Bao Rina,  Grant Ellen,  Ou Yangming

Final Pr. ID: Poster #: SCI-030

Hypoxic Ischemic Encephalopathy (HIE) is a brain injury caused by a lack of blood and oxygen supply to the brain. HIE affects 4,000,000 term-born neonates per year worldwide, with an estimated 2 billion/year cost in the US, let alone family burdens. Therefore, reducing mortality and morbidity for HIE patients remains an important public health concern. Therapeutic hypothermia (TH) was established in 2005 as a standard therapy by cooling patients to 33-34°C in the first six postnatal hours for 72 hours. However, 35–50% of the patients still experience adverse outcomes, defined as death or cognitive Bayley Scales of Infant Development by age two years. Ongoing HIE-related trials worldwide are testing whether new therapies can supplement TH and further reduce adverse outcomes. However, therapeutic innovation is slow and inconclusive, for 1) before therapy, patients at high risk of developing adverse outcomes cannot be identified; 2) after therapy, outcomes cannot be measured until age two years. Besides, public MRI data exists for hundreds of patients with brain tumors, Alzheimer’s Disease, and other diseases, fueling AI’s success in MRI-based diagnosis and prognosis of brain tumor, Alzheimer’s Disease, and other disorders. In contrast, annotated MRIs with linked clinical and bio-marker data do not exist publicly for HIE. Our previous work has collected multi-site HIE MRI data. Therefore, to fill the gap in HIE diagnosis with MRI data, target high-risk patients, increase efficiency, evaluate therapeutic effects early, and expedite therapeutic innovations, in this work, we propose to predict 2-year neurocognitive outcomes in neonates using brain MRIs by deep learning methods. Read More

Authors:  Bao Rina , Grant Ellen , Ou Yangming

Keywords:  Brain MRIs, Brain injury, Hypoxic Ischemic Encephalopathy

Cheng Jocelyn,  Leesmidt Kantheera,  Liu Amanda,  Young Victoria,  Davda Sunit,  Berger-chen Sloane,  Courtier Jesse

Final Pr. ID: Poster #: EDU-039

Three-dimensional (3D) imaging has emerged as a valuable tool in diagnosing pediatric Müllerian duct anomalies (MDAs), offering superior anatomical visualization and assessment compared to traditional imaging techniques with two-dimensional ultrasound. MDAs are frequently associated with other congenital anomalies of the cervix, vagina, or urinary tract, and are a common cause of infertility and pregnancy loss after adolescence.

In pediatric patients, MDAs are often discovered incidentally during imaging for other conditions. Magnetic resonance imaging (MRI) is the preferred modality for evaluating MDAs in children, providing multiplanar capabilities and detailed soft tissue characterization while avoiding ionizing radiation. MRI protocols for MDAs typically include T2-weighted sequences for visualizing uterine morphology and T1-weighted sequences to detect blood products in cases of associated endometriosis or hematometra .

The use of 3D MRI techniques allows for enhanced depiction of uterine and vaginal anatomy, and is particularly advantageous in differentiating complex anomalies such as septate and bicornuate uteri. Additionally, 3D reconstructions can provide a virtual hysterosalpingogram (MR-HSG), offering a comprehensive assessment of the reproductive tract without the need for invasive procedures. 3D imaging's accuracy extends to the detection of associated renal anomalies, given the concurrent development of the urinary and reproductive systems. Identifying these anomalies early is crucial for planning surgical interventions that may involve both gynecologic and urologic components .

Overall, 3D imaging significantly enhances the diagnostic accuracy and management of pediatric Müllerian duct anomalies. By providing detailed anatomical insights and allowing for non-invasive classification, it plays a critical role in guiding treatment strategies, reducing the need for repeat surgeries, and improving long-term reproductive outcomes for affected patients.

The purpose of this educational exhibit is to:
1. Review the embryology, classification, and imaging features of Müllerian duct anomalies using 3-dimensional imaging
2. Review the indications and techniques for surgical management of Müllerian duct anomalies in pediatric patients
3. Provide sample cases and clinical courses of patients with specific Müllerian duct anomalies with tips for implementation of 3-D imaging
4. Allow learners to test their knowledge with a quiz. Read More

Authors:  Cheng Jocelyn , Leesmidt Kantheera , Liu Amanda , Young Victoria , Davda Sunit , Berger-chen Sloane , Courtier Jesse

