Ramirez Suarez Karen,  Miranda Schaeubinger Monica,  Barton Katherine,  Riedesel Erica,  Otero Hansel

Final Pr. ID: Poster #: EDU-022

The Choosing Wisely initiative, led by the American Board of Internal Medicine (ABIM) Foundation in collaboration with over 80 medical societies and organizations, was launched in 2012 in the United States and Canada. Choosing Wisely is a response to the estimation that roughly 20% of current medical tests and therapies lack justification, provide no value, and may pose risks. The American Academy of Pediatrics (AAP) became a participant in Choosing Wisely from the start, resulting in 16 pediatric specialty-specific lists designed to assist AAP members in responsible healthcare resource management. While pediatric radiology did not develop its own list, imaging recommendations were included on fully half of the published AAP/Choosing Wisely lists. Read More

Authors:  Ramirez Suarez Karen , Miranda Schaeubinger Monica , Barton Katherine , Riedesel Erica , Otero Hansel

Keywords:  Pediatric, Imaging, Radiology

Markowitz Richard

Final Pr. ID: Poster #: EDU-011

This poster reviews the early origins of the SPR, how it came to be, and who were the leaders who were responsible for its creation. These leaders and “giants” went on to train others who carried on their work and expanded it. Today, most pediatric radiologists can trace their professional genealogy back to one of the original founders of the SPR. As the SPR has grown and developed, it has become more inclusive and diverse. Twelve outstanding women have been presidents of the SPR since 1977. From the original goal of sharing a few cases among friends, it has grown into a mature, scientifically based platform for the creation and dissemination of new and cutting-edge developments in the field of pediatric imaging. We owe a debt of gratitude to those who preceded us; we remain inspired by them; and we carry forward their commitment, wisdom, and dedication to advancing the best practices to enhance children’s health. Read More

Authors:  Markowitz Richard

Keywords:  Education, Imaging, Pediatric Radiology

Gokli Ami,  Shekdar Karuna,  Reid Janet

Final Pr. ID: Paper #: 174

Both neuroradiologists and pediatric radiologists require unique skills to confidently manage pediatric neuroradiology cases either in a community setting, or in a specialized pediatric tertiary care hospital. We conducted a needs assessment of pediatric radiologists to define their neuroradiology subspecialty training experience and identify perceived skills and knowledge gaps as well as their attitudes toward a customized pediatric neuroradiology curriculum. Read More

Authors:  Gokli Ami , Shekdar Karuna , Reid Janet

Keywords:  Needs assessment, pediatric neuroradiology, training

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

Karani Kunal,  Teli Radhika,  Shah Jay,  Cornish Nathan,  Singh Manu,  Honig Shaun,  Stein Evan

Final Pr. ID: Poster #: EDU-005

Recognize the clinical features of vascular lesions of the orbit that occur in children.
Describe classification schemes of vascular lesions of the orbit that occur in children.
Identify the imaging features that permit differentiation among lesions.
Highlight new treatment modalities in which interventional radiologists can intercede. Read More

Authors:  Karani Kunal , Teli Radhika , Shah Jay , Cornish Nathan , Singh Manu , Honig Shaun , Stein Evan

Keywords:  Orbital, Vascular, Pediatric

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

Morales-tisnés Tatiana,  Miranda Schaeubinger Monica,  Yaya Carlos,  Milla Sarah,  Heller Richard,  Otero Hansel

Final Pr. ID: Poster #: EDU-025

Access to healthcare, and in particular to pediatric subspecialties, including pediatric radiology, is limited. Increasingly limited access creates or accentuates preexisting disparities and injustices. However, because of the complexity of the issue, it is difficult to objectively study and quantify it. This exhibit will describe current barriers to pediatric radiology access, available research tools and methodologies that can help us measure the impact of such barriers. Then, we propose a research agenda to systematically approach the problem. Read More

Authors:  Morales-tisnés Tatiana , Miranda Schaeubinger Monica , Yaya Carlos , Milla Sarah , Heller Richard , Otero Hansel

Keywords:  Pediatric radiology, Access to healthcare, Research agenda

Joshi Aparna,  Kalra Kunal

Final Pr. ID: Poster #: EDU-062

The number of reconstruction surgeries of the anterior cruciate ligament (ACL) in pediatric patients has risen dramatically over the past two decades as a result of changes in treatment philosophy and perhaps frequency of injury. It is therefore important for pediatric radiologists to recognize the normal postoperative appearance of the different surgeries as well as their complications. This educational exhibit will review the types of reconstructive methods used in both skeletally immature and mature patients (physeal-sparing, partial transphyseal and transphyseal), complications (growth disturbances, graft failure, impingement, arthrofibrosis, intra-articular bodies) and relevant imaging findings on plain radiography and MRI. Read More

