Final Pr. ID: Poster #: CR-035
A 10-year-old female with neurofibromatosis type 1 and severe dysplastic scoliosis, presented with a two-month history of difficulty ambulating due to lower back pain. The patient did not have neurological symptoms. An MRI of the thoracolumbar spine demonstrated subluxation of the right tenth and eleventh ribs through the neural foramina, causing mass effect on the thecal sac, but at T9-T10 without abnormal cord signal or cord compression. Several clusters of neurofibromas were present along the right ribs and paravertebral soft tissues at these levels. CT evaluation was performed for greater osseous definition, which confirmed the findings. The patient underwent complex posterior spine fusion and segmental spinal instrumentation, which included T9-T10 thoracoplasty, rib resections, and multiple Ponte osteotomies.
Cases of rib head protrusion into the central canal in the setting of dystrophic scoliosis have been documented in only a limited sample of case reports. The angulated short-segment curvature in dystrophic scoliosis causes vertebral body rotation, foraminal enlargement, spindling of transverse process, and penciling of the apical ribs. These changes can alter the articulation of the rib along the spinous process. The enlarged foramina also create a space into which a rib may displace. As a result, in most reported cases, the subluxed ribs were on the convex apex of the curve in the mid-to-lower thoracic region. The risk of cord injury makes complete depiction of the anatomy crucial for surgical management. Read More
Final Pr. ID: Poster #: CR-011
Hallermann-Streiff syndrome (HSS) is a very rare congenital disorder associated with characteristic head and face abnormalities include bird-like face, hypotrichosis, atrophy of skin, dental abnormalities, proportionate nanism, and many ophthalmic disorders. Many patients die during infancy because of life-threatening complications, such as respiratory and cardiac problems.
Authors: Choi Young-youn
Keywords: characteristic head and face abnormalities, antenatal sonography, thin tubular bones, widely opened fontanelle with sutures, flattened parietal bone, mid-facial hypoplasia, failure to thrive
Final Pr. ID: Poster #: EDU-002
Pediatric head CT examinations remain a mainstay imaging modality, frequently utilized to evaluate a wide spectrum of pediatric pathology. Current pediatric head CT protocols aim to use the least amount of radiation while providing imaging of diagnostic quality. Lower radiation doses, along with other factors, can occasionally cause CT artifacts that can affect the quality and the interpretation of images.
In this exhibit, we review examples of physics-based, patient-based and scanner-based CT artifacts on head CT exams, while also providing a brief explanation of the underlying physics and ways to mitigate the artifact. Imaging examples include among others: apparent posterior fossa masses due to beam hardening, apparent extra-axial fluid collections due to cupping artifact, apparent brain parenchymal hypodensities concerning for infarct, and apparent beading of intracranial vessels due to lower radiation doses administered.
Awareness of these artifacts is critical for radiologists, as they can potentially lead to misdiagnosis. Read More
Final Pr. ID: Poster #: SCI-059
There is no standardized evidence-based neonatal head ultrasound (HUS) training guidelines within the literature. Simulation models have previously shown to improve resident proficiency in performing ultrasound-guided procedures. We developed an ultrasound-compatible neonatal brain phantom from polyvinyl alcohol cryogel (Figure 1) with the relevant cross-sectional anatomy.
The purpose of this study was to determine whether resident performance in HUS improves with the use of this novel brain phantom training model. Read More
Keywords: Neonatal Head Ultrasound
Final Pr. ID: Poster #: SCI-047
Accurate imaging characterization of chronic subdural hemorrhage (cSDH) has clinical and forensic implications, and continues to challenge the radiologist. The MRI characteristics of surgically proven cSDH were retrospectively reviewed in the context of known pathomorphology of the aging SDH. Read More
Final Pr. ID: Poster #: EDU-14 (R)
The purpose of this exhibit is to educate sonographers on proper technique when performing cranial ultrasounds as well as present abnormalities they may encounter. I will present detailed scenarios when scanning pediatric heads which will discuss proper parameters including proper orders, technique, transducers, and limitations of patients. Age appropriate scanning will be addressed in order to ensure an adequate, diagnostic, and meaningful study. Normal and abnormal anatomy and pathology will be addressed and discussed. Patient positioning and transducer placement will be reviewed. Read More
Authors: Harding Jaclyn
Final Pr. ID: Poster #: SCI-055
The purpose of this study is to determine whether a decrease in hematocrit is predictive of an intracranial hemorrhage (ICH) on neonatal head ultrasound (HUS). Read More
Final Pr. ID: Poster #: EDU-012
Although head ultrasound (HUS) is most often used in the neonatal intensive care unit (NICU) setting as a screening exam for emergencies such as hydrocephalus, intracranial hemorrhage, and ischemic injury, a spectrum of congenital brain abnormalities may also be diagnosed, especially with state-of-the-art US technology that enables detection of more subtle malformations.
While brain MRI remains the gold standard for comprehensive evaluation of congenital CNS anomalies, knowledge of the appearance of such pathologies on HUS is vital: HUS is often the first exam performed, and some infants are too critically ill to undergo MRI. Identification of congenital anomalies by the radiologist may generate prognostic information that can impact critical medical decision-making and patient/family counseling in the NICU.