Keywords:  MRI, Mullerian Duct Anomalies, 3D Imaging

Gould Sharon,  Thacker Mihir

Final Pr. ID: Poster #: CR-022

Knee deformity is the most common and complex lower extremity abnormality associated with Thrombocytopenia Absent Radius (TAR) syndrome. Conventional pre-operative imaging includes radiographs and computed tomography (CT) for assessment of joint alignment. We report utilizing 3-D MRI series and manual segmentation on commeicially available software to create 3-D printed models for pre-operative planning in a TAR syndrome patient with largely unossified epiphyses who had unusually severe femoral anteversion and genu varum. We discuss the methods used for imaging and segmentation as well as the value and limitations of the 3D print in pre-operative planning for this case. Even with the limitations we encountered, better understanding of the spatial relationships and joint alignment was achieved with 3-D model generation and aided in planning for correction of the knee varus deformity and femoral torsion. In addition, the diagnostic MRI information provided the basis to forgo construction of cruciate ligaments at this stage due to an increased risk of failure related to severe joint deformity. Because the prognosis for TAR syndrome is good if the child survives the first 2 years, it is important that orthopedic interventions are well planned to give a good outcome. Utilization of advanced imaging tools such as 3D imaging and printing may aid in definitive surgical planning in complex cases such as this one, and MRI can be used to generate usable anatomical models for pre-operative planning in children with incompletely ossified epiphyses. Read More

Authors:  Gould Sharon , Thacker Mihir

Keywords:  3D printing, MRI, segmentation

Cortes Albornoz Maria,  Machado Rivas Fedel,  Fazio Ferraciolli Suely,  Afacan Onur,  Jaimes Camilo

Final Pr. ID: Poster #: EDU-073

In recent years, 7 Tesla MRI has become a valuable tool in the field of neuroimaging. Ultra-high field strength provides a superior signal-to-noise ratio, which is particularly advantageous for structural and vascular imaging, as well as MR Spectroscopy. Despite the many advantages, artifacts abound at 7T and limit its translation. Furthermore, the high SAR of these scanners and regulatory restrictions imposed by the FDA can limit accessibility for pediatric patients. This educational exhibit aims to delve deeper into these issues and:
1. Review the commercially available hardware.
2. Summarize regulatory and safety constraints.
3. Highlight the advantages of 7T for structural, vascular, and MRS.
4. Illustrate artifacts and limitations.
5. Present examples of brain abnormalities at 7T.

References:

1. Opheim G, van der Kolk A, Markenroth Bloch K, Colon AJ, Davis KA, et al. 7T Epilepsy Task Force Consensus Recommendations on the Use of 7T MRI in Clinical Practice. Neurology. 2021 Feb 16;96(7):327-341. doi: 10.1212/WNL.0000000000011413. Epub 2020 Dec 22. PMID: 33361257; PMCID: PMC8055334. Read More

Authors:  Cortes Albornoz Maria , Machado Rivas Fedel , Fazio Ferraciolli Suely , Afacan Onur , Jaimes Camilo

Keywords:  7 Tesla, Brain, MRI

Hu Anna,  Kim Jane,  Peck Jeffrey,  Haroyan Harutyun

Final Pr. ID: Poster #: EDU-059

Idiopathic hip chondrolysis (ICH) is a rare pediatric musculoskeletal disorder characterized by rapid and extensive loss of articular cartilage at the femoral head and acetabulum. Symptoms of ICH, such as pain, stiffness, and limping, are often nonspecific and may overlap with other pathologies. Diagnosis of ICH is multifactorial and relies on the correlation of imaging with the clinical presentation. Due to both the rarity of this entity and nonspecific clinical symptoms, ICH may be underdiagnosed.
In this educational poster, we will review the clinical presentation, describe the imaging findings of ICH with a special emphasis on MRI features using examples from our own institution, and discuss the treatment options as well as the natural progression of disease. Recognition of the imaging features is vital in early identification of ICH which may help prevent further irreversible cartilage loss. Read More

Authors:  Hu Anna , Kim Jane , Peck Jeffrey , Haroyan Harutyun

Keywords:  idiopathic, hip chondrolysis, MRI

Mutambuze Jean,  Marine Megan

Final Pr. ID: Poster #: EDU-024

Fetal neck masses are a complex and diverse group of anomalies that can present diagnostic and management challenges for clinicians. In addition to prenatal ultrasound, fetal magnetic resonance imaging (MRI) has emerged as a powerful tool for the evaluation of these masses due to its high soft tissue contrast and ability to provide detailed anatomical information, especially with respect to the fetal airway and mediastinum. This educational exhibit explores the use of fetal MRI in the assessment of 7 different head and neck masses encountered at our institution, including providing a diagnostic approach, describing imaging features, and demonstrating the utility of fetal MRI in predicting the level of airway management the fetus may need, providing important implications for prenatal counseling and delivery management. Read More

Authors:  Mutambuze Jean , Marine Megan

Keywords:  Fetal Imaging, Fetal Masses, Fetal MRI

Oztek Murat Alp,  Wright Jason,  Perez Francisco,  Khalatbari Hedieh,  Ishak Gisele

