Nichols Joshua,  Schmid Ariel,  O'neill Thomas

Final Pr. ID: Poster #: EDU-081

New cases of epilepsy occur in up to 1 in 500 children, 30% of whom will develop intractable seizures despite medical therapy. The majority of focal epilepsy cases can be attributed to a structural abnormality, although identification of the epileptogenic focus can be challenging and often requires a multimodal approach. Recent developments in neurological imaging have improved localization of epileptogenic foci as well as mapping of eloquent regions of the brain, aiding in treatment decision making, surgical planning, and patient outcomes.
The goal of this educational poster is to present a case-based review of imaging evaluation for drug-resistant focal epilepsy in the pediatric patient with a focus on indications and protocols for neuroimaging techniques including structural brain imaging and fMRI, particularly in an underserved community with resource constraints. An approach to pediatric structural MRI and fMRI will be presented including post-operative imaging follow up.
The pediatric neuroradiologist plays a critical role in localization of epileptogenic foci as well as functional mapping and plays a critical role in the care of children with intractable epilepsy. Read More

Authors:  Nichols Joshua , Schmid Ariel , O'neill Thomas

Keywords:  Functional, MR, Epilepsy

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

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

Tsitsiou Yvonne,  Rychik Jack,  Biko David,  Cahill Anne Marie,  Serai Suraj,  Durand Rachelle,  Golberg David,  Glatz Andrew,  Rand Elizabeth,  Wilkins Benjamin,  Witschey Walter,  Dodds Kathryn,  Russo Pierre

Final Pr. ID: Paper #: 071

Fontan–associated liver disease (FALD) is associated with increased risk of liver cirrhosis and hepatocellular carcinoma. Liver biopsy is the current gold standard investigation for diagnosing liver fibrosis. Magnetic Resonance Elastography (MRE) is a non-invasive procedure assessing liver stiffness. To date, only limited published studies are available describing the correlation of MRE and biopsy in Fontan-associated pediatric patients. Further, longitudinal changes in MRE require an increase in hepatic stiffness of >22% to indicate true change in stiffness (95% CI). The purpose of this study is to determine the clinical implication of MRE in FALD.

Read More

Authors:  Tsitsiou Yvonne , Rychik Jack , Biko David , Cahill Anne Marie , Serai Suraj , Durand Rachelle , Golberg David , Glatz Andrew , Rand Elizabeth , Wilkins Benjamin , Witschey Walter , Dodds Kathryn , Russo Pierre

Keywords:  MR Elastography, Fontan, Liver Biopsy

Moore Tyler,  Hopkins Katharine

Final Pr. ID: Poster #: EDU-082

Functional magnetic resonance urography (fMRU) provides not only anatomic information but quantitative functional information as well. Several free tools are available to perform functional analysis. One such tool, CHOP-fMRU, is appealing because its creators have provided extensive instructions on their software and scan protocols.

Several barriers were encountered in attempting to implement CHOP-fMRU at OHSU. First, to perform the analysis, the appropriate DICOM files must be acquired from PACS. CHOP-fMRU is compatible with a limited number of transfer syntaxes, so a conversion is required after PACS download if the encoding is incompatible. Second, CHOP-fMRU is incompatible with some types of data elements that can be found in files with valid DICOM formats. Third, only the dynamic series can be included when importing a study into CHOP-fMRU, and every image in the set must be present. If an image from another series is included or an image from the dynamic series is excluded, the user encounters an error. Finally, when the analysis has been performed, it is desirable to send the results to PACS. Unless the user has purchased an Interactive Data Language (IDL) license, the images may only be exported as JPEG files. These files must be packaged into DICOM files with the correct header data before they are sent to PACS using DICOM network protocol.

While these tasks could each be accomplished with any one of many available DICOM tools, some of the tasks are moderately complex, and performing them manually would be time consuming. Instead, an additional piece of software desigend solely to perform these functions as simply and efficiently as possible can be helpful. Such a solution was attempted at OHSU, and the resulting software, CHOP-fMRU Assistant, is presented here.

