Showing 4 Abstracts.
A 9-year-old girl presented with lethargy, fatigue and progressive exertional dyspnea for the last two-three years, and rapid breathing for the past six months. Chest X-ray showed confluent air space opacities in both lungs. Chest computed tomography (CT) scan done outside 3 months previously showed diffuse ground-glass opacities with interstitial thickening suggestive of crazy paving in bilateral lungs. To evaluate the disease progression without the radiation exposure associated with another CT scan, magnetic resonance imaging (MRI) was performed. It showed diffuse hyperintense areas bilaterally on T2 turbo spin echo and MultiVane XD sequences, indicative of ground-glass changes. Radiologically, a possibility of pulmonary alveolar proteinosis (PAP) was given. Subsequently, bronchoalveolar lavage and lung biopsy confirmed PAP. In PAP, the phospholipidoproteinaceous material which deposits within the alveoli presents with longer T2 relaxation time, and longer or equal T1 relaxation time which results in hyperintense signal, as seen in the index case. With the recent advances in lung MRI, short-duration protocols are able to give diagnostic information similar to CT in children [1-2], thereby emerging as an attractive radiation-free modality. MRI can demonstrate the findings of PAP similar to CT, and may be relatively better than CT in picking up the parenchymal changes associated with PAP [3]. To conclude, MRI may serve as an attractive radiation-free modality in diagnosing PAP in children and evaluating the lung changes over time. REFERENCES: 1. Sodhi KS, Khandelwal N, Saxena AK, et al. Rapid lung MRI in children with pulmonary infections: Time to change our diagnostic algorithms. J Magn Reson Imaging. 2016;43:1196-206. 2. Sodhi KS, Khandelwal N, Saxena AK, et al. Rapid lung MRI - paradigm shift in evaluation of febrile neutropenia in children with leukemia: a pilot study. Leuk Lymphoma. 2016;57:70-5. 3. Luo J, Yang D, Xiao E, et al. Lung MRI at 3T: comparison of CT and MRI in initial evaluation of pulmonary alveolar proteinosis. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2013;38:1160-6. Read More
Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022
Authors: Sodhi Kushaljit, Bhatia Anmol, Gauba Richa, Mathew Joseph L, Bal Amanjit
The application of compressed SENSE MR imaging technique can help in reducing the acquisition time for magnetic resonance cholangiopancreatography (MRCP). The present study was conducted to compare the acquisition time, diagnostic efficacy, and image quality of the newer compresses sense 3D-MRCP (CS-3D-MRCP) with conventional 3D MRCP (C-3D-MRCP) in children with pancreatitis. Read More
Meeting name: SPR 2023 Annual Meeting & Postgraduate Course , 2023
Authors: Sodhi Kushaljit, Maralakunte Muniraju, Bhatia Anmol, Saxena Akshay, Lal Sadhna
Keywords: MRCP, Pancreas, Compressed sense
A full-term newborn male was admitted to pediatric emergency on day one of life with respiratory distress and dysmorphism, which included radio-ulnar hemimelia, retrognathia, scoliosis, and clinodactyly. Antenatal fetal echocardiography had shown presence of mildly dilated right atrium and right ventricle with the possibility of aortic arch anomaly. Infantogram showed absent radius on right side with hypoplastic radius on left side, multiple digital anomalies in bilateral hands, and multiple segmentation anomalies in the entire spine. Echocardiography was done and it showed the presence of atrial septal defect (ASD), ventricular septal defect (VSD) and patent ductus arteriosus (PDA). However, the arch of aorta and the descending thoracic aorta could not be evaluated due to poor acoustic window. For better delineation of arch anatomy, the child underwent Computed tomography angiography (CTA). CTA confirmed the findings of ASD and VSD. In addition, there was dextrocardia with the heart being placed in the right hemithorax. A band of pulmonary parenchyma was seen extending between the bases of right and left lung between the heart anteriorly and the esophagus and spine posteriorly, thus establishing the diagnosis of horseshoe lung. The right lung was hypoplastic and two blind ending air filled diverticulae were seen arising from trachea at D2-D3 level and D5-D6 level, possibly representing atretic/ rudimentary right-sided bronchi. The bronchus supplying hypoplastic right lung was seen to arise from the left main bronchus suggestive of a bridging bronchus, which was diffusely attenuated in caliber with near complete occlusion in its proximal part near its origin. The main pulmonary artery was dilated. The left pulmonary artery was seen to be coursing anterior to the esophagus behind the left main bronchus, thus confirming the presence of pulmonary arterial sling. The right pulmonary artery was seen arising as a small caliber vessel from the left pulmonary artery and was seen supplying the hypoplastic right lung. Apart from the above findings, there was also presence of coarctation of aorta just distal to the origin of the left subclavian artery for a length of ~6mm with post stenotic dilatation. Considering the various co-existing anomalies on the imaging, a final diagnosis of LACHT syndrome (Mardini-Nyhan association) was made. Read More
Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022
Authors: Bhatia Anmol, R Rajath, Rani Usha, Saini Shiv, Saxena Akshay, Sodhi Kushaljit
Keywords: LACHT, Mardini-Nyhan, Horseshoe lung
To compare the visualization and anatomy of coronary arteries in children (<2 years) with congenital heart disease (CHD) on non-ECG gated and ECG gated computed tomography angiography (CTA). Read More
Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022
Authors: Sodhi Kushaljit, Bhatia Anmol, Rana Pratyaksha, Farook Shameema, Saxena Akshay, Singh Harkant, Mishra Anand, Manoj Rohit
Keywords: Coronary artery, CT Angiography