Authors:  Joshi Aparna , Kalra Kunal

Keywords:  Anterior cruciate ligament reconstruction, pediatric, radiology

Brahee Deborah,  Towbin Alexander

Final Pr. ID: Poster #: EDU-028

Pediatric pathology involving the jejunum is more common than one might initially expect. Early recognition of the important imaging characteristic, atypical findings, and useful imaging tools/techniques in the evaluation of jejunal pathology is important in prompt diagnosis and management of these patients.

In this educational exhibit we will present a series of cases involving pathology of the jejunum encountered in the pediatric population. We will focus on important pathologies affecting a difficult to image and sometimes forgotten portion of the intestine.

A range of acute, emergent and post-surgical cases are presented. Using an interactive, quiz based approach we will discuss the following pediatric pathologies that may affect the jejunum of pediatric patients from neonates to teenagers with multimodality imaging and pathologic examples:
Atresia
Meconium plug syndrome
Pneumatosis
Enteritis
Foreign body
Small bowel intussusception
Lymphoma
Ischemia/shock
Hernia
Graft versus host disease
Trauma
Vasculitis Read More

Authors:  Brahee Deborah , Towbin Alexander

Keywords:  Gastrointestinal, Pediatric, Imaging

Shah Amisha,  Rees Mitchell,  Kar Erica,  Bolton Kimberly,  Panigrahy Ashok,  Lee Vince

Final Pr. ID: Poster #: SCI-029

To evaluate the effect of different levels of adaptive statistical iterative reconstruction (ASIR) in pediatric lower extremity CT scan to compare the radiation dose, objective imaging parameters and subjective diagnostic image quality ratings. Read More

Authors:  Shah Amisha , Rees Mitchell , Kar Erica , Bolton Kimberly , Panigrahy Ashok , Lee Vince

Keywords:  ASIR, Radiation dose, CT scan, pediatric, extremity

Benitez Steven,  Levin Terry

Final Pr. ID: Poster #: EDU-063

With the expansion of the internet and the development of new media tools, learning methods among medical students and residents in all specialties particularly Radiology have changed. While didactic lectures and personal interaction with mentors each play an important part in education, self learning via a variety of internet sources has gained a significant role and has come to replace the use of standard textbooks. Existing online modules are minimally interactive and present radiographic images concurrently with text. In most, users use the cursor to hover over the image in order to display the abnormality. Read More

Authors:  Benitez Steven , Levin Terry

Keywords:  learning module, hips, pediatric

Mirza Eushaa,  Aziz Sumaiya,  Ajilogba Kaseem,  Delf Jonathan,  Dickinson Fiona,  Samanta Rajib,  Patel Ushma,  Swienton David,  Sharaf Ahmed

Final Pr. ID: Poster #: CR-044

Case:

We present the case of a 3 year old male patient who presented to ED with right sided weakness and facial drooling post fall with head injury. On examination, there was residual right sided weakness with poor eye contact and communicative difficulties.

Urgent CT Head revealed a focal, well defined hypo-attenuation in the left basal ganglia (Figure 1).

Subsequent MRI Head and Angiogram demonstrated an anomalous origin of the left middle cerebral artery (MCA) and lenticulostriate arteries on Time of Flight (TOF) angiographic images. The left internal cerebral artery (ICA) gives off the left posterior communicating artery which loops back on it giving off a very small MCA and forming a large, odd looking A1 anterior cerebral artery (ACA) (Figure 2). The left lenticulostriate arteries arise on the horizontal segment of the loop which forms the A1 ACA (Figure 2).

The left perforator territory demonstrates high T2/FLAIR signal with diffusion restriction involving the left putamen and upper aspect of the left caudate nucleus as seen on CT (Figure 3).

The patient was initiated on antiplatelet therapy with aspirin. He subsequently represented two months later with transient left sided weakness. Neurological examination was grossly normal apart from a slow gate.

Repeat MRI demonstrated reduction in the extent of the previous T2 signal abnormality within the left putamen consistent with expected evolution of previous infarct (Figure 4).

Dual antiplatelet therapy with the addition of clopidogrel was initiated. Subsequent clinical follow up found improvement in his verbal ability and eye contact.