Final Pr. ID: Poster #: CR-028

Aseptic or chemical meningitis is an inflammation of the meninges without an infectious cause. It is a diagnosis of exclusion which is reached only in the appropriate clinical context after a careful search for bacterial or viral pathogens is negative. Aseptic meningitis following transsphenoidal resection of craniopharyngioma has been reported in the neurosurgical literature with an incidence of up to 3%; however, it remains unfamiliar in the radiology literature and there have been only a few case reports describing associated imaging findings. The chemical meningitis is thought to be caused by the release of craniopharyngioma fluid which contains inflammatory cholesterol crystals. Clinical and CSF findings can be identical to bacterial meningitis except for the absence of identifiable bacterial or viral pathogens. Complications can include vasospasm, stroke, and death. The purpose of this report is to describe two cases of aseptic meningitis following craniopharyngioma resection with the hope of improving awareness among pediatric radiologists. Read More

Authors:  Oztek Murat Alp , Wright Jason , Perez Francisco , Khalatbari Hedieh , Ishak Gisele

Keywords:  Craniopharyngioma, Meningitis, MRI

Ly Juan Domingo,  Subramanian Subramanian,  Rajan Deepa,  Greene Stephanie,  Zuccoli Giulio

Final Pr. ID: Poster #: CR-010

An 11-year-old female presented with 3-weeks history of intractable vomiting, nausea, blurred vision, vertical nystagmus and ataxia with gait instability. A CT scan revealed a small calcification at the left craniocervical junction (CJJ) and mild effacement of the fourth ventricle (Figure). MRI showed a partially-enhancing medulla oblongata lesion and a non-enhancing cystic exophytic lesion abutting the left pre-medullary cistern. There was avid thick enhancement along the ventrolateral surface of the medulla oblongata. No restricted diffusion was present. MR spectroscopy demonstrated decreased NAA and elevated lactates. Based on imaging findings, a brainstem glioma with exophytic component was suspected. The CBC, CMP, ESR and CRP were normal. The patient underwent suboccipital craniectomy with C1 laminectomy, and an exophytic pale gray mass was identified. Multiple specimens were taken, and frozen diagnosis showed only necrosis. The cyst wall was resected. Resection of the brainstem component was limited by neurophysiology. Histologically, the lesion consisted of a fibrous cyst wall lined by columnar to pseudostratified columnar epithelium, findings reflecting a neuroenteric cyst. No glial tissue was identified. Gram stain and Grocott stain were negative for bacterial and fungal specimens. An empiric treatment with wide spectrum antibiotic was started. Follow-up MRI demonstrated near complete resolution of edema in the medulla oblongata, and substantial decrease in enhancement in anterolateral exophytic component and patient has substantially improved clinically. In retrospect, a sinus tract extended from the cystic lesion at the craniocervical junction into the brainstem causing edema, inflammation and enhancement which resolved once the cyst was surgically decompressed.

Conclusion:
This case shows a neuroenteric cyst connected to the brainstem, through a sinus tract leading to chronic inflammation and infection, resulting in imaging findings resembling a brainstem glioma. Surgical decompression of the cyst and antibiotic treatment resulted in resolution of the brainstem lesion. Read More

Authors:  Ly Juan Domingo , Subramanian Subramanian , Rajan Deepa , Greene Stephanie , Zuccoli Giulio

Keywords:  Neurenteric, magnetic resonance imaging MRI, glioma

Ben-david Eliel,  Zharkov Elena,  Pais Adi,  Kasirer Yair,  Bin-nun Alona

Final Pr. ID: Poster #: CR-029

A novel 1T MRI scanner, previously compared to a 1.5T Siemens scanner, was placed in our NICU. The 5-gauss safety line is inside the magnet, rendering standard magnetic safety precautions unnecessary and allowing maintaining ongoing critical care. Scans included near-term equivalent stable neonates and neonates in an acute / sub-acute setting of disease. Through the following cases we present the capabilities of the 1T in-NICU scanner to evaluate the neonatal brain throughout different phases of injury.

Case 1–Chronic. A 28 5/7 week infant born to mother with chorioamnionitis, developed sepsis. Cranial US showed bilateral IVH Grade III (L) / IV (R) on DOL 2. At DOL 49, ventriculomegaly and porencephalic cysts were detected on US. MRI at term equivalent age demonstrated the post hemorrhagic cystic degeneration and ventriculomegaly. Follow up MRI was performed at 4 months of age due to increasing head circumference. Presence of prior MRI images increased diagnostic confidence.

Case 2–Sub-acute. A term infant with moderate encephalopathy treated with therapeutic hypothermia, after absent fetal movements for two days. Complicated NICU course, with multi-system organ failure, seizures and severe hypoglycemia. MRI scan on DOL 14 showed punctate rim-T1 hyperintense foci with a hypointense center, opposite T2 signal and restricted diffusion, in the centrum semi-ovale and periventricular white matter. Sub-acute hemorrhage with suspected ischemic etiology was the working diagnosis.

