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

Edwards Emily,  Lee Marsha,  Phelps Andrew,  Kim Jane,  Courtier Jesse

Final Pr. ID: Poster #: EDU-090

Evaluation of pediatric abdominal vasculature is typically performed with contrast enhanced cross-sectional imaging or catheter angiography. Concern over radiation exposure and the safety of intravenous contrast agents in patients with impaired renal function has led to increased interest in non-contrast MR angiography. Recent advances in MRI pulse sequence design now allow for non-invasive high resolution imaging of pediatric abdominal vasculature without the use of radiation or intravenous contrast. Read More

Authors:  Edwards Emily , Lee Marsha , Phelps Andrew , Kim Jane , Courtier Jesse

Keywords:  MRA, vasculature, Technique

Bryant Audrey,  Kandil Ali

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

Gadolinium, a type of MRI contrast is typically used when imaging pediatric cardiac patients. Gadolinium enhances the images to give more clarity to the radiologists when distinguishing normal tissue from abnormal tissue. Further, contrast also allows for better visualization of the great vessels.

Gadolinium alters the magnetic properties of nearby water molecules in the tissue. While contrast itself does not alter the tissue composition, it does affect how the scanner takes the picture. Accordingly, images can differ between pre- and post-contrast administration. While IV contrast can be administered safely, it is not without logistic implications and/or risks.

MRI contrast can be given to pediatric cardiac patients intravenously, but IV access is oftentimes challenging in pediatric cardiac patients. In an effort to reduce the number of unsuccessful IV attempts and quantity of contrast administered, a novel non-contrast MR sequences is being utilized to better depict the great vessels in these children. If IV access is unsucessful or the patient cannot complete the MRI, this modality is employed to obtain more information on the patient's cardiact vasculature.

This purpose of this case report paper is to show the MR imaging when using a non-contrast sequence to identify cardiac vessels in pediatric patients who cannot recieve IV contrast. Read More

Authors:  Bryant Audrey , Kandil Ali

Keywords:  Pediatric, Contrast, Vasculature

Riemann Monique,  Bisbing Brecken,  Goncalves Luis,  Ramasubramanian Aparna

Final Pr. ID: Poster #: CR-002

PFV is a rare congenital orbital malformation in which there is failure of the hyaloid artery to regress causing a persistent vasculature within the vitreous portion of the eye. Patients present with leukocoria that can be unilateral or bilateral. The most concerning differential diagnosis is retinoblastoma. We present three case studies referred for evaluation to exclude retinoblastoma in which MFI assisted in making the diagnosis of PFV. Imaging was perfomed with a high frequency linear array transducer and established preset in accordance with FDA guidelines.
When characterizing orbital masses, early and accurate diagnosis is crucial to the patient’s prognosis. Ultrasound can be a superior method due to its ability to visualize superficial structures and detect slow velocity blood flow. While CD and SD are able to determine direction and velocity of flow, MFI improves the sensitivity and ability to display microvascularities.

Case 1
Three-month-old male with right eye leukocoria. Ultrasound demonstrated smaller right than left globe. A triangular retrolental amorphous and heterogeneous soft tissue mass was present. A mass with fibrovascular stalk containing a persistent hyaloid artery was observed with layering debris. Left orbit was normal. Findings consistent with right PFV.

Case 2
Six-week-old female with left eye leukocoria. Ultrasound demonstrated a normal right globe. The left globe had a hyperechogenic triangular mass extending from the posterior margin of the lens to the optic nerve. A persistent hyaloid artery was noted. The posterior margin of the lens was irregular. A small amount of subretinal fluid over lied the optic nerve. Findings consistent with left PFV.

Case 3
Newborn male with microphthalmia and possible cataractous lens. Ultrasound demonstrated right globe with lens intact, anechoic and normally located. A hyperechogenic mass with ill-defined borders extends from the posterior aspect of the lens to the retina along the central aspect of the globe. No calcifications were observed. Blood flow noted within a persistent hyaloid artery. The triangular portion of the mass attached to the lens also demonstrated increased microvascularity. Left globe with intact lens which was anechoic and normally located. Evaluation of the left posterior chamber demonstrates a similar-appearing mass with a persistent hyaloid artery. Findings consistent with bilateral PFV. Read More

Authors:  Riemann Monique , Bisbing Brecken , Goncalves Luis , Ramasubramanian Aparna

Keywords:  orbital, persistent fetal vasculature, micro flow imaging