Vaping associated pulmonary injury (VAPI) has recently received national attention as an epidemic resulting in cases of significant morbidity and mortality from electronic cigarette use. The purpose is to present the clinical and imaging findings in adolescents with pulmonary symptoms from suspected VAPI. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Hook Marcus, Barrera Ambika, Biko David, Dennis Rebecca, Rapp Jordan

Keywords: Vaping, Lung injury, Pneumonia

Dynamic Airway CT (DACT) has risen in popularity in recent years, however, studies of Tracheobronchomalacia (TBM) are hindered by inconsistent definitions which variously rely on airway area, airway diameter, and qualitative measures. We explore the interrater reliability of these measures. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: El-ali Alexander, Davis James, Otero Hansel, Biko David, Rapp Jordan

Keywords: dynamic airway imaging, CT, tracheobronchomalacia

To describe the normal progression of quantitative CT chest parameters in children Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Barrera Christian, Andronikou Savvas, Tapia Ignacio, White Ammie, Biko David, Otero Hansel

Keywords: Quantitative, CT, Lung

To investigate magnetic resonance (MR) imaging features of sacroiliac joint infections in children with respect to age and with clinical correlation. Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Cohen Sara, Biko David, Kaplan Summer, Barrera Christian, Serai Suraj, Nguyen Jie

Keywords: sacroiliitis

Clinical signs of the Neonatal Lymphatic Flow Disorder (NLFD) are a combination of the congenital chylothorax, chylous ascites and body edema. It can present as neonatal chylothorax (NC), neonatal chylous ascites, or congenital lymphatic dysplasia (CLD). The prenatal appearance of lymphangiectasia has been described as nutmeg lung. The purpose of this study is to describe prenatal and postnatal imaging features and outcomes of neonates with NLFD. Read More

Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017

Authors: Biko David, Johnstone Jordan, Dori Yoav, Itkin Maxim, Oliver Edward, Victoria Teresa

Keywords: lymphatic imaging, nutmeg lung, neonatal lymphatic flow disorder

Inguinal lymph node identification using ultrasound is critical in performing intranodal lymphangiography. We routinely utilize a 15 MHz “hockey stick” linear high resolution ultrasound probe (Philips Epic 7) for identification as well as to gain needle access into the inguinal lymph node. However in children with severe body wall edema and in low weight premature babied identification of lymph nodes can be difficult and sometimes impossible. Higher frequency ultrasound transducers offer the potential for improved identification of lymph nodes in such cases. The aim of this study was to compare imaging finding of high resolution US probe to the traditional 15 mHz probe in patients undergoing lymph node access for lymphangiography. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Krishnamurthy Ganesh, Escobar Fernando, Srinivasan Abhay, Smith Christopher, Biko David, Pinto Erin, Dewitt Aaron, Dori Yoav

Keywords: Ultra high frequency, lymph nodes, lymphatic intervention

With advances in intensive care, increasing numbers of premature neonates with severe respiratory distress have led to major challenges related to prolonged mechanical ventilation and chronic bronchopulmonary dysplasia. Acute lung injury and acute respiratory distress syndrome in children still confer significant morbidity and mortality despite advances in ventilation and resuscitative therapies. Much of the damage attributed to mechanical ventilation in critically ill infants and children is due to surface tension and ventilation of atelectatic lung. First reported clinically in neonates in 1989, partial liquid ventilation involves the endotracheal administration of an inert volatile perfluorochemical liquid. These perfluorocarbons aid in gas exchange due to their large oxygen and carbon dioxide carrying capacity. In addition, these chemicals possess low surface tension that allows for greater alveolar recruitment and improved lung compliance through clearance of debris and secretions. Early trials in preterm neonates and neonates with congenital diaphragmatic hernia suggested a role for liquid ventilation as salvage therapy for patients not responding to conventional mechanical ventilation and extracorporeal membrane oxygenation. Currently, efforts are underway to reassess its clinical utility in bronchopulmonary dysplasia. With this renewed clinical interest, it is important for pediatric radiologists at institutions utilizing these perfluorocarbons to be familiar with the clinical use and radiographic appearance of liquid ventilation. Read More

Meeting name: SPR 2018 Annual Meeting & Postgraduate Course , 2018

Authors: Degnan Andrew, Biko David, White Ammie, Servaes Sabah, Otero Hansel, Fox William, Shaffer Thomas, Zhang Huayan, Saul David