Case 3–Acute. A term infant delivered by stat C-section for non-reassuring fetal heart rate and low Apgar scores. Complicated NICU course, including multisystem organ failure, seizures, and burst suppression on cerebral monitoring. MRI scan on DOL 6 showed diffuse abnormal cortical T1 and white-matter T2 signal. Restricted diffusion was seen diffusely in a posterior distribution. Diffuse hypoxic ischemic injury was diagnosed.

Case 4–Hyper-Acute. A 31 week infant was delivered by stat C-section after major maternal trauma, with extremely severe hypovolemic shock. An MRI scan was performed at 8 hours of life, to determine direction of care while intubated and on vasopressor support. Extra-axial and intraventricular hemorrhage were seen, as well as diffuse restricted diffusion. The scan assisted family and physicians to reach a decision regarding discontinuing of care. Read More

Authors:  Ben-david Eliel , Zharkov Elena , Pais Adi , Kasirer Yair , Bin-nun Alona

Keywords:  Neonate, MRI, Brain

Brown Brandon,  Shea Lindsey,  Marine Megan

Final Pr. ID: Poster #: EDU-017

MRI evaluation of the placenta, and particularly placental vascularity, is a critical yet challenging task for the radiologist. Failure to accurately diagnose ischemic changes or to detect signs of the abnormally invasive placenta can have devastating consequences for both maternal and fetal patients. The radiologist's task is further complicated by the inability to use intravenous contrast.

In this presentation, we outline a 7-point, systematic method for evaluation of the placenta, highlighting key changes in appearance and signal intensity between 1.5T and 3T MR field strength, and also incorporating a novel method for evaluating blood flow within placental parenchyma utilizing a hybrid image derived from (noncontrast) SSFP and SSFSE pulse sequences. Our systematic approach analyzes the following diagnostic criteria: location, presence of deep vessels, presence of enlarged/ectatic vessels, presence of fibrin/blood products, disruption of uterine myometrial signal, focal bulge, and signal irregularity of the bladder dome. Finally, we correlate this diagnostic method with a quantitative scoring system which can further aid with delivery planning and prognostication. Read More

Authors:  Brown Brandon , Shea Lindsey , Marine Megan

Keywords:  MRI, placenta, vasculature

Beckhorn Catherine,  Lee Rachel,  Cao Joseph

Final Pr. ID: Poster #: CR-028

Background: Granular cell tumors (GCT) are rare Schwann cell-derived soft tissue tumors typically presenting as a solitary, painless nodule in adults in the 4th to 6th decades of life, rarely presenting in children. GCT most commonly originate from gastrointestinal mucosa of the tongue or oral cavity, and are 2-3 times more common in women. While generally benign, approximately 2% of cases may be malignant; therefore, GCTs are typically treated with local surgical control.
Case: A 7-year-old male with sickle cell trait presented to clinic for a painless “pea-sized lump” on his penile shaft, which had been present since infancy but had recently grown larger. Ultrasound demonstrated a 1.8 cm lenticular-shaped mass on the dorsal mid shaft of the penis superficial to the fascial borders of the cavernous cavernosum. There was mild internal vascularity, but no invasion past fascial borders, surrounding soft tissue changes. On MRI, the mass was uniformly T1 iso-intense and T2 slightly hyperintense, with slight postcontrast enhancement. The mass was well-circumscribed, wrapped around the corpus cavernosum without invasion of the tunica albuginea, and exhibited uniform restricted diffusion, calcification, or internal fat. No lymph node involvement was noted on imaging. Surgical resection 8 months later noted a 3 cm mass, which now extended into the glans, with pathology consistent with benign GCT, with positive staining for S-100, CD68, SOX10, and calretinin, Ki-67 of 1%, and negative for SM actin. Due to depth of glans penetration, R2 resection was achieved based on the pediatric urologist’s decision to spare the glans, rather than performing a more aggressive distal penectomy. Post-operative MRI 4 months later demonstrated residual tumor with interval reduction in mass size. Additional investigation of the patient’s past medical history revealed that a benign GCT had been removed from the inside of his lip the previous year which helped support the final histopathologic diagnosis. While multifocal GCTs have been described in genetic syndromes, this patient had not undergone genetic testing to date. Read More

Authors:  Beckhorn Catherine , Lee Rachel , Cao Joseph

Keywords:  MRI, Genitourinary, Soft-Tissue Tumors

Elcic Lana,  Nashawaty Motassem,  Mousa Abeer,  Wermers Joshua

Final Pr. ID: Poster #: CR-014

Twin molar pregnancy featuring a complete hydatidiform mole and a coexisting live fetus is a rare but important condition with unique imaging findings. A 24-year-old pregnant female presented for concern for molar pregnancy on ultrasound at an outside facility. The gestational age of the pregnancy at presentation was 22 weeks and 6 days. MRI was obtained which revealed a single living fetus in cephalic presentation. Along the anterior and left lateral uterine body/fundus was a large lesion with multiple small discrete T2 hyperintense cysts intermixed with more solid T2 isointense components, as well as T2 hypointense, T1 hyperintense foci consistent with hemorrhagic products. The lesion was distinct and did not arise from the placenta. Same day ultrasound revealed a “snowstorm” appearance, consistent with twin molar pregnancy with a complete hydatidiform form and coexistent live fetus. Read More