CHOP-fMRU Assistant is a program written in C# using the Grassroots DICOM (GDCM) library. Current features include automatic transfer syntax conversion, removal of many potentially incompatible data elements, easy exclusion of unwanted series, analysis of the dynamic series for missing images, and conversion of the results from CHOP-fMRU to DICOM files for upload to PACS. CHOP-fMRU Assistant is available at https://github.com/overtone1000/CHOP-fMRU_Assistant under an open-source license and is offered with an associated wiki to help other institutions who have encountered similar barriers while attempting to implement CHOP-fMRU. Read More

Authors:  Moore Tyler , Hopkins Katharine

Keywords:  MR, Functional, Renal

Grimm Elizabeth,  Law Emily,  Luo Yu

Final Pr. ID: Poster #: EDU-015

Arthritis in pediatric patients presents a range of diagnostic challenges, including conditions such as septic arthritis, inflammatory arthritis, idiopathic chondrolysis, toxic synovitis, Lyme arthritis, and hemophilic arthritis. These conditions often share overlapping clinical and imaging features, complicating accurate diagnosis. However, key differences in clinical presentation and imaging findings can aid in differentiation. For instance, both septic arthritis and inflammatory arthritis may present with joint pain, swelling, and limited range of motion, with ultrasound commonly revealing joint effusion. Septic arthritis is typically characterized by an acute onset, high fever, elevated white blood cell (WBC) count, and significantly increased inflammatory markers. MRI findings often include complex joint effusions, synovial thickening, and periarticular bone marrow edema, with advanced cases showing periarticular myositis or pyomyositis and osteomyelitis involvement. In contrast, inflammatory arthritis usually presents with gradual onset, low-grade fever, and minimal WBC elevation, with MRI findings of symmetric or asymmetric synovial thickening, synovial enhancement, pannus formation, and mild to none surrounding muscular or bony involvement.
This educational exhibit aims to review the epidemiology of pediatric arthritis, including septic arthritis, inflammatory arthritis, idiopathic chondrolysis, toxic synovitis, Lyme arthritis, and hemophilic arthritis. It will discuss appropriate imaging protocols and highlight key clinical and imaging features that distinguish each arthritis, enhancing diagnostic accuracy and optimizing patient management. Read More

Authors:  Grimm Elizabeth , Law Emily , Luo Yu

Keywords:  Septic Arthritis, MR, Infection

Lu Fang,  Anupindi Sudha,  Pollock Avrum,  Johnson Ann,  Adzick N,  Victoria Teresa

Final Pr. ID: Poster #: EDU-075

Duodenal atresia (DA) results from failure of recanalization of the solid core of the duodenum, usually diagnosed as the classic “double bubble”. It may come in solitary or associated with other congenital abnormalities. The aim of this educational exhibit is to describe and demonstrate common and uncommon presentations of prenatal DA and associated anomalies with emphasis on fetal MR findings. Read More

Authors:  Lu Fang , Anupindi Sudha , Pollock Avrum , Johnson Ann , Adzick N , Victoria Teresa

Keywords:  duodenal atresia, Fetal MR

Nyalakonda Ramyashree,  Muehe Anne,  Iles Benjamin,  Theruvath Ashok,  Siedek Florian,  Agarwal Vibhu,  Hawk Kristina,  Jeng Michael,  Daldrup-link Heike

Final Pr. ID: Paper #: 148

To compare the detection of lesions between DW-MRI and ¹⁸F-FDG PET/MR for staging and restaging of Langerhans Cell Histiocytosis (LCH), using all clinical outcomes and imaging data as the reference standard. Also, this study will compare the differences between LCH chemotherapy responders and non-responders. Read More

Authors:  Nyalakonda Ramyashree , Muehe Anne , Iles Benjamin , Theruvath Ashok , Siedek Florian , Agarwal Vibhu , Hawk Kristina , Jeng Michael , Daldrup-link Heike

Keywords:  Langerhans Cell Histiocytosis, Diffusion Weighted Imaging, 18F-FDG PET/MR

Salman Rida

Final Pr. ID: Poster #: CR-020

Early onset colorectal cancer (EOCRC) in children has an incidence of approximately 1 per million, representing only 1% of all pediatric malignancies. Despite being rarer in the pediatric population, pediatric rectal carcinoma is on the rise and has worse outcomes than in adults. A large cohort study identified adenocarcinoma as the most common rectal tumor in pediatric patients and the major cause of death in this category of patients. Most EOCRC tumors are sporadic, with only 20-30% of patients having a hereditary genetic predisposition with Lynch syndrome being the most common hereditary cancer syndrome implicated in the pathogenesis of EOCRC. Pediatric rectal tumors tend to be larger and more likely to have lymph node involvement, and distant metastases.

