Southard Richard,  Ellsworth Erik,  Moe Tabitha,  Augustyn Robyn,  Thorkelson Marrit,  Bardo Dianna

Final Pr. ID: Poster #: EDU-090

The structure of the heart is more complex than 4 major chambers, 4 major valves, venous inflow and arterial outflow.

Muscular and soft tissue ridges, perforated membranes, tissue flaps, electrical pathways, external grooves, endocardial surface characteristics, and a core architecture structured of fibrous tissue and embryonic tissue remnants form distinguishing anatomic landmarks. These structures provide insight into cardiac development, serve physiologic purpose, define structural and functional elements, as well as offer prognostic information.

Specific details of cardiac anatomy may not be recognized on cardiac MR and CT examinations. Structural anomalies that affect cardiac function and anatomic or physiologic relationships may be abnormal in hearts with congenital malformations. The fine structural details of the heart are typically not part of an imagers search pattern and are therefore overlooked or underreported. Each minute structure and anatomic characteristic provides clues to errors in cardiac formation and may provide clinically relevant diagnostic information. After palliation of CHD defining anatomic structure may be lost, displaced, interrupted or even restored.

Important processes, corresponding anatomic landmarks, and effects of malformation in defining congenital heart disease anatomy, physiology and functional variation from normal include basal structures such as the central fibrous body of the heart, atrial structures including the crista terminalis, the sinus venarum, and eustacian valve, and ventricular structures such as the crista supraventricularis.

Each structure is described along with its normal location, anatomy functional and physiologic importance, the effect of congenital malformation, and imaging findings as in the example of the central fibrous body (table 1).

Minute cardiac anatomy will be shown in illustration as well as in CT and MR images (figure 1). Read More

Authors:  Southard Richard , Ellsworth Erik , Moe Tabitha , Augustyn Robyn , Thorkelson Marrit , Bardo Dianna

Keywords:  Cardiac anatomy, Cardiac MR, Cardiac CT, Congenital heart disease, Embryology

Sideris Georgios,  Tenenbaum Mary,  Catanzano Tara

Final Pr. ID: Poster #: EDU-005

Embryogenesis is a complicated process that requires fine-tuning of multiple factors. Certain transient vestigial structures play a key role in the development and maturation of the developing organs. Persistence or incomplete regression of these primitive structures can give rise to numerous disease entities that may vary from incidental findings to potentially life-threatening conditions. Knowledge of these embryonic remnants is critical for radiologists, as they are encountered in daily practice and can often mimic other pathologies. The purpose of this educational material is to provide a comprehensive presentation of the most important embryonic remnants that radiologists and trainees need to be aware of. The structures that will be discussed, along with their related pathologies, include: aortic arches, cardinal veins, branchial arches, thyroglossal duct, thymopharyngeal duct, nasopalatine duct, Rathke’s cleft, allantois, vitelline duct, Mullerian duct, Wolfian duct, cloaca, notochord, neurenteric canal, falcine sinus, septum pellucidum and primary vitreous. Facts about their embryological background, anatomical location and clinical manifestations will be provided, as well as representative radiological images and differential considerations. Read More

Authors:  Sideris Georgios , Tenenbaum Mary , Catanzano Tara

Keywords:  Embryology

Woon Tian Kai,  Fuad Alkhatib Rugaiyah,  Fortier Marielle

Final Pr. ID: Poster #: EDU-011

Partial anomalous pulmonary venous return (PAPVR) consists of a wide spectrum of uncommon congenital anomalies in which one or more pulmonary veins drain directly or indirectly into the right atrium as a result of abnormalities during pulmonary venous embryogenesis. Thus, keen understanding of the underlying embryological origins of the pulmonary venous system is essential to recognize the variations in PAPVR, and radiological assessment is imperative to elucidate the complex anomalous cardiovascular anatomy for subsequent clinical and surgical management. The purpose of this educational exhibit is to provide a brief discussion of the embryological development of pulmonary veins and a detailed review of the diverse array of PAPVR variations with the aid of various case studies and CT imaging findings including sinus venosus atrial septal defect, Scimitar syndrome and anomalous left pulmonary veins. Read More

Authors:  Woon Tian Kai , Fuad Alkhatib Rugaiyah , Fortier Marielle

Keywords:  PAPVR, Partial anomalous pulmonary venous return, Embryology

Gadde Judith,  Rebsamen Susan,  Kennedy Tabassum

Final Pr. ID: Poster #: EDU-040

1. To briefly review the embryology and anatomy of the pituitary gland.
2. To illustrate the imaging spectrum of duplication of the pituitary gland through an example, to include often associated anomalies such as thickening of the hypothalamus and a palatal teratoma.
3. To review the theories of pathogenesis leading to duplication of the pituitary gland. Read More

