pr. ID: Poster #: SCI-035

Treatment pathways for isolated distal radius fractures in children are evolving and becoming more tailored to specific fracture types, including different management plans for stable buckle fractures (BFs) versus unstable distal radius fractures (DRFs). We propose a measurement rule to aid differentiation of stable BFs from unstable DRFs in children.
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Authors:  Iles Benjamin , Samora Julie , Singh Satbir , Ruess Lynne

Keywords:  Quality Improvement, Radiography, Children

Mata-mbemba Daddy,  Daneman Alan

Final Pr. ID: Poster #: EDU-021

There are a variety of masses in neonates, infants and young children that may disappear spontaneously without active intervention. However, there has been no published review of what type of masses could disappear and what the spectrum of their imaging features is. It is essential for radiologists to understand imaging features of these entities in order to provide pediatrician and pediatric surgeons with critical information that will enable them to manage these patients expectantly without surgical intervention.
The entities that will be illustrate in this review include, among others: multicystic dysplastic kidneys, suprarenal masses (including intraabdominal sequestration, neuroblastoma and adrenal hemorrhage), ovarian cyst and torsion, duplication cyst of gastrointestinal tract, cyst of liver and kidneys. We will:
1. Review the clinical and imaging features of these masses including their changes during follow-up imaging studies.
2. Emphasize the imaging features that are helpful in differentiating these entities from other entities that require active intervention
3. Describe an appropriate approach to deal with uncertain diagnoses.
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Authors:  Mata-mbemba Daddy , Daneman Alan

Keywords:  disappear mass, neonate, infant and young children

Carmona Daniela,  Erripa Jose,  Lostra Juliana,  Rizzi Ana,  Dardanelli Esteban,  Moguillanky Slvia,  Lipsich Jose

Final Pr. ID: Poster #: CR-017

Gastrointestinal stromal tumors (GIST) in children are not well characterized, different adult rare entity. It corresponds to a heterogeneous group of lesions for correct classification requires histological, immunohistochemical evaluation and in some cases also adds to the cytogenetic diagnosis. We describe the findings of pediatric GIST. Read More

Authors:  Carmona Daniela , Erripa Jose , Lostra Juliana , Rizzi Ana , Dardanelli Esteban , Moguillanky Slvia , Lipsich Jose

Keywords:  gastrointestinal stromal tumors, CD17 +, children, imaging

Bruce Cristian,  De Barbieri Florencia,  Zegpi Maria Soledad,  Sergio Gonzalez

Final Pr. ID: Poster #: EDU-039

The purpose of this exhibit is to show a number of unusual skin lesions that can be seen in children, emphasizing the sonographic appearance and clinical and pathological correlation. We have found this barely described in the literature. Read More

Authors:  Bruce Cristian , De Barbieri Florencia , Zegpi Maria Soledad , Sergio Gonzalez

Keywords:  skin, sonography, children

Calle Toro Juan,  Andronikou Savvas

Final Pr. ID: Poster #: EDU-025

To retrospectively review the imaging planes performed, the number pyloric layers visible and the location of measurements taken, in infants with suspected (HPS). Read More

Authors:  Calle Toro Juan , Andronikou Savvas

Keywords:  pyloric, ULTRASONOGRAPHY, Children

Dubois Josée,  Thomas-chausse Frederic,  Ghali Rafik,  Soulez Gilles

Final Pr. ID: Poster #: CR-042

Congenital portosystemic shunt is a rare vascular malformation that leads to severe complications. Two types are described: extrahepatic and intrahepatic. Extrahepatic shunt is represented by a direct communication of the portal trunk, or one of its branches of origin, to the inferior vena cava, or one of its branches.

We present two cases of extrahepatic shunt treated with stent-graft placement.

Case 1: Two y.o. male with cutaneous telangiectasias and liver calcifications on abdominal ultrasound. An extrahepatic portosystemic shunt was detected on color Doppler examination.

MR and catheter angiography revealed a large fistula between the main portal vein and the suprarenal inferior vena cava. The fistula was closed by deploying a balloon expandable stent-graft in the retrohepatic inferior vena cava. Five years later, the liver function was normalized and no complication was observed.

