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Society for Pediatric Radiology – Poster Archive

Ct Angiography
Showing 5 Abstracts.

Salman Rida,  More Snehal,  Ferreira Botelho Marcos,  Ketwaroo Pamela,  Masand Prakash,  Molossi Silvana,  Jadhav Siddharth

Final Pr. ID: Paper #: 047

Anomalous Aortic Origin of Coronary Artery (AAOCA) is the 2nd most common cause of sudden cardiac death in the young. Coronary artery origins are evaluated as part of transthoracic echocardiography (TTE) and diagnostic precision may be limited by technical limitations, operator dependence, and patient cooperation. MRI and gated Cardiac Computed Tomographic Angiography (CCTA) are often utilized in patients where an anomaly is suspected on TTE. There is limited literature comparing TTE and CCTA in children with suspected AAOCA. The purpose of this study is to determine the distribution of various coronary anomalies comparing TTE and CCTA data, and define the added value advanced imaging brings in clinical decision-making. Read More

Authors:  Salman Rida , More Snehal , Ferreira Botelho Marcos , Ketwaroo Pamela , Masand Prakash , Molossi Silvana , Jadhav Siddharth

Keywords:  Anomalous coronaries, CT angiography, Echocardiography

Yen Christopher,  Kukreja Kamlesh,  Masand Prakash

Final Pr. ID: Poster #: CR-010

Female conjoined throraco-omphalopagus twins were delivered via cesarean section at 35 weeks 5 days gestational age to a 38-year-old mother who received standard prenatal care. After resuscitation, the twins were transferred to the neonatal ICU, where they remained for monitoring and growth as they were assessed for potential separation.
CT angiography was performed at 3-4 months of life using a staged approach. Selective IV and oral contrast administration was used over two visits to delineate shared and non-shared structures. Most significantly, there was a single shared liver with anomalous hepatic venous drainage. Twin A had three normal caliber hepatic veins draining into a normal IVC, but a large branch of the middle hepatic vein traversed midline into Twin B and received hepatic venous drainage from Twin B via numerous anomalous vessels. Twin B had a normal IVC but three diminutive hepatic veins, thought to be due to reduced venous drainage as a result of the anomalous shared vasculature.
After multidisciplinary discussion, interventional radiology was consulted for hepatic venogram and intervention as needed. The anomalous communicating vessels were identified on hepatic venogram via Twin A femoral approach. Occlusion of the anomalous branches was achieved with serial embolization of the primary draining vessel on the Twin A side using Amplatzer vascular plugs. Successful occlusion was confirmed on venography after the final embolization procedure.
Follow-up Doppler ultrasound exams confirmed improved hepatic venous outflow in Twin B, initially with reversal of flow in the anomalous veins back toward the IVC of Twin B, followed by nonvisualization of the anomalous veins on later exams. CT angiography later showed enlarged caliber of the native Twin B hepatic veins. Following the optimization of hepatic venous outflow, the multispecialty surgical team proceeded with separation. The twins were separated at 13 months of age without complication. In addition to restoring venous outflow to allow for a successful surgical outcome, it was noted that the Amplatzer devices were used as surgical landmarks during separation for identification of shared anatomy. Through careful planning and execution, diagnostic and interventional radiology techniques played a critical role in this successful outcome.
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Authors:  Yen Christopher , Kukreja Kamlesh , Masand Prakash

Keywords:  Conjoined twins, Interventional Radiology, CT Angiography

Salman Rida,  More Snehal,  Ferreira Botelho Marcos,  Ketwaroo Pamela,  Masand Prakash,  Jadhav Siddharth

Final Pr. ID: Paper #: 048

Norwood procedure is a 3-stage surgical palliation for patients with functionally single ventricle anatomy, most commonly hypoplastic left heart syndrome. Complications after stage I operation are not uncommon and include Blalock Taussig Thomas (BTT) /Sano shunt abnormalities, Damus-Kaye-Stansel (DKS) anastomotic narrowing, and neo-aortic arch /branch vessel stenosis. Transthoracic echocardiography (TTE) is traditionally the mainstay for evaluation. The purpose of our study is to compare Gated Cardiac Computed Tomographic Angiography (CCTA) with TTE when evaluating post-operative complications after stage I Norwood procedure and implications of CCTA findings on management.
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Authors:  Salman Rida , More Snehal , Ferreira Botelho Marcos , Ketwaroo Pamela , Masand Prakash , Jadhav Siddharth

Keywords:  Congenital heart disease, CT Angiography, Echocardiography

Hull Nathan,  Robb Tiffany,  Young Phillip

Final Pr. ID: Poster #: EDU-039

This poster will review the complexities and challenges of performing CTA on pediatric patients on ECMO and provide practical suggestions for performing these exams. Read More

Authors:  Hull Nathan , Robb Tiffany , Young Phillip

Keywords:  ECMO, CT Angiography, Pediatric