Kirihetti Liyanage Neelika,  Kumbla Surekha

Final Pr. ID: Poster #: EDU-001

Post-transplant lymphoproliferative disorder (PTLD) is an important cause of morbidity and mortality which affects transplant recipients of solid organs and allogenic bone marrow transplants. Paediatric recipients of organs that require high levels of immunosuppression are the most susceptible population. Incidence and the frequency of PTLD in paediatric age group is consistently higher than it is in adults. There is insufficient recent literature on imaging features of PTLD in the paediatric age group.
Our purpose is to illustrate multi-modality imaging characteristics of PTLD affecting different organs and systems in a cohort of paediatric patients with biopsy proven PTLD. Read More

Authors:  Kirihetti Liyanage Neelika , Kumbla Surekha

Keywords:  PTLD, Transplant, Lymphadenopathy

Siegel Marilyn,  Ramirez Giraldo Juan Carlos,  Cullinane Mike,  Bhalla Sanjeev

Final Pr. ID: Paper #: 136

Patients undergoing lung and stem cell transplants require serial CT examinations and hence dose reduction techniques are mandatory. The newest 3^rd generation dual-source CT scanner incorporates spectral beam shaping at 100 kilovoltage (kVp) using a dedicated tin filter (100 kVp Sn), which improves dose efficiency by removing low-energy photons that contribute little to noncontrast image quality. The purpose of this study was to compare radiation exposure in non-contrast-enhanced pediatric chest CT at 100 kVp Sn imaging and at conventional low kVp imaging in the same patient cohort. Read More

Authors:  Siegel Marilyn , Ramirez Giraldo Juan Carlos , Cullinane Mike , Bhalla Sanjeev

Keywords:  Dose Reduction, ALARA, Lung and Stem Cell Transplant

Ruiz Martha,  Bhargava Ravi,  Marfil Braulio,  Hawkes Michael,  Shapiro James

Final Pr. ID: Poster #: SCI-008

Doppler ultrasound (DUS) is routinely used to assess graft status after liver transplantation (LT). Although early post-surgical assessment is encouraged, the exact prognostic value of DUS parameters is unknown.

The purpose of this study was to determine the prognostic value of DUS parameters obtained in the immediate postoperative period. Read More

Authors:  Ruiz Martha , Bhargava Ravi , Marfil Braulio , Hawkes Michael , Shapiro James

Keywords:  Doppler, Liver transplant, Prognosis

Alis Jonathan,  Levin Terry,  Kurian Jessica,  Mahadeo Kris,  Taragin Benjamin

Final Pr. ID: Poster #: EDU-092

Sickle Cell Disease (SCD) affects approximately 100,000 individuals in the US. Despite medical advances, morbidity is high and their lifespan remains shortened. Hematopoietic stem cell transplantation (HSCT) is the only curative treatment to date and as outcomes improve its use has increased. Complications of HSCT are frequent and some literature suggests there is a higher incidence in the SCD population. In addition, preexisting vasculopathy in this population may contribute to an increased incidence of post-transplant CNS toxicity. We present the imaging findings of HCST complications in children with SCD. Read More

Authors:  Alis Jonathan , Levin Terry , Kurian Jessica , Mahadeo Kris , Taragin Benjamin

Keywords:  Graft versus host disease, bone marrow transplant, HSCT

Infante Juan

Final Pr. ID: Poster #: EDU-026

Renal dysfunction in a transplant kidney is a common clinical problem which is usually attributed to either rejection or arterial stenosis. While the overall incidence of transplant renal artery stenosis is low, the question of stenosis remains after Doppler examinations although abnormal Doppler ultrasounds are often later proven to be false positives. In the author's experience, these false positive cases are almost always associated with high correction angles (at or near 60 degrees). Conversely, repeating a positive Doppler study by maneuvering the transducer to produce a lower correction angle often resolves the apparently elevated velocity.

A contributing factor to the usage of high correction angles is the actual angle of takeoff of the transplant renal artery relative to the external iliac artery. This can make performing the study with a low correction angle a physically challenging task for the sonographer. Nevertheless, proper effort when scanning these cases is indicated to save the patients from unnecessary follow-up studies and possibly unnecessary invasive procedures.


This educational exhibit aims to address the following learning points:

1) The basis for avoiding high correction angles can be traced to back to basic trigonometric principles which we must keep in mind during image acquisition and interpretation
2) The mechanism for false positive Doppler studies in post-transplant renal artery stenosis is often an unnecessarily high Doppler correction angle
3) Repeating a positive Doppler study with the aim of minimizing the correction angle through optimal probe placement can help avoid unnecessary further testing including possibly invasive procedures
4) The angle of takeoff and variable trajectories of transplant renal arteries can pose difficult physical and cognitive problems for the ultrasound operator Read More

Authors:  Infante Juan

Keywords:  renal artery stenosis, renal transplant, Doppler

Qiu Cecil,  Donaldson James,  Rajeswaran Shankar,  Kim Stanley,  Superina Riccardo,  Mohammad Saeed,  Whitehead Bridget,  Green Jared

Final Pr. ID: Poster #: SCI-033

Biliary stenosis continues to be an important source of morbidity in pediatric liver transplantation. Percutaneous transhepatic cholangiography (PTC) with cholangioplasty and placement of an internal/external biliary drainage catheter has been the standard of care for biliary stenosis at our institution for over twenty years. The purpose of this article is to present the largest and most comprehensive pediatric series to date detailing the percutaneous management of liver transplants complicated by biliary stenosis. Read More

Authors:  Qiu Cecil , Donaldson James , Rajeswaran Shankar , Kim Stanley , Superina Riccardo , Mohammad Saeed , Whitehead Bridget , Green Jared