Authors:  Elcic Lana , Nashawaty Motassem , Mousa Abeer , Wermers Joshua

Keywords:  Ultrasound and MRI, Fetal Imaging, Pregnancy

Kilpattu Ramaniharan Anandh,  Pednekar Amol,  Parikh Nehal,  Nagaraj Usha,  Manhard Mary Kate

Final Pr. ID: Poster #: SCI-026

Acquiring high-resolution diagnostic pediatric MR images is challenging due to patient movement during long scan times, resulting in spatial blurring and motion artifacts. Developing rapid acquisition methods is essential to obtaining diagnostic-quality MR images. Recently, an echo planar imaging (EPI)-based Multi-Inversion Spin and Gradient Echo (MI-SAGE) sequence was reported to acquire multiple tissue contrasts from adult brains with a single 1-minute scan. This study demonstrates the utility of a 1-minute MI-SAGE acquisition in pediatric subjects to generate clinically relevant synthetic image contrasts (T1w, T2w, T2*w) from quantitative relaxometry maps (T1, T2, and T2*). Read More

Authors:  Kilpattu Ramaniharan Anandh , Pednekar Amol , Parikh Nehal , Nagaraj Usha , Manhard Mary Kate

Keywords:  Pediatric, synthetic MRI, relaxometry

Mccauley Robert,  Pierre Kevin,  Yekeler Ensar,  Sharma Priya,  Rodero Cardoso Mariana

Final Pr. ID: Poster #: CR-027

Sparganosis is a rare parasitic infection caused by the plerocercoid larvae of Spirometra spp. That is seldom encountered in humans. Clinical presentations are often nonspecific, and imaging findings can mimic other soft tissue lesions and lead to misdiagnosis. We present a case of a 14-year-old female with an abdominal wall lesion initially suspected to be cutaneous endometriosis, which was later diagnosed as sparganosis.

Case Presentation:
A 14-year-old female presented with a progressively enlarging, tender subcutaneous mass located superior and left of the umbilicus. The lesion was associated with intermittent pain, particularly exacerbated during menstruation, which raised clinical suspicion for cutaneous endometriosis. Abdominal MRI revealed a 2.5 cm subcutaneous mass with heterogeneous signal intensity on both T1- and T2-weighted images. Areas of hyperintensity suggested hemorrhagic components, which can be seen with endometriotic implants.

The patient underwent surgical excision of the mass. Intraoperatively, a well-defined subcutaneous lesion was removed without complications. Histopathological examination unexpectedly revealed a cestode consistent with Spirometra spp. (sparganosis), along with mixed inflammation, granulation tissue formation, and focal necrosis. The cystic structure corresponded to the parasite's infection site. Postoperative management included prescribing albendazole therapy following stool sample collection to rule out residual parasitic infection.

Discussion:

Sparganosis is an uncommon parasitic infection in humans that is typically acquired through ingestion of contaminated water or undercooked meat from intermediate hosts. It often presents as a slowly growing subcutaneous mass, which can be mistaken for other soft tissue lesions such as lipomas, cysts, or, as in this case, endometriosis. Imaging findings are nonspecific; MRI may show cystic or solid masses with variable enhancement patterns. In this patient, MRI findings closely resembled cutaneous endometriosis due to the presence of hemorrhagic components within the lesion.

Definitive diagnosis of sparganosis is usually established postoperatively via histopathological identification of the parasite. This case demonstrates the importance of considering parasitic infections in the differential diagnosis of subcutaneous masses. Read More

Authors:  Mccauley Robert , Pierre Kevin , Yekeler Ensar , Sharma Priya , Rodero Cardoso Mariana

Keywords:  MRI, Infection, Pediatric Radiology

Nuruzzaman Farzana,  Ferguson Polly,  Zhao Yongdong,  Sato T Shawn,  Stimec Jennifer,  Iyer Ramesh,  Carbert Andrew,  Paschke Joel,  Potts Lauren,  Zhang Xiaoyue,  Maksymowych Walter

Final Pr. ID: Poster #: SCI-032

The ChRonic nonbacterial Osteomyelitis Magnetic Resonance Imaging Scoring (CROMRIS) consensus-based scoring system was adapted to assess specific features of bone and soft tissue inflammation in MRI of patients with CNO in a web-based interface. The objectives were to evaluate the absolute agreement of components of and summary CROMRIS scores at each body site, and the inter-rater reliability across raters. Read More

Authors:  Nuruzzaman Farzana , Ferguson Polly , Zhao Yongdong , Sato T Shawn , Stimec Jennifer , Iyer Ramesh , Carbert Andrew , Paschke Joel , Potts Lauren , Zhang Xiaoyue , Maksymowych Walter

