Histiocytic necrotizing lymphadenitis, also known as Kikuchi-Fujimoto disease, is a benign, self-limited disorder, associated with B symptoms (fever, weight loss) and painful lymphadenopathy. The combination of lymphadenopathy with B symptoms in the pediatric population raises suspicion for malignant diseases such as lymphoma, neuroblastoma, and rhabdomyosarcoma. We evaluated a series of children with biopsy-proven histiocytic necrotizing lymphadenitis to assess for unique imaging characteristics. Read More

Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024

Authors: Sandigo Saballos Isabela, Arguello Fletes Gladys, Fenton Laura

Keywords: Benign causes of lymphadenopathy, CT Perinodal infiltration and necrosis, CT Nodal Necrosis

A 29-year-old female (G6P4) was referred to our center following identification of thoracoomphalopagus conjoined twins, with fused heart and liver, at 20 weeks of gestation. Fetal echocardiogram and fetal cardiac MR (CMR) were performed at 21 weeks gestation to evaluate potential for post-natal repair. Fetal CMR was performed at 1.5 Tesla using an MRI compatible fetal doppler ultrasound (DUS) device (smart-sync, Northh imaging) for cardiac gating. Protocol included multiplanar cine SSFP sequences and multiplanar blackblood sequences. Fetal echocardiography and CMR were used together to understand the complex anatomical arrangements. Each twin had 2 sets of atria (with an interatrial connection) but only a single ventricle. Twin A had a left ventricle, pulmonary atresia and MAPCAs. Twin B had a right ventricle had coarctation of the aorta, bilateral SVCs and partial anomalous pulmonary venous return. After counselling regarding the grave prognosis of both twins, the patient decided to deliver at her local hospital with comfort care. Teaching Points from this Case This case of conjoined twins at 21 weeks gestation, is the youngest example of successful clinical DUS fetal CMR. In this case, fetal CMR was used to demonstrate the great vessel anatomy and was fundamental in ascertaining the absence of a path to successful surgical palliation for either twin. Additionally, fetal CMR was used as the primary modality during patient counselling to explain the anomalies. The high degree of diagnostic certainty that the fetal CMR facilitated, allowed the family to avoid the unnecessary emotional and financial expense that relocation for delivery would have incurred and facilitated palliative care at their local center. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Fuentealba Cargill Andrea, Friesen Richard, Fujiwara Takashi, Park Sungho, Arguello Fletes Gladys, Englund Erin, Barker Alex, Londono Obregon Camila, Browne Lorna

Keywords: Fetal MRI, Cardiac MRI, 4D Flow