Authors:  Gadde Judith , Rebsamen Susan , Kennedy Tabassum

Keywords:  Duplication, pituitary, Embryology, Teratoma

Handa Atsuhiko,  Priya Sarv,  Sato T Shawn,  Sato Yutaka

Final Pr. ID: Poster #: EDU-077

Neurocristopathies are a group of disorders characterized by a common origin in aberrant neural crest development. These include common pediatric disorders such as Hirschsprung’s disease, Treacher Collins syndrome, Di George syndrome, MEN type 2A/2B as well as common pediatric tumors such as neuroblastoma, pheochromocytoma, Ewing’s sarcoma, neurofibromatosis, medullary carcinoma of the thyroid and melanoma.
Neural crest cells are derived from discrete cell masses that arise at the junction between the neural and epidermal ectoderm in neurula-stage vertebrate embryos. Neural crest cells migrate extensively in an organized manner and spread widely throughout the body. Derivatives of neural crest cells include Schwann cells in the leptomeninges, nerve root ganglia in the central nervous system, thyroid C cells, bone formation in the mandible and skull base, dermis of the head and neck, myenteric nerve plexuses of the intestines, pigment cells of the skin, paravertebral sympathetic ganglia, and adrenal medulla cells.
Developmental disturbances of the neural crest cells give rise to a variety of disorders as listed above and have collectively been termed neurocristopathies by Bolande in 1974. Patients with one neurocristopahty have an increased risk of having other neurocristopathies. Familial inheritance has also been shown. There is a variability in the combinations of lesions found in the same patient or family.
Recent advances in genetics and developmental biology have provided deeper insights into these collection of conditions. New technologies in biology including iPS cell technology are expected to further advance our understanding of neurocristopathies. Read More

Authors:  Handa Atsuhiko , Priya Sarv , Sato T Shawn , Sato Yutaka

Keywords:  neurocristopathy, neural crest cells, embryology

Meldrum Jaren,  Wood Jonathan,  Rooks Veronica

Final Pr. ID: Poster #: EDU-104

The purpose of this exhibit is to provide radiologists at various levels of training with a concise and comprehensive illustrated review of anomalies associated with persistence of the falcine sinus. The exhibit will rely on literature review, illustrations, and multimodality imaging from patients with persistent falcine sinus associations. Read More

Authors:  Meldrum Jaren , Wood Jonathan , Rooks Veronica

Keywords:  falcine sinus, vein of Galen, occipital meningocele, cranial vascular embryology, cranium bifidum

Meyer Dustin,  Chandra Tushar,  Hayes Laura,  Neville Kucera Jennifer

Final Pr. ID: Poster #: EDU-011

Neural tube defects affect approximately 1/1000 pregnancies; left untreated these defects may lead to devastating consequences. The purpose of this presentation is to: 1) familiarize the reader with the normal anatomy seen on neonatal spine ultrasound, 2) describe normal variants often encountered on spine ultrasound, 3) provide an illustrated summary of spine embryology, and 4) discuss the various pathologies/disorders that may occur during each phase of spine embryology. Read More

Authors:  Meyer Dustin , Chandra Tushar , Hayes Laura , Neville Kucera Jennifer

Keywords:  Spine, Embryology, Ultrasound

Kariher Julia,  Duden Peter,  Clark Meghan,  Hook Marcus

Final Pr. ID: Poster #: EDU-019

Learning Objectives:
Review normal kidney development and embryology
Understand spectrum of renal fusion abnormalities, associated genitourinary abnormalities, and their clinical manifestations
Recognize imaging findings and important associations

Kidney Development and Abnormalities:
The metanephric blastema becomes the functioning kidney and the ureteric bud develops into the ureters and upper collecting system. Typical kidney development begins at 4 weeks gestation. Over 4-7 weeks gestations, the developing kidneys rise from the sacrum to the abdomen moving apart from each other and rotating medially with final positioning at week 9.

Renal positioning defects include malrotation which is abnormal rotation of the kidney along its long axis. The hilum often faces anteriorly, as the kidney fails to medially rotate during ascent.

Ectopic kidneys are position defects where the kidneys are not located in the renal fossa. Renal ectopia can be simple, wherein the kidney remains ipsilateral, or crossed, wherein the kidney is located contralateral to the distal ureter insertion. Pelvic kidney is the most common simple ectopia. Ectopic kidneys may coexist with fusion defects. Associated symptoms include vesicoureteral reflux, increased urinary tract infections, and renal calculi formation.

The horseshoe kidney is the most common congenital partial renal fusion abnormality (1/400 live births with male predilection).

Case Report:
Our case report had a prenatal diagnosis of absent left kidney and postnatal diagnosis of imperforate anus. Ultrasound revealed left to right crossed fused renal ectopia. Voiding cystourethrogram demonstrated additional abnormalities in the genitourinary tract, including a fistulous connection between the bladder and uterine segment/vagina and bifid appearance of the uterus with bilateral grade II vesicoureteral reflux. MRI redemonstrated left-to-right crossed fused renal ectopia and vesicovaginal/rectovaginal fistulas.

Conclusion
Cross fused renal ectopia is part of a spectrum of congenital genitourinary abnormalities and are common in prenatal assessment. Read More

Authors:  Kariher Julia , Duden Peter , Clark Meghan , Hook Marcus

Keywords:  Cross fused renal ectopia, Renal, Embryology