Keywords:  Liver transplant, PTC, Biliary stenosis

Martinez-rios Claudia,  Tijerin Bueno Marta,  Ahmad Tahani,  Oudjhane Kamaldine,  Navarro Oscar

Final Pr. ID: Poster #: EDU-091

Pediatric liver transplant (PLT) is an established treatment for many hepatic conditions in children. In recent years there has been a significant increase in the number of PTL associated with an improved survival. In children however, due to the complex surgical procedures and peculiar hemodynamic physiology there is also an increased risk for vascular and biliary complications. High resolution ultrasonography (US) is the modality of choice to evaluate and monitor the evolution of pediatric liver graft. This exhibit intends to illustrate fellows and residents with the US characteristics of the normal hepatic anatomy, the normal early and late US appearances of the graft, and the US features of complications that may compromise graft’s survival. Read More

Authors:  Martinez-rios Claudia , Tijerin Bueno Marta , Ahmad Tahani , Oudjhane Kamaldine , Navarro Oscar

Keywords:  liver, transplant, ultrasound, normal, complications

Samreen Naziya,  Sharma Priya,  Tuna Ibrahim,  Rajderkar Dhanashree

Final Pr. ID: Poster #: EDU-113

1. To establish the role of imaging in diagnosing the atypical/unexpected cases of post transplant lymphoproliferative disorder in Pediatric population.
2. To review the role of Radiology Imaging in staging, treatment monitoring and predicting the prognosis in Pediatric PTLD. Read More

Authors:  Samreen Naziya , Sharma Priya , Tuna Ibrahim , Rajderkar Dhanashree

Keywords:  Transplant, Lymphoproliferative, PTLD, Unexpected, Management of PTLD

Valdez Quintana Melissa

Final Pr. ID: Poster #: EDU-030

The purpose of these educational exhibit is to illustrate the tomographic evaluation of living renal donors for pediatric patients
Renal transplantation has become the treatment of choice for end stage renal disease in children. Living donor renal transplantation is a better option for recipient and graft survival in comparison with cadaveric donor. Laparoscopic nephrectomy is preferred for removing the kidney from living donors, therefore the surgeons need accurate anatomic information
We present an approach for the evaluation of living renal donors by tomography. Selected cases illustrating the evaluation of renal parenchyma, renal arteries, renal veins and collecting system are shown, including the key points of anatomic information that are valuable for the surgeons Read More

Authors:  Valdez Quintana Melissa

Keywords:  kidney transplant, CT, donor

Riemann Monique,  Bailey Smita,  Angadi Siddhartha,  Biyyam Deepa,  Turman Martin

Final Pr. ID: Poster #: SCI-016

Approximately 800 children in the United States undergo renal transplant each year. Allograft failure is driven by interstitial fibrosis often due to chronic antibody mediated rejection. Renal biopsy is the gold standard to detect allograft dysfunction but limited by sampling error and inherent procedural and anesthesia risk. Ultrasound shearwave elastography (US-SWE) is a non-invasive imaging technique that assesses the mechanical stiffness of tissue. The primary aim of this study was to examine the relationship between US-SWE values, pathologic fibrosis/rejections scores and serology in pediatric recipients of renal transplant. Read More

Authors:  Riemann Monique , Bailey Smita , Angadi Siddhartha , Biyyam Deepa , Turman Martin

Keywords:  ultrasound, elastography, pediatric renal transplant

Poyiadji Neo,  Sabharwal Gauravi,  Leschied Jessica,  Ledbetter Karyn,  Song Tom,  Collins Denise,  Montecalvo Joseph

Final Pr. ID: Poster #: CR-034

E-cigarette, or vaping, product use associated lung injury (EVALI) is a newly recognized entity that is being reported with increasing frequency in the literature and mainstream press. The aim of this case report is to radiographically illustrate the fairly rapid progression of a severe case of EVALI that ultimately required a successful bilateral lung transplant, and to describe a unique histopathology correlation.

Case Report:
Our patient is a 16-year-old, previously healthy male with a two year history of vaping who presented to an outside hospital for dyspnea and nonproductive cough. He was initially treated with antibiotics for community acquired pneumonia. Initial contrast-enhanced CT of the chest demonstrated subtle bilateral but right lower lobe predominant centrilobular nodules, ground glass opacities (GGO) and mild septal thickening. Bronchial alveolar lavage, microbiology studies and autoimmune panel were negative for an infectious or autoimmune etiology. Repeat chest CT only five days later following clinical deterioration demonstrated a dramatic worsening of bilateral nodular airspace opacities, septal thickening, GGO and dependent diffuse consolidations. Pneumomediastinum and mild bronchiectasis were also present. Our patient’s condition continued to decline requiring intubation and subsequent ECMO support. He was transferred to our tertiary care center for bilateral lung transplant. Histopathology of the explanted lungs described predominant acute necrotizing and granulomatous bronchopneumonia with areas of organizing pneumonia. Read More

Authors:  Poyiadji Neo , Sabharwal Gauravi , Leschied Jessica , Ledbetter Karyn , Song Tom , Collins Denise , Montecalvo Joseph

Keywords:  Vaping related lung injury, lung transplant

Milks Kathryn

Final Pr. ID: Poster #: EDU-033

Proficiency in intra-abdominal pediatric vascular ultrasound is essential for all pediatric radiologists. Command of spectral Doppler findings is vital in identifying early abdominal vascular pathology, particularly in the evaluation of pediatric patients with liver disease or following orthotopic liver transplantation. The following is a condensed review of normal and abnormal abdominal vascular ultrasound with emphasis on liver disease and the posttransplant pediatric patient. Read More

Authors:  Milks Kathryn

Keywords:  Ultrasound, Vascular, Liver transplant