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
Vascular:
1. Carotid vasculitis secondary to petrous abscess
Miscellaneous Lesions:
1. Cholesteatoma (congenital and acquired)
2. Cholesterol granuloma Read More

Authors:  Karuppiah Viswanathan Ashok Mithra , Wilson Nagwa

Keywords:  Temporal Bone, Children, Acquired lesions

Masum Rukya,  Dixon Chanae,  Ryan Maura,  Jaju Alok

Final Pr. ID: Poster #: EDU-067

This review describes the CT and MRI features of developmental variants and pathological lesions that involve the skull base, excluding those centered in the nasal cavity, nasopharynx, sinuses and orbits.
Normal anatomy of developing bony skull base will be illustrated. The lesions are categorized by pathology rather than locations, and the following entities will be covered.
Congenital and developmental lesions - arrested pneumatization, aberrant arachnoid granulations, dermoid/epidermoid cysts, ecchordosis physaliphora, encephaloceles, persistent craniopharyngeal canal
Inflammatory/Infectious lesions - skull base osteomyelitis, petrous apicitis, cholesterol granuloma
Benign lesions - Fibrous dysplasia, aneurysmal bone cyst, osteoma, osteochondroma, meningioma
Malignant lesions - Langerhans cell histiocytosis, lymphoma, neuroblastoma metastasis, Ewing’s sarcoma, osteosarcoma, chordoma, chondrosarcoma Read More

Authors:  Masum Rukya , Dixon Chanae , Ryan Maura , Jaju Alok

Keywords:  Skull base, Pediatrics, skull base lesion

Rajani Heena,  Graeber Brendon

Final Pr. ID: Poster #: EDU-064

Although juvenile inflammatory arthritis is one of the most common atraumatic joint pathologies in children, many other infectious, vascular, and hemorrhagic lesions, benign and malignant neoplasms, and tumor-like conditions are known to affect the pediatric synovium and periarticular soft tissues. In a child with suspected joint pathology, radiographs are an essential part of the initial imaging assessment, followed by MRI for more definitive characterization of the synovial lesion. Ultrasound is also an important adjunct modality in the imaging of these entities.

In this educational poster, we highlight the diagnostic imaging features of some of the common and uncommon pediatric synovial pathologies with emphasis on the specific MRI characteristics that aid in accurate diagnoses, such as presence of a solid or cystic mass, thick enhancing synovium, rice bodies, cartilaginous and osseous loose bodies, vascular channels, hemosiderin staining, articular erosions and marrow edema. Synovial sarcoma and vascular malformations, while not truly synovial lesions, are also considered because they are sometimes located near the joints and because they can have clinical and imaging overlap with synovial lesions.

The following entities will be illustrated and reviewed:
1. Baker cyst
2. Ganglion cyst
3. Oligo-articular JIA (knee and wrist)
4. Tuberculous arthritis
5. Tenosynovial giant cell tumor
6. Hemophilic arthropathy
7. Synovial chondromatosis
8. Low-flow vascular malformation
9. Synovial sarcoma (knee, ankle and elbow)

We also propose an MRI-based diagnostic algorithm for accurate characterization of pediatric synovial pathologies based on morphology (localized versus diffuse, cystic versus solid); signal characteristics on T2-weighted images, gradient sequences and post-gadolinium images; and associated osseous changes, in addition to certain highly specific radiological features of each entity. Read More

Authors:  Rajani Heena , Graeber Brendon

Keywords:  Synovial lesions, MRI

Sharma Priya,  Estrin Yvonne,  Loubriel Daphne,  Rajderkar Dhanashree

Final Pr. ID: Poster #: EDU-118

Learning Objective: This educational exhibit will review a variety of pediatric splenic lesions and their appearance on various specific multimodality imaging finding as seen on ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). This exhibit will also review an algorithm to approaching non-cystic splenic lesions in pediatrics. Read More

Authors:  Sharma Priya , Estrin Yvonne , Loubriel Daphne , Rajderkar Dhanashree

Keywords:  Splenic Lesions, Spleen, Algorithm

Almarshad Mody,  Aljabr Aljoharah,  Aldraihem Ahmed

Final Pr. ID: Poster #: EDU-033

The goals of this study were to categorize abdominopelvic lesions in infants, analyze their imaging characteristics, identify common and uncommon lesions, and provide a comprehensive collection of images. Read More

Authors:  Almarshad Mody , Aljabr Aljoharah , Aldraihem Ahmed

Keywords:  Abdominopelvic, Lesions, Infancy

Biswas Som,  Sandhu Preet

Final Pr. ID: Poster #: EDU-061

To study the various mandibular and maxillary lesions in pediatric age group.