Discussion:

There are numerous reported anatomical variants involving the MCA, such as a duplicated, accessory and fenestration, which are related to the embryological development of the MCA (1-3). Recently, twig-like MCA’s have been reported which are likely thought to be a secondary consequence to developmental stenosis of the proximal MCA (4). There are currently no case reports describing the anomalous distal ICA, ACA and MCA findings such as those in our case report. We hypothesise that the patient clinical symptoms are likely due to the anomalous origin and tortuosity of the lenticulostriate arteries resulting in hypoperfusion and ischaemia (5). Clinical improvement was demonstrated after initiating antiplatelet therapy. Moreover, interestingly despite the small calibre MCA there was no evidence of ischaemia within this territory. Read More

Authors:  Mirza Eushaa , Aziz Sumaiya , Ajilogba Kaseem , Delf Jonathan , Dickinson Fiona , Samanta Rajib , Patel Ushma , Swienton David , Sharaf Ahmed

Keywords:  Pediatric Neuroradiology, Pediatric Stroke

Tsang Brian,  Gupta Aaryan,  Takahashi Marcelo,  Ola Tolulope,  Baffi Henrique,  Doria Andrea

Final Pr. ID: Poster #: SCI-031

1) To systematically review the uses of AI for magnetic resonance (MR) imaging assessment of primary pediatric cancer and identify common literature topics and knowledge gaps. 2) To assess the adherence of the existing literature to the Checklist for Artificial Intelligence in Medical Imaging (CLAIM) guidelines. Read More

Authors:  Tsang Brian , Gupta Aaryan , Takahashi Marcelo , Ola Tolulope , Baffi Henrique , Doria Andrea

Keywords:  Artificial intelligence, Pediatric cancer, Magnetic resonance imaging

Qi Jing,  Eutsler Eric,  Siegel Marilyn

Final Pr. ID: Poster #: EDU-068

Dual-energy CT (DECT) refers to the acquisition of CT datasets at two different energy spectra, which allows differentiation and classification of tissues. The purpose of this this poster is to describe post-processing algorithms and clinical applications of DECT in children on a dual-source CT system. Read More

Authors:  Qi Jing , Eutsler Eric , Siegel Marilyn

Keywords:  Dual energy CT, Pediatric Radiology, Clinical application

Lins De Carvalho Tiago,  Voss Stephan

Final Pr. ID: Poster #: EDU-084

This educational exhibit provides an overview of the role radiotracers play in diagnosing, staging, and treating neuroblastoma and neuroendocrine tumors (NETs) in pediatric patients, particularly those associated with certain cancer predisposition syndromes (CPS), which are linked to an increased incidence of neuroendocrine tumors, including pheochromocytoma, and paraganglioma (PPGL). Read More

Authors:  Lins De Carvalho Tiago , Voss Stephan

Keywords:  Nuclear Medicine, Neuroblastoma, Pediatric Radiology

Infante Ignacio,  Mackintosh Cecilia,  Anoni Clara,  Otero Eduardo,  Galeano Monica

Final Pr. ID: Poster #: EDU-012 (S)

The objective of this review is to summarize the earliest radiological findings of AMC (arthrogryposis multiplex congenital), detail the most frequently affected joints, identify associated syndromes, and expose the radiological findings in children whose therapy was delayed. Read More

Authors:  Infante Ignacio , Mackintosh Cecilia , Anoni Clara , Otero Eduardo , Galeano Monica

Keywords:  joint contractures, associated syndromes, pediatric radiology

Harvey Carly,  Allbery Sandra,  Powers Andria

Final Pr. ID: Poster #: CR-074

Juvenile Granulosa Cell Tumor of the Testis is a rare testicular tumor that falls within the category of stromal cord neoplasms. There have been less than 50 cases described in the literature with all cases being described as having a cystic component (1, 2). We present a case of a 6 month old boy presenting with unilateral scrotal swelling. Ultrasound evaluation revealed an entirely solid, hypervascular, intratesticular mass. Alpha-fetoprotein levels were negative. At surgery, radical orchiectomy was performed and pathology revealed a Juvenille Granulosa Cell Tumor.

