Park Halley,  Burgos Daylen Sire

Final Pr. ID: Poster #: CR-025

Pulmonary vein thrombosis is an exceedingly rare occurrence but should be considered in the differentials in evaluation for opacity seen on the chest radiograph, in a coagulopathic pediatric patient. Read More

Authors:  Park Halley , Burgos Daylen Sire

Keywords:  Pulmonary vein thrombosis, coagulopathic, pulmonary embolism

Cielma Tara,  Hill Cara,  Mirza Sobia,  Sanchez Ramon

Final Pr. ID: Poster #: EDU-004

Venous thromboembolism (VTE) is a multifactorial disease and a significant source of morbidity. Though the incidence of VTE, composed of deep venous thrombosis (DVT) and pulmonary emobolism (PE), is more common in adults, an increasing number of children are being diagnosed. Children who are critically ill are at greatest risk of developing VTE.

Duplex sonography is a critical front line tool in the detection and evaluation of venous thrombosis. Serial surveillance examinations allow real-time assessment of thrombosis including propagation and progression.

Recognizing the presentation and sonographic appearance of venous thrombosis assists the clinician in timely therapeutic decision-making and clinical management.

The goals of this exhibit are:

1. Describe the technical approach of performing duplex vascular ultrasound, including tips and technology that assist in optimizing studies.
2. Discuss the incidence, risk factors, and clinical characteristics of pediatric VTE.
3. Depict the sonographic appearance of thrombosis with emphasis on correlation to other modalities.
4. Discuss prognosis and long-term outcomes of VTE in children.
5. Describe future techniques and applications. Read More

Authors:  Cielma Tara , Hill Cara , Mirza Sobia , Sanchez Ramon

Keywords:  Deep venous thrombosis, Venous thromboembolism, Pulmonary embolism

Priya Sarv,  Narayanasamy Sabarish,  Nagpal Prashant

Final Pr. ID: Poster #: CR-005

Pulmonary embolism (PE) is a potentially life-threatening condition, and accurate imaging is critical for timely diagnosis. While CT pulmonary angiography is the gold standard, MR angiography (MRA) offers a radiation-free alternative, particularly important in younger patients. However, MRA is prone to artifacts that can mimic pathology and lead to false-positive interpretations.

We present two cases of 15-year-old patients who presented to the emergency department with acute chest pain and underwent MRA as part of the diagnostic workup to avoid radiation exposure. In both cases, imaging demonstrated central dark signal voids within the pulmonary arteries, raising concern for thrombus. Closer review revealed these findings were attributable to Gibbs ringing artifact, which occurs due to undersampling and edge effects, producing alternating bright and dark bands that may simulate intraluminal filling defects. In one patient, additional challenges were posed by timing-related artifacts during k-space acquisition, where misalignment of contrast bolus and central k-space filling resulted in a “maki roll” appearance, further complicating interpretation.
Strategies to differentiate artifact from true thrombus include correlating with multiple imaging planes, and importantly, reviewing second or delayed angiographic runs to determine whether a defect persists or resolves. In both cases, the absence of persistent findings and awareness of artifact patterns prevented misdiagnosis of PE.
These cases underscore the importance of recognizing Gibbs ringing and timing-related artifacts in MRA of the pulmonary arteries. Careful image review and knowledge of common pitfalls are essential to avoid false-positive diagnoses and ensure appropriate patient management. Read More

Authors:  Priya Sarv , Narayanasamy Sabarish , Nagpal Prashant

Keywords:  Cardiovascular MRA, Magnetic Resonance Imaging, Pulmonary Embolism