Keywords: liquid ventilation, chest radiographs

Percutaneous lymphatic interventions (PLI) target the pulmonary lymphatic abnormalities seen in patients with plastic bronchitis (PB). Existing data in patients with congenital heart disease(CHD)indicates poor transplant-free survival after the diagnosis of PB. We describe various techniques of PLI and characterize intermediate-term survival and complications after PLI. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Krishnamurthy Ganesh, Srinivasan Abhay, Smith Christopher, Savla Jill, Biko David, Pinto Erin, Dewitt Aaron, Dori Yoav, Escobar Fernando

Keywords: Plastic bronchitis, percutaneous lymphatic intervention

Pediatric Contrast Enhanced Ultrasound (CEUS) is a safe and patient-friendly imaging modality. It improves the diagnostic capability of gray-scale and Doppler ultrasound without sedation, ionizing radiation and no use of iodinated or gadolinium-based contrast agents. Pediatric CEUS was originally used to detect vesicoureteral reflux, evaluate indeterminate focal liver lesions, assess and follow up solid-organ injuries sustained during blunt abdominal trauma. In 2016, the approval of Lumason® (Bracco Diagnostics Inc., Monroe Township, NJ) by the United States Food and Drug Administration (FDA) marked the beginning of a new era for CEUS imaging. Since then, clinical requests for pediatric CEUS not only increased in number but also for a variety of examinations covering practically every organ system, including pediatric brain, lungs, solid organs and bowel. In addition, intracavitary applications of pediatric CEUS are now extending beyond the urinary tract, to include urogenital and anorectal malformations. Intravenous and intracavitary CEUS is used in pediatric interventional radiology, to confirm enteric tube placement, guide biopsies and drainage procedures and aide organ vascular mapping (e.g. renal, central vessels). Novel pediatric CEUS applications now used include intranodal CEUS lymphangiography for confirmation of needle position preceding MRI lymphagiography. Pediatric CEUS is performed in a number of clinical settings including inpatient units, outpatient radiology, emergency department, and intraoperative. These evolving indications and uses of CEUS combined with continuous advances in ultrasound technology, such as three-dimensional/four-dimensional ultrasound and improved contrast sensitivity, are establishing pediatric CEUS as an important alternative imaging examination that can complement or supplement fluoroscopy, CT and MRI. This presentation reviews the current wide spectrum of pediatric CEUS applications and imaging findings, according to body part, and the associated imaging findings. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Ntoulia Aikaterini, Back Susan, Hwang Misun, Gokli Ami, Anupindi Sudha, Biko David, Srinivasan Abhay, Poznick Laura, Darge Kassa

Keywords: contrast ultrasound, pediatric applications

Fontan–associated liver disease (FALD) is associated with increased risk of liver cirrhosis and hepatocellular carcinoma. Liver biopsy is the current gold standard investigation for diagnosing liver fibrosis. Magnetic Resonance Elastography (MRE) is a non-invasive procedure assessing liver stiffness. To date, only limited published studies are available describing the correlation of MRE and biopsy in Fontan-associated pediatric patients. Further, longitudinal changes in MRE require an increase in hepatic stiffness of >22% to indicate true change in stiffness (95% CI). The purpose of this study is to determine the clinical implication of MRE in FALD. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Tsitsiou Yvonne, Rychik Jack, Biko David, Cahill Anne Marie, Serai Suraj, Durand Rachelle, Golberg David, Glatz Andrew, Rand Elizabeth, Wilkins Benjamin, Witschey Walter, Dodds Kathryn, Russo Pierre

Keywords: MR Elastography, Fontan, Liver Biopsy

To report on our initial experience with the use of mesenteric dynamic contrast MR lymphangiography (DCMRL) for evaluation of the lymphatics in patients with concern for mesenteric lymphatic flow disorders and compare these findings to intranodal (IN) DCMRL and intrahepatic (IH) DCMRL. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Biko David, Pinto Erin, Krishnamurthy Ganesh, Escobar Fernando, Dori Yoav, Smith Christopher, Dewitt Aaron, Gillespie Matthew, Rome Jonathan, Glatz Andrew, Rapp Jordan, Otero Hansel, O'byrne Michael

Keywords: MR lymphangiography, mesenteric imaging

Review imaging findings on static and dynamic contrast enhanced magnetic resonance lymphangiogram (DCMRL) in young infants who presented with chylothorax and correlate these imaging findings with clinical outcomes. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Gaballah Marian, Otero Hansel, Rapp Jordan, Rome Jonathan, Biko David, Dori Yoav, Pinto Erin, Krishnamurthy Ganesh, Smith Christopher, Escobar Fernando, Dewitt Aaron, Taha Dalal, Edgar James

Keywords: lymphatic, Lymphangiogram, chylothorax