Testicular tumors arising in the neonatal and prepubescent period are a unique set of tumors distinct from their adult counterparts. In this younger age group, germ cell tumors predominate. Of the germ cell tumors, Yolk Sac tumors are the main tumor of clinical significant, and the reason why alpha-fetoprotein is such a relevant marker (3). Stromal cell tumors account for only a small percentage of testicular tumors within this age group. When they do occur, Juvenile Granulosa Cell Tumors (JGC) predominate, particularly if the child is under 1 year of age, with this tumor type being the most common testicular tumor present at birth (3,4). JGC tumors are associated with genetic and structural anomalies of the Y chromosome, ambiguous genitalia, and contralateral undescended testis. One of their defining pathologic characteristics is positive staining with Inhibin (3).To date there are no cases of metastatic JGC tumors. In all reported cases, Sonographic evaluation demonstrates a grossly multicystic tumor (2). The adult variant of Granulosa Cell tumors can appear as a solid mass with little or no cystic component and carries the risk of metastasis of approximately 20% (2). Surgical management of testicular JGC tumors has largely been radical orchiectomy but, some studies have shown tumor sparing excision to be curative in cases with salvageable testicular parenchyma (2). This finding highlights the importance of including stromal cell tumors, particularly JGC, in the differential for solid appearing testicular masses in the neonate. With more reported cases of JGC tumors of the testes, surgical management could include a more conservative approach. Although JGC tumor of the testis is not known to be malignant, given the atypical features of this tumor and similarities with its more malignant adult counterpart, close surveillance is warranted to ensure benign course. Read More

Authors:  Harvey Carly , Allbery Sandra , Powers Andria

Keywords:  Juvenille Granulosa Cell Tumor, Testicular Tumor, Pediatric, Solid

Ilivitzki Anat,  Scolnik Michal

Final Pr. ID: Poster #: EDU-095

In this pictorial essay on typical and atypical lung metastases in pediatric patients, we aim to assist radiologists in identifying suspicious features on CT scans. Our goal is to guide decisions regarding follow-up imaging to ensure a timely diagnosis, enabling children to receive prompt and potentially lifesaving treatment. Read More

Authors:  Ilivitzki Anat , Scolnik Michal

Keywords:  CT Chest, Pediatric Radiology, Oncology

Boyd Kevin,  Thakrar Pooja

Final Pr. ID: Poster #: EDU-055

The purpose of the exhibit is: 1. Illustrate the presence of multiple and accessory ossification centers about the hip that can make it challenging to diagnosis fractures on radiographs in adolescence. 2. Demonstrate that posterior acetabular fractures are typically hidden behind the femoral head on radiographs. 3. Review variant os acetabuli that are commonly encountered in patients with hip pain and demonstrate that the orientation of the fragments compared with posterior acetabular fractures can help to make a distinction. 4. Highlight that a complete pelvis radiograph (AP or AP/Frog leg lateral) in trauma patients or hip pain NOS can aid in the detection of fractures and assess for asymmetry of normal variants. Read More

Authors:  Boyd Kevin , Thakrar Pooja

Keywords:  Acetabular Fractures, Pediatric Hip, Hip variant

Supakul Nucharin

Final Pr. ID: Poster #: EDU-017

To summarize our experience using Computed Tomography Angiography (CTA) of the liver as an imaging tool for pre-living donor liver transplantation (LDLT) evaluation in biliary atresia (BA) patients. This pictorial review will illustrate and discuss several aspects of imaging techniques and the important findings that clinician need to know before LDLT.

Key imaging findings for vascular anatomy/collateral vessels will be made, emphasizing what clinicians need to know. Correlation with intraoperative findings will also be provided.
Read More

Authors:  Supakul Nucharin

Keywords:  Biliary atresia, LDLT, liver transplantation, CTA liver, Pediatric

Verma Nupur,  Patel Pratik,  Rajderkar Dhanashree

Final Pr. ID: Poster #: EDU-108

Accidents remain a top cause of morbidity and mortality in pediatric patient. Assessment for blunt trauma to the abdomen is difficult in the trauma patient and findings of bowel injury can be subtly or confounded by visceral injuries. The most specific finding of free air in blunt hollow visceral organ is often minimally present, or entirely unseen. The pediatric radiologist must be familiarity with the more often seen and less specific secondary signs on CT, including free fluid, bowel wall thickening, and mesenteric contusion injury. We present, by case example, bowel injuries in the traumatic pediatric patient and their management and outcomes, while addressing common pearls and pitfalls. As many of these patients do well with non-operative treatment the radiologist must also be familiar with findings that would allow such option, to appropriately advice referring providers and manage potential re-image of the pediatric patient. Read More