Case 2: Thirteen y.o. male referred for three hepatic lesions and an extrahepatic portosystemic shunt.

MR and angiography revealed a large fistula between the left portal vein and the inferior vena cava. It was closed by deploying a custom self-expandable stent-graft (Zenith, Cook Medical, Bloomington, IN) in the inferior vena cava. At five years follow-up, the patient is asymptomatic with a resolution of the liver lesions.
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Authors:  Dubois Josée , Thomas-chausse Frederic , Ghali Rafik , Soulez Gilles

Keywords:  Stent, Portosystemic shunt, Liver, Embolization, Children

Regmi Pradeep,  Amatya Isha

Final Pr. ID: Poster #: CR-019

Primary tubercular osteomyelitis accounts for less than 10% of extra-pulmonary tuberculosis (TB) in childhooduMultifocal tuberculosis with more than one site especially in immune-competent children is rare. Very few cases of multifocal involvement of ribs and sternum are reported. We are presenting a case of a 14-year-old boy presented with painless swelling in the chest.
Clinical history
The 4-year-old child presented with painless swelling on his anterior chest in midline and back pain on and off for 3 months duration. No history of trauma. However, he lost about 3 kilograms of his weight in this duration. On examination, the swelling was soft and painless on palpation. No exit points in the skin. There was no lymphadenopathy. However, other systemic examinations were unremarkable. Lab parameters revealed a WBC count of 11,000 with lymphocyte-predominant.
In children, the bones most commonly affected are the metaphysis of the long bones (femur, tibia, fibula, radius, ulna and humerus), spine, pelvic girdle and skull bones. Multifocal skeletal tuberculosis is uncommon in children and accounts for less than 10% of skeletal tuberculosis. Sternum TB commonly occurs by reactivation of latent focuses formed throughout the course of hematogenous or lymphatic dissemination of primary tuberculosis. Extra-pulmonary tuberculosis in children varies from 21-44%. Pericardial involvement is one of the crucial sites of involvement. About 10% of children develop constrictive pericarditis in follow up for pericardial effusion.
The diagnosis of bone tuberculosis is particularly challenging as the presentation of skeletal tuberculosis is often insidious, with an absence of the classical features of pulmonary tuberculosis or typical systemic features such as fever, cough, night sweats or weight loss (history of localized painless swelling and weight loss were present in our case). The gold standard for diagnosis comprises histological examination verification. Needle aspiration or excisional biopsy for histopathological diagnosis of sternum TB is obligatory. Both Needle aspiration and biopsy were performed in our case.
The clinical presentation in patients with multifocal musculoskeletal tuberculosis may closely mimic that in patients with multiple bone metastases, which makes the accurate clinical diagnosis challenging. Clinical and even radiological findings may be indistinguishable from malignant disease, so histopathological evaluation is warranted in such cases.
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Authors:  Regmi Pradeep , Amatya Isha

Keywords:  Multifocal osteomyelitis, Tubercular, Children

Porto Luciana

Final Pr. ID: Poster #: SCI-002

Sudden visual impairment in children occurs sporadically, but when present needs urgent attention. Optimal management strategies and timely recognition are required. Often psychogenic disorders are the cause in school-age children; but this is a diagnosis of exclusion. Therefore, MRI plays an important role in ruling out pathology along the optic pathways or helping with the diagnosis of underlying life threatening diseases, such as hydrocephalus or intracranial mass. The purpose of this study was first to evaluate non-traumatic (tumoural and non-tumoural) causes of acute vision impairment; and second, to assess if conventional neuroimaging is helpful children with sudden visual impairment. Read More

Authors:  Porto Luciana

Keywords:  MRI, children, visual impairment

Martinez-rios Claudia,  Bajno Lydia,  Daneman Alan,  Moineddin Rahim,  Van Der Kaay Danielle Cm,  Wasserman Jonathan