The subject of this case is a 17-year-old female presenting with rectal bleeding and weight loss. She underwent a colonoscopy which was suggestive of proctitis and biospies were taken. The clinical presentation and scope exam were suggestive of inflammatory bowel disease such as ulcerative colitis. Magnetic resonance enterography (MRE) was ordered to check for small bowel disease involvement. MRE showed circumferential rectal wall thickening and enhancement with corresponding restricted diffusion, associated with multiple polypoid lesions protruding into the perirectal fat and some of which appears inseparable from the adjacent uterus. There were also multiple enlarged perirectal lymph nodes. The biopsies from the colonoscopy demonstrated non specific inflammatory changes. Based on the MRE findings which were suggestive of malignant process, a biopsy of one of the rectal polyps was performed and showed evidence of rectal adenocarcinoma. CT chest, abdomen and pelvis demonstrated metastatic lung nodules and liver lesion. Staging rectal MRI was also performed at an outside adult institution. Patient was then started on chemotherapy. Genetic testing identified a heterozygous germline variant of uncertain significance in the POLD1 gene. Germline POLD1 mutations were historically associated with polyposis of the GI tract and early onset colorectal cancer and there have been increasing reports of patients with mutations in this gene who did not have polyps prior to cancer development.

The aim of this case report is to underscore the importance of exploring this diagnosis when imaging findings do not align with a suspected benign condition. Read More

Authors:  Salman Rida

Keywords:  Rectal Bleeding, MR Enterography, Cancer

Davila Jorge,  Highmore Kerri,  Miller Elka

Final Pr. ID: Poster #: SCI-064

The objective of this prospective study was to determine the accuracy of MR Enterography (MRE) in the assessment of mucosal healing in patients with Pediatric Crohn’s Disease (PCD) after starting treatment. MARIA and Clermont scores are MRE scores that were originally developed in adult population for the assessment of severity of Crohn's Disease (CD) in correlation to Crohn's Disease Endoscopic Index of Severity (CDEIS). MARIA score has shown close correlation to disease severity of colonic CD and Clermont score has shown close correlation to terminal ileum disease. A few reports have shown correlation of mucosal heling when assess by MRE scores and CDEIS in Adult population, but not work is available in pediatrics. Read More

Authors:  Davila Jorge , Highmore Kerri , Miller Elka

Keywords:  MR Enterography, pediatric crohn's disease

Hill Ann,  Hirsig Leslie,  Yazdani Milad,  Collins Heather,  Jenkins Dorothea

Final Pr. ID: Poster #: SCI-015

MRS is the best prognostic indicator for hypoxic-ischemic encephalopathy (HIE) but is difficult to obtain early after injury. We investigated whether cerebral blood flow measures of resistive indices (RI) and time average maximum velocities (TAMx) shortly after birth would relate to later degree of neural injury by MRI in hypothermic HIE newborns. We predicted that abnormally high/low blood flow would be associated with poor outcomes. Read More

Authors:  Hill Ann , Hirsig Leslie , Yazdani Milad , Collins Heather , Jenkins Dorothea

Keywords:  Cerebral Blood Flow, Hypoxic Ischemic Encephalopathy (HIE), Magnetic Resonance Spectroscopy (MRS)

Lillis Anna,  Krishnamurthy Ramkumar,  Boe Brian,  Setty Bhuvana,  Sena Laureen,  Krishnamurthy Rajesh

Final Pr. ID: Paper #: 018

Dynamic Contrast Enhanced MR Lymphangiography (DCMRL) allows evaluation of the central conducting lymphatics in patients with central lymphatic flow dysfunction. Direct injection of gadolinium contrast into inguinal lymph nodes followed by serial imaging allows visualization of lymphatic channels and lymphodynamics. This study reviews the DCMRLs performed at our institution over a 2 year period including indications, findings and impact on clinical management. Read More

Authors:  Lillis Anna , Krishnamurthy Ramkumar , Boe Brian , Setty Bhuvana , Sena Laureen , Krishnamurthy Rajesh

Keywords:  MR Lymphangiography, Thoracic Duct, Lymphatic

Joshi Aparna,  Grove Jason,  Ladino-torres Maria

Final Pr. ID: Poster #: EDU-005

Dynamic contrast-enhanced MR lymphangiography (DCEMRL) with intranodal injection has emerged as a useful tool in evaluating lymphatic disorders. We share our institutional experience with DCEMRL in infants through a detailed discussion of technique and series of case presentations.