Authors:  Verma Nupur , Patel Pratik , Rajderkar Dhanashree

Keywords:  Trauma, Pediatrics, Dose Reduction in CT, Abdominal Injury

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

Lall Neil,  Spaeth-cook Douglas,  Ho Mai Lan,  Zucker Evan

Final Pr. ID: Poster #: EDU-002

Artificial Intelligence (AI) holds great promise in pediatric radiology, but its adoption has been slower compared to adult imaging. Although a 2022 special issue of Pediatric Radiology highlighted potential AI applications, the number of FDA-cleared AI algorithms for pediatric radiology remains limited. As of October 2024, out of 333 FDA-cleared AI Software-as-a-Medical-Device (SaMD) tools, only 26 (8%) are applicable to pediatric imaging, despite children comprising 22% of the U.S. population. More strikingly, only three (<1%) of these SaMD tools are specifically designed for pediatric use, focusing on dental cavity detection, bone age assessment, and hip dysplasia. This educational exhibit showcases the different types of FDA-cleared SaMD AI algorithms designated for use in pediatric radiology and identifies the clinical needs being served as well as those that have yet to be addressed. Additionally, the exhibit will explore the discordance in the development of AI imaging tools for the pediatric population compared to adults, highlighting risks created by this gap and addressing the reasons for such a disparity. Read More

Authors:  Lall Neil , Spaeth-cook Douglas , Ho Mai Lan , Zucker Evan

Keywords:  Artificial Intelligence, Pediatric Radiology, Informatics

You Sun Kyoung,  Lee So Mi,  Cho Hyun-hae

Final Pr. ID: Poster #: SCI-005

To investigate of imaging findings of brain computed tomography (CT) and demographic findings of children with head trauma under 2 years. Read More

Authors:  You Sun Kyoung , Lee So Mi , Cho Hyun-hae

Keywords:  brain, computed tomography, brain trauma, pediatric

Moretti Jean-baptiste,  Alchourron Emilie,  Stein Nina,  Farhat Ziad,  Garel Juliette,  Lapierre Chantale,  Dubois Josée,  El-jalbout Ramy

Final Pr. ID: Poster #: SCI-003

Pediatric carotid artery Intima-Media Thickness (IMT) is a non-invasive ultrasound marker of early atherosclerosis. Obesity in children is associated with increased IMT. The objective of this meta-analysis is to report IMT values in children living with overweight/obesity in the literature. Read More

Authors:  Moretti Jean-baptiste , Alchourron Emilie , Stein Nina , Farhat Ziad , Garel Juliette , Lapierre Chantale , Dubois Josée , El-jalbout Ramy

Keywords:  Carotid Intima-Media Thickness, Pediatric, Cardiovascular Risk

Holz Emily,  Fisher Paul

Final Pr. ID: Poster #: CR-050

Neurocysticercosis (NCC) is the result of infection of the nervous system by the larvae of Taenia solium—the pork tapeworm. It is endemic in regions of Latin America, Sub-Saharan Africa, and Asia, however, is also of concern in non-endemic regions as a result of immigration and travel to endemic regions. NCC is a major cause of seizures, however disease presentation varies based on the number, growth, and location of lesions as well as the inflammatory response of the host. In addition to seizures, other common clinical manifestations are headaches, intracranial hypertension, focal deficits, and altered mental status. Case Presentation: A 13-year old female with a history of intermittent headaches presented to the emergency department with severe headache, nausea and vomiting, and altered mental status. Upon evaluation, the patient had a Glasgow Coma Scale score of 8, indicative of a severe level of brain injury. A brain MRI revealed a non-enhancing “cystic” ovoid lesion filling much of the third ventricle. A subsequent CT revealed a scolex (anterior end of the tapeworm) with obstructive hydrocephalus at the level of the third ventricle and cerebral aqueduct. NCC has 3 stages—vesicular, colloidal or granular, and calcified—each with characteristic findings on imaging. In the vesicular stage, imaging shows cysts with central hyperdensity on CT representing the scolex. In the colloidal or granular stage, imaging shows cysts with surrounding enhancement and edema, and in the calcified stage, calcifications are visible. In this case, the patient appeared to be at the end of the vesicular stage, transitioning into the colloidal or granular stage as there was evidence of a scolex on CT and a cystic lesion with interstitial edema, however it was non-enhancing. Additionally, in NCC parenchymal lesions are most common, and with antiparasitic treatment, have a generally benign prognosis. Extraparenchymal disease, which includes ventricular cysts as seen in this patient, is less common and is not benign, often resulting in obstructive hydrocephalus, also evident in this patient, and may even result in death. Based on imaging findings, the patient underwent fenestration of the cyst and biopsy, which revealed fragments of a parasitic organism. NCC can result in life-threatening consequences including hydrocephalus, herniation, and edema, so while treatment generally consists of anti-inflammatory and antiparasitic medications, surgery may be indicated in some patients. Read More