To present the differentiating features of these lesions. Read More

Authors:  Biswas Som , Sandhu Preet

Keywords:  Pediatric Jaw, Mandibular lesions, Maxillary lesions

Chilukuri Sanjeev,  Molleston Jean,  Karmazyn Boaz

Final Pr. ID: Poster #: EDU-013

Management of incidentally discovered pediatric liver lesions can be challenging. As compared with adults, no formal guidelines exist on this subject. Our purpose is to suggest an approach to the management of incidental pediatric liver lesions based on review of the literature and our institutional multidisciplinary experience.

Outline:
- Main considerations when evaluating incidental liver lesions in children (including age, alpha fetoprotein level, lesion size, imaging characteristics differentiating benign and malignant tumors, role of contrast-enhanced US, role of hepatobiliary contrast MRI)
- Suggested approach to the management of incidental liver lesions detected by US, CT, and MRI
- Examples of common incidental liver lesions (cyst, hemangioma, focal nodular hyperplasia, hepatocellular adenoma, focal fatty infiltration and sparing) Read More

Authors:  Chilukuri Sanjeev , Molleston Jean , Karmazyn Boaz

Keywords:  Incidental, Liver, Lesion

Keehn Brian,  Patel Mittun,  Peterson Michael,  Dance Logan,  Biyyam Deepa,  Pokorney Amber,  Barnes Craig

Final Pr. ID: Poster #: EDU-071

Radiologists have classically been taught the imaging findings of skeletal “Don’t touch lesions” on radiographs. The radiologist's goal is to best characterize these boney lesions and avoid tissue biopsy, especially since some bone lesions are misleading when viewed histologically, with nonaggressive lesions appearing aggressive. Many of these classical “Don’t touch lesions” are now being further evaluated with contrast enhanced magnetic resonance imaging (MRI). MRI findings of these radiographically classical lesions are not as well understood by radiologists with less MRI experience. We will provide an education exhibit to display MRI and corresponding radiographic appearances of characteristic “Don’t touch lesions”. Read More

Authors:  Keehn Brian , Patel Mittun , Peterson Michael , Dance Logan , Biyyam Deepa , Pokorney Amber , Barnes Craig

Keywords:  Don't touch lesions, benign bone lesions

Raissaki Maria,  Demetriou Stelios,  Skiadas Christos,  Spanakis Kostas,  Stratigaki Maria,  Katzilakis Nikos,  Stiakaki Eftichia,  Karantanas Apostolos

Final Pr. ID: Poster #: EDU-012

There are various conditions or diseases that may cause multiple bone marrow lesions in children or adolescents. Radiographically, lytic lesions may become apparent after loss of >50% of bone mineral content. Scintigraphy requires osteoblastic activity and is not specific. MRI has been increasingly employed for the investigation of diseases that involve the skeleton and for further delineation of radiographic findings in symptomatic children.
Purpose: To describe the MRI findings of entities resulting in multiple bone marrow lesions in children and provide a wide differential diagnosis. Read More

Authors:  Raissaki Maria , Demetriou Stelios , Skiadas Christos , Spanakis Kostas , Stratigaki Maria , Katzilakis Nikos , Stiakaki Eftichia , Karantanas Apostolos

Keywords:  bone marrow, polyostotic, multifocal bone lesions, mri

Sheikh Zishan,  Kumbla Surekha,  Bracken Jenny

Final Pr. ID: Poster #: EDU-060

Neck lesions are a common clinical scenario encountered in children. They can present as neck lumps or be discovered incidentally on medical imaging performed for other indications. While most paediatric neck lesions are benign, they can be a source of morbidity to patients and cause considerable anxiety to their care givers. Neck lesions in infants are made additionally more challenging as this area can be difficult to assess clinically. A clinically evident or suspected neck mass has, as a result, become a common indication for medical imaging in this age group. Being aware of the spectrum of neck lesions seen in infants and their respective imaging manifestations helps direct management appropriately in these cases.