Techniques for nodal access and imaging infants with DCEMRL are explained through text and step-by-step illustrations.

MR lymphangiography images of infants between 22 days and 8 weeks of age are presented with multi-modality correlation, including patients with congenital chylous ascites, non-immune fetal hydrops, and postsurgical chylothorax. Each case discussion includes a review of relevant lymphatic anatomy, explanation of the disease process, and key teaching points regarding DCEMRL in infants. Read More

Authors:  Joshi Aparna , Grove Jason , Ladino-torres Maria

Keywords:  Lymphangiography, Infant, MR

Bodner Jeffrey,  Khanna Geetika,  Riedesel Erica,  Gill Anne,  Hawkins Matt,  Shah Jay,  Variyam Darshan,  Alazraki Adina

Final Pr. ID: Poster #: EDU-052

Evolution of MR Lymphangiography has expedited diagnosis and advanced potential implications for treatment in lymphatic disorders. In particular, evaluation of the central conducting lymphatic channels with dynamic contrast enhanced MR provides better spatial resolution, while sparing ionizing radiation inherent in lymphangio-scintigraphy and catheter lymphangiography.

We will review indications, technique with pearls and pitfalls, and overall success rates after MR lymphangiography at our institution. To discuss post-imaging clinical outcomes and implications for treatment. To illustrate imaging findings of various lymphatic pathology diagnosed on MR. Read More

Authors:  Bodner Jeffrey , Khanna Geetika , Riedesel Erica , Gill Anne , Hawkins Matt , Shah Jay , Variyam Darshan , Alazraki Adina

Keywords:  Lymphatic, Lymphangiography, MR

Hughes Jordan,  Chowdhary Anisa,  Walczak Edward,  Awan Baarkullah,  Jalili Mohammad

Final Pr. ID: Poster #: EDU-088

Fetal MRI is useful in the detection and evaluation of several fetal pulmonary abnormalities including congenital diaphragmatic hernia, pulmonary hypoplasia and pulmonary airway malformations. MRI offers a noninvasive modality that is complementary to ultrasound for detecting fetal abnormalities. Fetal MRI can also be beneficial in helping to establish the prognosis and assisting in perinatal management. One of the major advantages of MRI is that it allows the quantitative measurement of lung volume thereby providing the observed total fetal lung volume (TFLVo) which can be compared to expected total fetal lung volume. A ratio of observed to expected ratio can be calculated. This can be useful in prognosis and risk stratification, particularly in diaphragmatic hernias. MRI also has the advantage of excellent spatial resolution and evaluation of soft tissues structures that may be present above the diaphragm. In this exhibit we will provide several cases including congenital diaphragmatic hernia, congenital pulmonary airway malformation and bilateral pulmonary hypoplasia to illustrate the benefit and utility of fetal MRI for the evaluation of fetal thoracic abnormalities. Read More

Authors:  Hughes Jordan , Chowdhary Anisa , Walczak Edward , Awan Baarkullah , Jalili Mohammad

Keywords:  MR, Congenital Diaphragmatic Hernia, Pulmonary Hypoplasia

Albers Brittany,  Yang Yiting,  Parikh Ashishkumar,  Shah Chetan

Final Pr. ID: Poster #: SCI-015

Head CT is often performed in the emergency setting to evaluate for new neurologic symptoms. CT is limited in evaluation of acute stroke, brainstem and posterior fossa lesions, demyelinating disease, and diffuse axonal injury. Unremarkable head CT may be falsely reassuring and can delay treatment. Limited sequence MR (LSMR) is a new approach for evaluating a patient with neurologic symptoms. In order for LSMR to be feasible, it must be accurate, efficient, and cost-effective. Read More