Authors:  Holz Emily , Fisher Paul

Keywords:  Pediatric Neuroradiology, Hydrocephalus, Brain MRI

Goehner Melissa,  Anderson Mary,  Pinson Monica,  Simoneaux Stephen

Final Pr. ID: Poster #: EDU-007 (T)

To describe and discuss some of the challenges of performing DEXA scans on pediatric patients including positioning, technical obstacles, reference data and post-processing and describing how to overcome some of these challenges.
1. Positioning: Many patients with syndromes, have scoliosis, para or quadriplegia, or contractures that make placing the patient on the table difficult. In these patients, imaging has to be adapted to the patients’ abilities and some components may need to be eliminated. With cerebral palsy and muscular dystrophy for example, the whole body and AP spine might have to be deferred and only a hip and forearm obtained.
2. Technical obstacles: There are many technical obstacles that can present challenges when performing DEXA scans on pediatric patients. Patients who have prostheses or metal rods present technical obstacles. There is no way to remove the metal artifacts in a whole body scan on these patients, so a hip or forearm might be the most accurate way to obtain the patient’s bone density due to this technical factor.
3. Reference Data: The reference data for pediatrics is limited in national data bases. For example, a total Z-score will not be factored for children under the age of 5 because there is not enough information in the national database for comparison. There is also not enough information on children of certain ethnicities. This presents a problem when diagnosing and treating children with abnormal bone density.
4. Post-processing could be different for each user. It can also be different for machines manufactured by different companies. For example, a machine made by Hologic might produce different numbers than a machine made by General Electric. Also, if the user does not place the post-processing tools the exact same way the prior user did, the results can vary.
Overcoming some of these challenges has presented opportunities to grow. Sedation is used for children who may not be able to be perfectly still for a Dexa and positioning tools help on some of the more challenging patients. Learning how to work around prostheses and working with the ordering physicians and radiologists with the limited amount of reference data are a few ways of growing from these challenges. Placement of post-processing tools are the key to providing key information in comparing Dexa scans for patients who have them regularly for evaluations. Staff Education is the largest challenge to overcome. Read More

Authors:  Goehner Melissa , Anderson Mary , Pinson Monica , Simoneaux Stephen

Keywords:  Dexa, pediatric

Barczuk Marzena,  Roik Danuta,  Ostapska Zofia,  Biejat Agnieszka,  Brzewski Michal

Final Pr. ID: Poster #: EDU-007

Computed tomography with its excellent spatial and temporal resolution remains valuable diagnostic modality in pediatrics. On the other hand there has been increasing attention placed on the radiation risks associated with CT imaging, especially in children.
In recent years many advances in CT hardware and software, for example automatic exposure control tools and iterative reconstruction techniques allowed for the reduction of applied radiation dose while maintaining image quality.

The aim of our educational exhibit is:

- to present optimal protocols for chest CT in the youngest age group of children, scanned according to body weight protocols (0-10kg; 10-30kg) with assesement of image quality and dose indices (CTDIvol and DLP; SSDE)
- to present pictorial review of the pediatric chest pathologies in low dose chest CT Read More

Authors:  Barczuk Marzena , Roik Danuta , Ostapska Zofia , Biejat Agnieszka , Brzewski Michal

Keywords:  Pediatrics, Dose, CT

Gould Sharon,  Harty M.,  Ostrowski John,  Tsuda Takeshi

Final Pr. ID: Poster #: SCI-008

Diseases of the coronary arteries are rare in children, but can present as unexpected catastrophic events without preceding symptoms. It is essential to identify patients at risk to prevent potentially serious cardiovascular events. Coronary CT angiography (CCTA) has been widely studied in adults, but its clinical applications are not well established in children. Read More

Authors:  Gould Sharon , Harty M. , Ostrowski John , Tsuda Takeshi

Keywords:  Coronary, CTA, Pediatric

Sher Andrew,  Hayatghaibi Shireen,  Kan J.,  Sammer Marla

Final Pr. ID: Paper #: 077

To analyze the effect of point-of-care ACR-clinical decision support (CDS) software embedded in the electronic health records (EHR) on CT ordering patterns in a quaternary care pediatric emergency center (EC). Read More

Authors:  Sher Andrew , Hayatghaibi Shireen , Kan J. , Sammer Marla

Keywords:  decision support, pediatric, informatics