Awareness of abdominal aorta abnormalities in pediatric patients is essential for appropriate diagnosis and management of the patients suffering from these conditions. Due to a nonspecific presentation, and sometimes being asymptomatic earlier in life, imaging has an important role in diagnosis of these abnormalities. Aneurysm and dissection are excluded, as they are not specific to children and with few exceptions mostly present in older patients. We review the clinical presentation and show imaging findings of mid aortic syndrome, Takayusu arteritis, rare entities such as idiopathic infantile arterial calcification. Also we show imaging of the anatomic variants of the distal aorta such as middle sacral artery, persistent sciatic artery, abdominal aorta coarctation and blind ending aorta, with a short review of embryologic development of abdominal aorta. These anomalies are not common, however if remain undiagnosed might have serious consequences. -Midaortic syndrome is an uncommon disease with progressive narrowing of the abdominal aorta and its major branches, typically involving interrenal segment of the aorta; it affects mostly children and young adults, the cause is not clear, might be the result of an intrauterine insult to the intima and subintimal tissues. Aside from diagnosis, imaging has a major role in endovascular treatment of mid aortic syndrome. -Takayusu arteritis, also predominantly involves aorta and its major branches of younger patients, with strong female predominance, and frequently found in Asian patients. Destruction of arterial medi leads to aneurysm formation and uncommonly rupture of the involved artery. -Idiopathic infantile arterial calcification, a rare entity presenting with extensive calcification and stenosis of large and medium sized arteries, usually leads to early death from coronary artery occlusion. -The aortoiliac variants are rare and not commonly discussed in the imaging literature. Some anomalies might be asymptomatic in young ages, but might complicate surgeries like heart, renal transplant, or hip surgery and increases the risk of morbidity and mortality. Some of these anomalies such as persistent sciatic artery need long term follow-up, given the possibility of aneurysmal degeneration. Read More

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

Authors: Saadat Vandad, Chawla Soni, Chen Johnathan, Iskander Paul, Ghahremani Shahnaz

Keywords: Aorta, takayusu, midaortic

Intestinal failure is a rare but devastating condition in pediatric patients that is often caused by short bowel syndrome (SBS) secondary to necrotizing enterocolitis, volvulus, or intestinal atresia. Patients require the use of total parenteral nutrition (TPN) to survive, which can lead to cholestasis and end stage liver disease (ESLD). Treatment of intestinal failure in pediatric patients who have developed subsequent liver failure from TPN with multivisceral (MVTx) transplantation has progressed dramatically in the past two decades as a result of improvements in immunosuppression, surgical technique, and post-transplant care. The number of transplantations has always been relatively low due to a lack of appropriate donors and the rarity of intestinal failure. However, given the high acuity of patients that do ultimately undergo these procedures, recognition of post-operative complications is critical for graft survival and improved outcomes. This educational exhibit will review the indications and relevant anatomy for these types of transplantations. Magnetic resonance (MR) findings related to post-transplantation complications will be presented with imaging correlates from other modalities (CT, PET/CT, US) as needed. Read More

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

Authors: Loo Jerry, Iskander Paul, Chen Johnathan, Hall Theodore, Boechat Ines, Ghahremani Shahnaz

Keywords: intestinal, liver, magnetic resonance