Authors:  Albers Brittany , Yang Yiting , Parikh Ashishkumar , Shah Chetan

Keywords:  Emergency, CT, MR

Shellikeri Sphoorti,  Setser Randolph,  Acord Michael,  Srinivasan Abhay,  Vatsky Seth,  Escobar Fernando,  Whitaker Jayme,  Cahill Anne Marie

Final Pr. ID: Poster #: EDU-047

Percutaneous interventions are increasingly being performed under MR-guidance due to the absence of ionizing radiation, the ability to visualize target lesion and the capability to monitor real-time treatment effect. Here we outline our experience with developing an interventional MRI (iMRI) service at a pediatric institution. Read More

Authors:  Shellikeri Sphoorti , Setser Randolph , Acord Michael , Srinivasan Abhay , Vatsky Seth , Escobar Fernando , Whitaker Jayme , Cahill Anne Marie

Keywords:  Interventional MRI, MR-guided procedures

Maddocks Alexis,  Ayyala Rama,  Jimenez Jesus,  Miller Russell,  Duron Vincent

Final Pr. ID: Poster #: SCI-006

Giant omphaloceles are large in size and contain a significant portion of liver. Giant omphaloceles are often associated with other co-morbidities, such as pulmonary hypoplasia, which can lead to respiratory insufficiency, prolonged intensive care support, assisted ventilation, and death. The purpose of this study is to develop a prognostic model for prediction of post-natal outcomes in patients with giant omphaloceles using fetal MRI calculated observed to expected total lung volumes (O/E TLV). Read More

Authors:  Maddocks Alexis , Ayyala Rama , Jimenez Jesus , Miller Russell , Duron Vincent

Keywords:  omphalocele, Fetal MR

Biko David,  Pinto Erin,  Krishnamurthy Ganesh,  Escobar Fernando,  Dori Yoav,  Smith Christopher,  Dewitt Aaron,  Gillespie Matthew,  Rome Jonathan,  Glatz Andrew,  Rapp Jordan,  Otero Hansel,  O'byrne Michael

Final Pr. ID: Paper #: 015

To report on our initial experience with the use of mesenteric dynamic contrast MR lymphangiography (DCMRL) for evaluation of the lymphatics in patients with concern for mesenteric lymphatic flow disorders and compare these findings to intranodal (IN) DCMRL and intrahepatic (IH) DCMRL. Read More

Authors:  Biko David , Pinto Erin , Krishnamurthy Ganesh , Escobar Fernando , Dori Yoav , Smith Christopher , Dewitt Aaron , Gillespie Matthew , Rome Jonathan , Glatz Andrew , Rapp Jordan , Otero Hansel , O'byrne Michael

Keywords:  MR lymphangiography, mesenteric imaging

Du Tianyi,  O'brien William

Final Pr. ID: Poster #: EDU-048

This educational exhibit will provide an illustrative review of the following orbital and intracranial complications of sinusitis in children:
Post-septal orbital cellulitis
Ophthalmic vein thrombosis
Cavernous sinus thrombosis
Epidural abscess
Subdural empyema
Meningitis
Cerebritis
Brain abscess
Pott Puffy Tumor Read More

Authors:  Du Tianyi , O'brien William

Keywords:  CT, MR, MRI

Vey Brianna,  Cho Joo,  Taylor Susan,  Mehollin-ray Amy,  Alazraki Adina,  Khanna Geetika,  Linam Leann

Final Pr. ID: Poster #: EDU-047

MR Urography is an advanced imaging technique with increasing utilization that allows the interpretation of both anatomic and functional urologic data. This allows for a more efficient study of renal parenchymal and collecting system abnormalities, however the complexity and volume of functional data can make for an intimidating task to the interpreting radiologist. Key factors to success include: adequate patient preparation, optimal imaging protocol in conjunction with sedation/anesthesia and complex advanced post-processing techniques.