Keywords:  Whole Body MRI, Chronic Recurrent Multifocal Osteomyelitis

Pena Trujillo Valeria,  Alkhadrawi Adham,  Gallo Sebastian,  Langarica Saul,  Jaimes Camilo,  Gee Michael,  Do Synho,  Victoria Teresa

Final Pr. ID: Poster #: SCI-001

To develop an AI-based automatic tool for Amniotic fluid volume (AFV) and fetal weight (FW) quantification that easily integrates into everyday diagnostic workflow Read More

Authors:  Pena Trujillo Valeria , Alkhadrawi Adham , Gallo Sebastian , Langarica Saul , Jaimes Camilo , Gee Michael , Do Synho , Victoria Teresa

Keywords:  Fetal MRI, Artificial Intelligence, Diagnostic

Patel Akash,  States Lisa

Final Pr. ID: Poster #: EDU-082

With the increased demand and utilization of PET/MRI in oncologic imaging, there is an ever increasing database of non-malignant pathology that has not yet been described on PET/MRI. Furthermore, the pediatric population provides an even more unique breadth of pathology that is often only seen in this age group. It is important to be able to accurately identify these common pathologies so as to not mistake them for malignancy and to prevent unnecessary follow up imaging studies and further invasive diagnostic procedures.

For this educational exhibit we review over 200 clinical pediatric 18F-FDG PET/MRs performed at our institution and highlight the most common and most interesting cases of FDG-avid non-malignant pathology.

Listed below are some of the cases to be included in the poster:
-Benign FDG avid bone tumors including non-ossifying fibromas
-Benign causes of FDG avid lymphadenopathy including cat scratch disease
-Benign causes of FDG avid lung lesions including aspiration pneumonia
-Benign causes of gastro-intestinal FDG uptake including pseudomembranous colitis
-Benign FDG avid infectious pathologies including a liver abscess Read More

Authors:  Patel Akash , States Lisa

Keywords:  PET/MR, PET/MRI, benign

Barhaghi Krystle,  Schuchardt Eleanor,  Schafer Michal,  Meyers Mariana,  Behrendt Nicholas,  Barker Alex,  Cuneo Bettina,  Friesen Richard,  Browne Lorna

Final Pr. ID: Paper #: 102

Previous studies show that phase contrast MRI (PC-MRI) can successfully measure fetal blood flow in late gestation singleton fetuses. To date there is a paucity of data quantifying fetal blood flow of twin or early gestational age pregnancies (~19 weeks). Twin-twin transfusion syndrome (TTTS) is a rare complication of monochorionic pregnancies that is believed to result from inequal flow distribution between fetuses. In this novel investigation, we utilized PC-MRI to investigate fetal aortic flow in early gestational age fetuses with TTTS or selective Intrauterine Growth Restriction (sIUGR). We compared flow distribution between the smaller and larger fetus in each twin pair. Read More

Authors:  Barhaghi Krystle , Schuchardt Eleanor , Schafer Michal , Meyers Mariana , Behrendt Nicholas , Barker Alex , Cuneo Bettina , Friesen Richard , Browne Lorna

Keywords:  Fetal MRI, Twins, Phase Contrast MRI

Dorigatti Soldatelli Matheus,  Calixto Camilo,  Jaimes Camilo,  Warfield Simon,  Gholipour Ali,  Karimi Davood

Final Pr. ID: Poster #: SCI-015

Diffusion-weighted Magnetic Resonance Imaging (dMRI) is increasingly used to study the fetal brain in utero. dMRI enables streamlined tractography, a computation with unique applications such as white matter tract-specific analysis and structural connectivity assessment. However, due to low fetal dMRI data quality and the challenging nature of tractography, existing methods often produce highly inaccurate results. This study addresses these challenges by proposing an anatomically constrained tractography method that accurately segments fetal brain tissue directly within dMRI. Read More

Authors:  Dorigatti Soldatelli Matheus , Calixto Camilo , Jaimes Camilo , Warfield Simon , Gholipour Ali , Karimi Davood

Keywords:  Diffusion MRI, Fetal MRI, Neural Network

Harris Chris,  Drum Elizabeth

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

Anesthesiologists face challenges in practicing in locations outside of the operating room. In particular when working in the MRI environment there may be unfamiliarity of the physiologic monitors and other equipment, MRI safety policies and procedures, limited access to expected equipment or additional anesthesia providers, unsure imaging protocols and positions as well as inability to rescue patients in the MRI scanner room. Read More

Authors:  Harris Chris , Drum Elizabeth

Keywords:  Anesthesia, MRI

El Hawari Mohamad,  Joshi Akash,  Zarchan Adam,  Dobbs-desilet Debbie,  Ornelas Samuel