Final Pr. ID: Poster #: EDU-109

High-resolution ultrasonography (US) is a valuable and accessible imaging tool to assess and characterize the thyroid gland in children. Pediatric thyroid nodules are infrequent. However, the incidence of thyroid carcinoma in children is near twice the adult population, where the risk of malignancy is up to 15%. Children also have an increased risk for recurrence (39%) as compared to adults, justifying further work and a more aggressive approach. Prompt recognition of the common and uncommon sonographic features of thyroid cancer in children will allow radiologist to identify this malignancy in early stages of the disease, expediting appropriate treatment improving the standard of patient care. The purpose of this exhibit is to 1. To illustrate the spectrum of sonographic findings of thyroid cancer in a pediatric population. 2. To describe the typical sonographic characteristics of malignant thyroid nodules in children. 3. To identify the uncommon features of pediatric thyroid cancer. 4. To describe an appropriate approach to deal with uncertain diagnosis. Read More

Authors:  Martinez-rios Claudia , Bajno Lydia , Daneman Alan , Moineddin Rahim , Van Der Kaay Danielle Cm , Wasserman Jonathan

Keywords:  Thyroid, cancer, children, ultrasound

Mahomed Nasreen

Final Pr. ID: Poster #: EDU-010

Abstract: HIV is a global pandemic. According to the UNAIDS Report on the Global Aids Epidemic 2013, approximately 3.3 million children under the age of 15 years are living with HIV infection globally. Sub-Saharan Africa has the highest burden of disease with 2.9 million of HIV-infected children. HIV has affected the epidemiology of childhood pneumonia, changing the spectrum of pathogens, antimicrobial susceptibility of bacteria and prognostic outcome. More than 70% of HIV-infected children will suffer at least one episode of a pulmonary infection in the course of their illness. The pneumococcal conjugate vaccine (PCV) demonstrated vaccine efficacy of 20% in HIV-uninfected children and 13% in HIV-infected children in South African using WHO standardized chest X-ray interpretation criteria. The chest X-ray remains the most readily available and the commonest imaging modality for childhood pneumonia. A combination of clinical findings with pattern recognition on chest X-ray narrows the differential diagnosis. We present a pictorial review of chest X-ray findings in HIV-infected children due to infectious causes: pulmonary TB, bacterial pneumonia, Pneumocystis jiroveci pneumonia, viral pneumonia and non- infectious causes: immune reconstitution inflammatory syndrome (IRIS), lymphocytic interstitial pneumonia (LIP) and lymphoma.
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Authors:  Mahomed Nasreen

Keywords:  chest X-rays, HIV-infected children

Roman Martinez Angelica Viridiana,  Suarez Pilar,  Hidalgo-tobon Silvia

Final Pr. ID: Poster #: SCI-007 (S)

demonstrate that using the anatomical division of the liver suggested by Couinaud allows a more accurate quantification of the amount of fat. Read More

Authors:  Roman Martinez Angelica Viridiana , Suarez Pilar , Hidalgo-tobon Silvia

Keywords:  liver, MRI, children

Barrera Christian,  Andronikou Savvas,  Otero Hansel

Final Pr. ID: Poster #: EDU-018

Nutritional deficiencies in children are prevalent both in the US and abroad often under-diagnosed unless symptomatic. Some nutritional deficiencies have conspicuous imaging findings that might help with diagnosis and/or follow up in a timely manner. Similarly, imaging might be needed to diagnose or follow complications related to malnutrition and eating disorders such as bulimia, anorexia nervosa, binge eating and pica. This educational exhibit will review radiographic, CT and MR imaging of nutritional deficiencies and complications of malnutrition and eating disorders in children Read More

Authors:  Barrera Christian , Andronikou Savvas , Otero Hansel

Keywords:  Nutrition, Children, Eating disorder

Oudjhane Kamaldine,  Alzahrani Ahmed

Final Pr. ID: Poster #: EDU-068

Soccer practice is steadily increasing in the world and brings its statistics of injuries, most of them acute and minor. There is a better understanding of the epidemiology and biomechanics in the genesis of such injuries. This electronic presentation on soccer injuries in children outlines the following: 1. Review of epidemiology and biomechanics factors (equipment, athletic skills, contact sport). 2. Mechanisms of injury: headings, avulsion, contusion, fracture, twisting knee injury, overuse). 3. Imaging characteristics at various sites of injury. Read More