The goals of this educational poster are to provide a systematic approach to evaluating congenital brain anomalies on HUS and illustrate the ultrasound appearance of common and less common congenital abnormalities with MRI comparisons, as well as highlight potential pitfalls in making these diagnoses.
Covered entities include:
Posterior fossa malformations: e.g., Chiari II, Dandy-Walker
Midline anomalies: e.g., Holoprosencencephaly, agenesis of the corpus callosum, pericallosal lipoma
Cortical malformations: e.g., Gray matter heterotopia, schizencephaly, lissencephaly
Vascular malformations: e.g., Vein of Galen malformation
Congenital infections: e.g., Congenital cytomegalovirus Read More
Final Pr. ID: Poster #: EDU-026
To illustrate the findings of multimodality imaging exploration of the lumps and bumps in the pediatric neck and head. Read More
Final Pr. ID: Poster #: CR-001
Intracranial hemorrhage (ICH) and ischemic brain injury are rare in the fetus. The most common location of hemorrhage in the fetus is intraventricular and is related to prematurity. Intracranial hemorrhage in the fetus can be intra or extra-axial and its recognition is important because of its complications and poor outcome. The causes of fetal intracranial hemorrhage are idiopathic, maternal, and of the fetus; maternal causes vary, and the main is trauma. Domestic violence increases during pregnancy, placing the mother and the fetus at risk for injury.
Features of central nervous system nonaccidental trauma in pediatric patients are well established, however, there are not too many examples in the literature of these imaging findings in the fetal stage.
The purpose of this case is to demonstrate the features of intracranial hemorrhage and ischemic brain injury caused by nonaccidental trauma during pregnancy and the evolution after birth.
The subject of this case report is a 36-week gestation product referred because of severe ventriculomegaly detected during an obstetric ultrasound; a fetal MRI was performed which showed an acute to subacute hemispheric bilateral subdural hematoma, infratentorial subdural hemorrhage, retroclival hematoma, subarachnoid hemorrhage, ventriculomegaly, brain edema, and midline shift. The patient was born at 38 weeks through C-section with no respiratory effort and a 4 points APGAR score, he was intubated and spent 38 days in the NICU, during his stay a postnatal transfontanelar ultrasound and a brain MRI were performed and showed persistence of the supratentorial and infratentorial subdural hematomas bigger in size with an epidural component, retroclival hematoma, subarachnoid hemorrhage, brain edema, midline shift, uncal herniation and hemispheric ischemic vascular event. The etiology of this extensive and atypical presentation hemorrhage was inquired including coagulation and genetic disorders, and the medical background of the parents which came out normal; after thorough interrogation, the mother revealed trauma related to domestic violence.
In our case, we will show that the localization and features of nonaccidental trauma of the central nervous system in the fetal stage are similar to the pediatric stage. Read More
Final Pr. ID: Poster #: EDU-038
The pediatric orbit presents a wide spectrum of possible abnormalities which differ significantly from those seen in adults. Evaluation of the various pediatric orbital abnormalities depends on radiologic assessment with different imaging techniques to aid in diagnosis. The purpose of this exhibit is to describe and differentiate the more commonly encountered pediatric orbital abnormalities using a multimodality approach. Read More
Final Pr. ID: Poster #: EDU-088
Sonography is often the initial evaluation of facial lumps and bumps. Most of these lesions are benign, although some malignant lesions may present in this fashion. For education and reference, we composed a pictorial guide of a wide variety of etiologies of facial lumps and bumps.
Final Pr. ID: Poster #: SCI-049
The purpose of this study is to determine the reliability of sonographic (US) lung measurements compared with Fetal MR in fetuses with congenital diaphragmatic hernia. The sonographic lung head ratio (LHR) is a widely used prognostic tool in CDH, but can be difficult to obtain due to shifted mediastinum and fetal position. To our knowledge, comparison of MRI measured LHR with US has not been previously reported. Read More
Final Pr. ID: Poster #: EDU-074
Sinonasal tumors in the pediatric population are uncommon. Tumors affecting the nasal cavity and paranasal sinuses in children can arise from either soft tissue or bony structures and differ substantially from adult sinonasal masses. The aim of our exhibit is to review imaging features of a myriad of sinonasal neoplasms and tumor-like masses unique to the pediatric population ranging from the more well-known rhabdomyosarcoma and Ewing’s sarcoma to rarer lesions such as desmoplastic fibroma, nasal chondromesenchymal hamartoma, and melanotic neuroectodermal tumor of infancy. Read More
Final Pr. ID: Poster #: EDU-112
The calvarium and overlying scalp is a uniquely changing entity in childhood that presents a dynamic source of pathologies in early life as the child grows and the sutures fuse. Various “lumps and bumps,” both symptomatic and not, may be discovered by the parents or detected by pediatricians. Although some may be diagnosed clinically, others may require imaging for diagnosis. Ultrasound offers a simple and often definitive alternative to CT and MRI for evaluation of calvarial lesions, avoiding unnecessary radiation and expense; however, it requires a sonologist with thorough understanding of the various calvarial and scalp entities. The purpose of this exhibit is to describe the progression of calvarial and scalp lesions encountered from the neonatal period through young adulthood. Read More
Authors: Milks Kathryn