Final Pr. ID: Poster #: EDU-101

Congenital high airways obstruction sequence (CHAOS) refers to a relatively rare fetal anomaly caused by high airway obstruction (tracheal or laryngeal) caused by atresia or stenosis. Similar imaging findings can be seen with airway obstruction due to oropharyngeal or neck masses such as teratoma. Antenatal imagining findings include but not limited to dilated fluid filled trachea and proximal bronchi, bilateral enlarged echogenic lungs with relative small sized midline heart, flattening or eversion of the diaphragm, feta ascites and anasarca and polyhydramnios. The prognosis is overall poor, however it is improved after planning for delivery and performing EXIT procedure (ex utero intrapartum treatment) with tracheostomy.
We present a case of a 20-year-old female G1P0 at 25 weeks of gestation diagnosed with Congenital high airways obstruction sequence (CHAOS) with typical features on prenatal ultrasound and fetal MR. Delivery was planned and an EXIT procedure was performed and the newborn survived. Read More

Authors:  El Hawari Mohamad , Joshi Akash , Zarchan Adam , Dobbs-desilet Debbie , Ornelas Samuel

Keywords:  Congenital High Airway Obstruction Sequence, Ultrasound, MRI

Ayyala Rama,  Maddocks Alexis,  Anupindi Sudha,  Victoria Teresa

Final Pr. ID: Poster #: SCI-041

Intraabdominal cystic lesions are relatively common prenatal diagnoses. Determining its etiology and diagnosis can be challenging on prenatal imaging. Fetal MR is a helpful imaging modality that can provide additional anatomic and physiologic information. The purpose of this study is to evaluate MR imaging findings of fetal intraabdominal cystic lesions with correlation with postnatal imaging and outcome. Read More

Authors:  Ayyala Rama , Maddocks Alexis , Anupindi Sudha , Victoria Teresa

Keywords:  Fetal, MRI, Cyst

Osman Radya,  Karmazyn Boaz,  Marine Megan,  Wanner Matthew,  Radhakrishnan Rupa,  Supakul Nucharin,  Ducis Katrina,  Jennings Samuel,  Jea Andrew

Final Pr. ID: Paper #: 128

Evaluate temporal change in position of the tip of the conus medullaris in infants with borderline or low position of the conus on initial spine ultrasound (US) performed at less than 3 months of age. Read More

Authors:  Osman Radya , Karmazyn Boaz , Marine Megan , Wanner Matthew , Radhakrishnan Rupa , Supakul Nucharin , Ducis Katrina , Jennings Samuel , Jea Andrew

Keywords:  Tethered cord, Ultrasound, MRI

Veale Simone,  Choudhary Arabinda,  Kecskemethy Heidi,  Gould Sharon

Final Pr. ID: Poster #: SCI-013

This retrospective pilot study was performed to assess the utility of limited protocol MRI for appendicitis in excluding ovarian torsion by assessing ovarian symmetry with regard to size and appearance comparing torsed cases to controls. Read More

Authors:  Veale Simone , Choudhary Arabinda , Kecskemethy Heidi , Gould Sharon

Keywords:  Ovary, Torsion, MRI

Lewis Heidi,  Kucera Jennifer

Final Pr. ID: Poster #: CR-033

Atretic cephalocele is a rare type of neural tube defect that occurs in the parietal or occipital scalp. Most cases present postnatally with a scalp nodule which may also have associated skin and hair abnormalities. We will present a case of atretic cephalocele diagnosed with fetal MRI as well as two additional cases of postnatally diagnosed atretic cephalocele in different patients.

A 26 week gestational age male fetus was found to have ventriculomegaly on routine OB ultrasound and was referred to maternal fetal medicine. Further ultrasound imaging demonstrated features suspicious for a posterior fossa encephalocele. A fetal MRI was then performed which demonstrated imaging findings consistent with an atretic cephalocele.

The imaging findings associated with atretic cephalocele including embryologic positioning of the straight sinus, the “spinning top” appearance of the tentorial incisura, and the “cigar shaped” CSF tract in the interhemispheric fissure will be illustrated in the exhibit using both fetal and postnatal MRI. Although the exact embryological development of atretic cephaloceles is not completely understood, the proposed mechanisms will be discussed. A brief summary of the associated syndromes and clinical outcomes reported in the literature will be presented.