In this educational poster, we aim to provide an initial overview of MRU with practical points on appropriate patient preparation and study optimization, followed by a detailed overview of the myriad of functional data acquired with each study. Finally, we will review a series of image-rich cases along with the post-processed functional data in order to illustrate the approach to interpretation in the setting of anatomic abnormalities on MRU. Read More

Authors:  Vey Brianna , Cho Joo , Taylor Susan , Mehollin-ray Amy , Alazraki Adina , Khanna Geetika , Linam Leann

Keywords:  MRU, Functional, MR

Trout Andrew,  Zhang Bin,  Dillman Jonathan,  Anupindi Sudha,  Gee Michael,  Khanna Geetika,  Xanthakos Stavra,  Baikpour Masoud,  Calle-toro Juan,  Ozturk Arinc,  Serai Suraj

Final Pr. ID: Paper #: 008

MR elastography (MRE) is increasingly being used to non-invasively assess diffuse liver disease in children. However, there are limited normal liver stiffness data for MRE in children. The purpose of this study was to determine normal liver stiffness measured by MRE for children and assess for associations with demographic factors, MRI field strength and MRI vendor. Read More

Authors:  Trout Andrew , Zhang Bin , Dillman Jonathan , Anupindi Sudha , Gee Michael , Khanna Geetika , Xanthakos Stavra , Baikpour Masoud , Calle-toro Juan , Ozturk Arinc , Serai Suraj

Keywords:  Elastography, MR, Liver

Nevo Elad,  States Lisa,  Magee Ralph

Final Pr. ID: Poster #: EDU-008 (T)

PET/MRI is a relatively new imaging modality whose efficacy is still being determined. One of the major draws to PET/MR over PET/CT is the reduction in radiation exposure to patients. This is especially desirable in the pediatric population due to the likelihood of multiple exposures during their lifetime, and the increased sensitivity they have to radiation. A typical whole body PET/CT exam can take about 30 minutes, whereas a typical whole body PET/MR exam takes about 90 minutes at our institution. The introduction of a new 3D T2 Dixon technique sequence for PET/MR has the potential of decreasing total scan time significantly, however maintaining current image quality and diagnostic value is critical. Our objective is to test out this new sequence to see whether scan times are reduced and if it is a viable diagnostic replacement for our current T2 sequence. Read More

Authors:  Nevo Elad , States Lisa , Magee Ralph

Keywords:  PET/MR, Optimization

Reddy Nidhi,  Chan Sherwin,  Robinson Amie,  Mardis Neil,  Dahl Amy,  Fickenscher Kristin

Final Pr. ID: Poster #: SCI-017

Inflammatory bowel disease (IBD), including Crohn disease, is a cause of significant morbidity in the pediatric population. Perirectal disease is a Crohn related complication affecting as many as 62% of children. Magnetic resonance enterography (MRE) is being increasingly utilized in characterizing the extent of IBD. Dedicated perirectal disease imaging, such as a T2 SPACE, requires an additional 10-15 minutes of imaging time on an already time constrained modality. The goal of our study was to determine the best imaging protocol for patients without clinically suspicious perirectal disease based on the incidence in this population. Read More

Authors:  Reddy Nidhi , Chan Sherwin , Robinson Amie , Mardis Neil , Dahl Amy , Fickenscher Kristin

Keywords:  Perirectal Disease Imaging, MR Enterography, Pediatric MRI

Chopra Mark,  Watson Tom,  Olsen Øystein

Final Pr. ID: Poster #: CR-023

The incidence of paediatric inflammatory bowel disease (pIBD) is increasing. MR enterography (MRE) is increasingly recognised as the gold standard imaging technique for the small bowel in IBD. The advantages of MRE include the lack of ionising radiation and greater soft tissue definition. It also allows functional information from diffusion sequences and is used for IBD diagnosis, monitoring of disease activity and complications such as abscess, stricture or fistula. Extra-intestinal manifestations can also be identified.

Younger children often need a general anaesthetic (GA) in order to undergo MRI. Excellent distension of the small bowel loops on MRE is essential to aid accurate assessment. As the child cannot drink a large volume of fluid prior to anaesthetic induction, fluid distension is facilitated through insertion of a nasojejunal tube and instillation of fluid via the tube whilst under GA. We present our institutional practice from a large paediatric hospital for performing MR enterography under GA in young children.

A retrospective study of our Radiology Information Service (RIS) was undertaken to identify children under the age of 10 years who underwent MRE under GA between 2010-2015. The anaesthetic charts of these children were obtained and the anaesthetic duration / complications were recorded. The imaging was reviewed to evaluate the MRI quality, degree of distension and report finding. The MR protocol and sequence optimisation will also be discussed.