A review of neck lesions seen in infants seen at a tertiary paediatric centre over the last two decades is presented with correlation of imaging findings across multiople modalities with the final diagnosis. Our aim is to provide an overview of both common and rare neck lesions seen in this age group by using broad categories of congenital, inflammatory and aggressive/malignant lesions. As well as showcasing cases with classic imaging findings we will include some cases where features overlapped between different varieties of neck lesions to illustrate pitfalls in imaging neck lesions in infants. Read More

Authors:  Sheikh Zishan , Kumbla Surekha , Bracken Jenny

Keywords:  infant, neck, lesion

Utturkar Atul,  Kan J.,  Ditzler Matthew,  Schallert Erica,  Jadhav Siddharth,  Smith Brian,  Gladstein Aharon

Final Pr. ID: Paper #: 063

Bassett's ligament is an accessory fascicle of the anterior tibiofibular ligament that is not well addressed in pediatric patients. In the adult literature, it is known that the ligament is not present in some patients, but may be thickened in the setting of talar dome osteoarthritis. The purpose of our study was to determine the prevalence of Bassett’s ligament and measure its thickness in pediatric patients with MRI findings of lateral talar osteochondral lesions (OCLs), medial talar OCLs, and posterior ankle impingement and compare these measurements with patients with a normal ankle MRI. Read More

Authors:  Utturkar Atul , Kan J. , Ditzler Matthew , Schallert Erica , Jadhav Siddharth , Smith Brian , Gladstein Aharon

Keywords:  osteochondral lesion

Mcbee Morgan,  Towbin Alexander,  Dillman Jonathan,  Trout Andrew

Final Pr. ID: Poster #: EDU-004

Cystic liver lesions in the pediatric population are relatively uncommon but encompass a wide range of pathologies. It is important for radiologists to be familiar with the differential diagnosis and imaging characteristics of each entity because prognosis and treatment vary widely. This educational exhibit will review the appearance of various cystic liver lesions in the pediatric population by ultrasound, CT, and MRI and will review clinical presentation and genetic/biologic causes. Read More

Authors:  Mcbee Morgan , Towbin Alexander , Dillman Jonathan , Trout Andrew

Keywords:  hepatic cyst, Cystic mass, Fluid lesion

Yepuri Aparna Devi,  Loomis Judyta,  Gilbert Vezina

Final Pr. ID: Poster #: EDU-051

The purpose of the pictorial review is to aid in understanding and identifying the spectrum of possible congenital oral lesions and make the radiologist familiar, as early detection of these is required to avoid potential perinatal and postnatal complications.

We performed a retrospective review of radiology reports from our pediatric hospital system, inclusive of our fetal imaging center, focusing on congenital oral lesions with prenatal or postnatal diagnoses. Utilizing multiple keywords through our radiology report data mining software, we reviewed cases over the last 15 years and grouped lesions based on the most likely diagnosis. Available prenatal and postnatal imaging, clinical management, and pathology was reviewed.

Our review of cases yielded both common congenital oral lesions, such as hemangiomas, as well as more extensive malformations and tumors of the face extending to the oral cavity. Lesions such as epulis, oral duplication cysts, and lingual ectopic thyroid were rarer in our review, but have imaging characteristics important to recognize by the radiologist. We selected representative images from the spectrum of congenital oral and outlined radiology and clinical teaching points. Read More

Authors:  Yepuri Aparna Devi , Loomis Judyta , Gilbert Vezina

Keywords:  oral lesions

El-ali Alexander,  Coblentz Ailish,  Degnan Andrew

Final Pr. ID: Paper #: 066

Solitary epiphyseal lesions are rare in children, and no large series describes the relative frequency of different etiologies. Understanding the incidence and nature of epiphyseal lesions is critical in informing radiologists encountering these lesions. Read More

Authors:  El-ali Alexander , Coblentz Ailish , Degnan Andrew

Keywords:  Bone tumor, Epiphysis, Solitary lytic lesion

Bates Nicholas,  Nurkic Tarik,  Sharma Priya,  Rajderkar Dhanashree

Final Pr. ID: Poster #: EDU-116

There are many recognized causes of benign bony lesions in pediatric age group. Some of the lesions are commonly encountered, and some of them are very rare. The purpose of our exhibit is to illustrate a complete spectrum of the benign bony pathologies including 'Donot touch lesions'. Read More

Authors:  Bates Nicholas , Nurkic Tarik , Sharma Priya , Rajderkar Dhanashree

Keywords:  Benign, Multifocal, Do No touch lesions, Multifocal benign lesions in Pediatric Population, Benign bony lesions

Ferreira Botelho Marcos,  Greenfield Susan,  Hughes Katrina,  John Susan

Final Pr. ID: Poster #: EDU-027

Congenital bronchopulmonary malformations are frequently encountered in the routine clinical practice. The specific diagnosis of pulmonary sequestration, associated or not with congenital pulmonary airway malformations (hybrid lesion) has important treatment and prognostic values. The purpose of this exhibit is to explain the current understanding of pulmonary sequestrations and improve diagnostic accuracy among general and pediatric radiologists when describing such lesions. Read More

Authors:  Ferreira Botelho Marcos , Greenfield Susan , Hughes Katrina , John Susan

Keywords:  Pulmonary sequestration, Congenital bronchopulmoary malformation, Hybrid lesion