Atretic cephalocele is a rare condition that is usually diagnosed postnatally with several characteristic imaging findings. These same abnormalities can also be seen on fetal MRI which can lead to an earlier diagnosis and more appropriate family counseling. Read More

Authors:  Lewis Heidi , Kucera Jennifer

Keywords:  atretic cephalocele, Fetal MRI

Mahalingam Neeraja,  Bates Alister,  Higano Nara,  Gunatilaka Chamindu,  Woods Jason,  Somasundaram Elanchezhian

Final Pr. ID: Poster #: SCI-010

To develop an optimized AI model to automatically segment lung volumes from pulmonary magnetic resonance images (MRI) and generate tidal volume calculations for neonatal patients with chronic lung disease of prematurity (bronchopulmonary dysplasia, BPD). Read More

Authors:  Mahalingam Neeraja , Bates Alister , Higano Nara , Gunatilaka Chamindu , Woods Jason , Somasundaram Elanchezhian

Keywords:  Bronchopulmonary Dysplasia, MRI, Deep Learning

Poot Jeffrey,  Subramanian Subramanian,  Gumus Serter,  Squires Judy

Final Pr. ID: Poster #: EDU-078

Ultrasound is a common screening examination performed in infants prior to closure of osseous posterior elements. Although radiologists with pediatric neuroradiology subspecialty training may be very familiar with many abnormalities encountered sonographically, pediatric radiologists without pediatric neuroradiology subspecialty training are often less familiar. Further, the ultrasound appearance of abnormalities of infant spine may be less well known than appearance on MRI. The purpose of this educational review is to demonstrate normal appearance of infant spine and illustrate abnormalities that are frequently and infrequently encountered during screening ultrasound evaluation, with MRI for comparison. Read More

Authors:  Poot Jeffrey , Subramanian Subramanian , Gumus Serter , Squires Judy

Keywords:  Spine, Ultrasound, MRI

Utz Norbert,  Daumer Ilona,  Katoh Marcus

Final Pr. ID: Poster #: CR-022

To present two rare cases of spondylodiscitis of the infant age group who refused to walk and stand. Both had no fever and showed only mild laboratory signs of infection with slight CRP and ESR elevation without leukocytosis. Read More

Authors:  Utz Norbert , Daumer Ilona , Katoh Marcus

Keywords:  Spondylodiscitis, Toddler, MRI

Villanueva Fernando,  Barragan Eduardo,  Suarez Pilar,  Hidalgo-tobon Silvia

Final Pr. ID: Poster #: SCI-006 (S)

Los problemas en el desarrollo del lenguaje se han incrementado en anios recientes, se estima que solo en Mexico el siete por ciento de los ninios presenta alteraciones del lenguaje. La caracterizacion de los valores de ADC y FA asociados al area de Broca y Wernicke propuestas por el modelo clasico pueden permitir en un mediano plazo detectar anomalias en el sistema del lenguaje pudiendose utilizar para un diagnostico temprano. Por esta razon nuestro primer objetivo es caracterizar ambos parametros en pacientes sanos que permita establecer valores de control. Read More

Authors:  Villanueva Fernando , Barragan Eduardo , Suarez Pilar , Hidalgo-tobon Silvia

Keywords:  mri, brain, Language

Ratnayake Charith,  Subramanian Subramanian,  Narayanan Srikala,  Gaesser Jenna

Final Pr. ID: Poster #: CR-023

We present novel brain MRI findings in 2 children presenting with seizures due to TMCO1 mutation. Both children had absent olfactory bulbs and olfactory tracts and hippocampal malrotation. EEG demonstrated right temporal slow waves and intermittent focal slowing. One child had pontine hypoplasia, hypoplasia of bilateral optic nerves/chiasm, and an absent right cochlear nerve. In both children, there was increased mineralization in bilateral globi pallidi and bilateral substantia nigra on SWI sequence, possibly from excessive calcium. Ventriculomegaly and cavum septum pellucidum were also present in both children. Spine MRI revealed segmentation abnormalities including partial fusion of T2/T3 vertebral bodies and fusion of the posterior elements of T3-T5. Both children exhibited dysplastic and bifid ribs, demonstrating partial posterior fusion. Right renal agenesis was also noted in one child.

TMCO1 mutation results in cerebro-facio-thoracic dysplasia (CFTD) due to abnormal calcium homeostasis. The transmembrane and coiled-coil domains 1 protein directs formation of endoplasmic reticulum calcium leak channels which facilitate calcium leak upon overload of the endoplasmic reticulum. Failure of calcium leak results in abnormal cell function resulting in delayed osteogenesis, reduced mitochondrial volume, reduced mitochondrial respiration, and decreased endoplasmic reticulum stress mediated apoptosis. These children have distinctive craniofacial dysmorphism, global developmental delay, and skeletal anomalies. Previous studies have demonstrated only mild ventriculomegaly, corpus callosum abnormalities, frontotemporal atrophy, and three cases of associated epilepsy. Olfactory bulb agenesis may be due to abnormal development of the cribriform plate of the ethmoid and failure of olfactory nerves to induce development of the olfactory bulb from the telencephalon. We demonstrate that TMCO1 may play a more extensive and previously undescribed role in neurodevelopment, specifically in the formation of the hippocampus, optic nerve, and pons. Read More

Authors:  Ratnayake Charith , Subramanian Subramanian , Narayanan Srikala , Gaesser Jenna

Keywords:  Pediatric, Dysplasia, MRI