12 patients were included in the study, aged from 23 months to 10 years.The length of GA time ranged from 110-185 minutes (average 142 minutes) and no significant adverse effects were described. The mean fluoroscopy radiation dosage for NJ insertion was low (8 micrograys) and the success rate was high (91%).
All completed studies were reviewed and oral contrast reached the terminal ileum in 100%. Bowel distension was rated as good or excellent in all cases.

Our institutional experience has shown that MRE under GA with nasojejunal tube enteroclysis is feasible and can safely produce high quality, diagnostic imaging in the young paediatric patient.
Read More

Authors:  Chopra Mark , Watson Tom , Olsen Øystein

Keywords:  MR enterography, Inflammatory bowel disease, general anaesthesia, enteroclysis

Kelleher Michael

Final Pr. ID: Poster #: EDU-035

The purpose of this educational exhibit is to describe the most common pediatric bone marrow patterns, including normal variants and common pathology. Read More

Authors:  Kelleher Michael

Keywords:  MR, Bone marrow

Patel Hanisha,  Mayl Jonathan,  Maheshwari Mohit,  Mohan Suyash,  Chandra Tushar

Final Pr. ID: Poster #: EDU-055

Moyamoya disease (MMD) is an uncommon cerebrovascular disease that is characterized by progressive stenosis of the terminal portion of the internal carotid artery and its main branches, which is accompanied by the development of collateral vessels at the base of the brain. The purpose of this educational exhibit is to provide a succinct review of the imaging findings of MMD and its frequently associated complications, demonstrate the role of various imaging techniques in diagnosis and clinical decision making, and give an overview of surgical approaches and post operative appearances. Read More

Authors:  Patel Hanisha , Mayl Jonathan , Maheshwari Mohit , Mohan Suyash , Chandra Tushar

Keywords:  Moyamoya, MR Angiogram, MR perfusion

Binkovitz Larry,  Sutton Samuel

Final Pr. ID: Poster #: CR-032

To present the first PET/CT and PET/MRI imaging findings of acase of multiple myeloma, MM, in a pediatric patient. Read More

Authors:  Binkovitz Larry , Sutton Samuel

Keywords:  Plasmacytoma, PET/CT, PET/MR

Farrell Crystal,  Pareek Anuj,  Muehe Anne,  Pribnow Allison,  Steffner Robert,  Avedian Raffi,  Daldrup-link Heike

Final Pr. ID: Poster #: EDU-088

PET/MR is a valuable and growing imaging method for the assessment and management of pediatric bone tumors. Although plain radiography remains the first line modality for initial evaluation, cross sectional imaging is often required for further characterization of indeterminate or aggressive appearing lesions. Due to its superior soft tissue contrast resolution compared to CT, MR has become the mainstay in tissue characterization, locoregional staging, and surgical planning of pediatric bone tumors. By adding functional and metabolic information, FDG-PET imaging is useful for “one stop” local tumor and whole-body staging, evaluating response to therapy and surveillance. 18F-FDG PET/MR scans have the benefit of lower radiation and increased patient convenience compared to 18F-FDG PET/CT scans. However, due to the relatively recent development of this technology, many radiologists may be unfamiliar with the technical considerations and interpretation pearls and pitfalls of PET/MR. This educational exhibit reviews the imaging technique, reporting requirements, and imaging characteristics of the most common pediatric bone tumors with 18F-FDG PET/MR. Read More

Authors:  Farrell Crystal , Pareek Anuj , Muehe Anne , Pribnow Allison , Steffner Robert , Avedian Raffi , Daldrup-link Heike

Keywords:  PET/MR, bone tumor, cancer

Maianski Irit,  Ahmad Tahani,  Khan Naeem

Final Pr. ID: Poster #: EDU-127

The purpose of this pictorial review is
* To illustrate the classic MRI characteristics of PA in common and less typical locations in both standard advanced MRI sequences. Special attention to MR Spectroscopy will be provided
* To outline the less specific imaging features
* To discuss the relevant differential diagnosis according to tumor location Read More

Authors:  Maianski Irit , Ahmad Tahani , Khan Naeem

Keywords:  Pilocytic Astrocytoma, MR spectroscopy