Authors:  Oudjhane Kamaldine , Alzahrani Ahmed

Keywords:  soccer, children, biomechanics, anterior cruciate ligament, muscle strain

Mohd Zaki Faizah,  Han Huan Hoe,  Abdul Hamid Hamzaini

Final Pr. ID: Poster #: EDU-093

To illustrate the diagnostic value of magnetic resonance (MR) urography in children with urinary tract abnormalities.
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Authors:  Mohd Zaki Faizah , Han Huan Hoe , Abdul Hamid Hamzaini

Keywords:  MR Urography, children

Rowell Amy,  Greenberg S Bruce,  Gauss C. Heath

Final Pr. ID: Paper #: 006

Our aim is to determine the normal elastography liver stiffness values in children and if sampling depth is a factor. Read More

Authors:  Rowell Amy , Greenberg S Bruce , Gauss C. Heath

Keywords:  elastography, liver, children

Laurindo Mariano De Oliviera Gabrielle,  García Gallegos Víctor,  Cobián Machuca Humberto

Final Pr. ID: Poster #: SCI-028

The presence of abnormal masses in the neck of children always represents a diagnostic challenge. Ultrasound can provide useful information about the origin of an inflammatory mass in the neck and is effective in differentiating solid from cystic lesions. The aim of this study was to evaluate the diagnostic performance of ultrasound in the characterization of abnormal neck masses of the pediatric population. Read More

Authors:  Laurindo Mariano De Oliviera Gabrielle , García Gallegos Víctor , Cobián Machuca Humberto

Keywords:  Neck Masses, Children, Ultrasound

Retamal Caro Andres,  Pérez-marrero Lizbet,  Horvath Eleonora,  Silva Claudio,  Rojas Paula

Final Pr. ID: Poster #: SCI-088

To determine the percentage of malignancy for the different TIRADS categories and the ultrasound patterns in children and adolescents.
To calculate the interobserver variability in the use of TIRADS classification in this group.
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Authors:  Retamal Caro Andres , Pérez-marrero Lizbet , Horvath Eleonora , Silva Claudio , Rojas Paula

Keywords:  TIRADS, thyroid cancer, thyroid node in children and adolescent, thyroid cancer in children and adolescent, sonographic patterns of thyroid node

Alizadeh Houman,  Siegel Marilyn,  Cullinane Mike

Final Pr. ID: Paper #: 146

Mediastinal tumors comprise a range of congenital, neoplastic and inflammatory tumors. While many benign and malignant lesions can be differentiated by CT appearance and attenuation values, many cannot be reliably separated. The purpose of this paper is to evaluate the feasibility of dual-energy computed tomography (DECT) in differentiating a spectrum of mediastinal tumors in children Read More

Authors:  Alizadeh Houman , Siegel Marilyn , Cullinane Mike

Keywords:  Dual Energy CT, Mediastinal Tumors, children

Schjerven Annette,  Fasmer Kristine,  Aukland Stein Magnus

Final Pr. ID: Poster #: SCI-02 (R)

Despite the development of new methods for the detection of Vesico Urethral Reflux (VUR), Voiding Cystourethrography (VCUG) still plays an important role in pediatric uroradiology. However, the use seems to have changed over time. International guidelines exist and the main indication is the Ultrasonography (US) finding of hydronephrosis, indicating a high grade VUR or, in boys, to exclude Posterior Urethral Valve (PUV). VUR is a common condition found in 30-40 % of children with UTI. Our department performs VCUG according to the guidelines given by the ESUR subgroup for Pediatric Uroradiology. Haukeland University Hospital (HUS) serve a population of 300000 people. At the Section of Pediatric Radiology, we observed a decrease in the use of VCUG. We therefore did a systematic review of all VCUGs performed at our department during 2013 and 2014, focusing in detail on the age group 1 year or less. We aim to be true to the image gently policy, maintaining the ALARA principle, keeping the radiation doses as low as reasonably possible. Read More

Authors:  Schjerven Annette , Fasmer Kristine , Aukland Stein Magnus

Keywords:  voiding cystrourethrography, vesico urethral reflux, children, alara