Showing 16 Abstracts.
Pediatric scrotal ultrasound pathology can be difficult because of the similar presentation of different pathology such as scrotal torsion, epididymitis, inguinal hernia, epididymal appendix torsion, and trauma. Identifying key factors of each condition is paramount to providing a clear diagnostic picture in the setting of an atypical presentation of any pathology. Epididymitis is an inflammatory process precipitated by bacterial or viral infections. Symptoms typically present as increasing scrotal pain with swelling of the epididymis. Depending on degree of severity imaging presentation can mimic other pathology. A 5 year old male transferred to a pediatric facility from an area hospital to assess suspected incarcerated hernia with outside CT and ultrasound images. Read More
Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019
Authors: Durfee Teela, Cielma Tara
Keywords: epididymitis, pediatric scrotal Ultrasound, Acute scrotal pain
Background: Lumbar puncture (LP) is used during the initial work-up of a febrile infant for diagnosis of central nervous system (CNS) abnormalities such as neoplasm, and infectious processes. In children, the L3-L4 and L4-L5 intervertebral space can be used to access the subarachnoid space. Collection of cerebral spinal fluid (CSF) is then tested for any markers of infection. At times, a lumbar puncture may fail and create a leak of CSF and hematoma within the meningeal space. Purpose: Through this case series, we will describe normal sonographic anatomy of the spinal canal and effective techniques to best demonstrate epidural hematoma post lumbar puncture. Retrospective review of ultrasound B-mode and cine loop images was performed with respect to the three cases. Typical imaging features include heterogenously echogenic material within the dorsal and ventral epidural space that may move with real-time patient motion. Additionally, the collection of material may compress the thecal sac, obliterating flow of CSF. High frequency linear sonography of the spinal canal and epidural space after unsuccessful lumbar puncture in experienced hands can adequately demonstrate anatomic detail of the spine and meningeal spaces and identify the epidural hematoma. Ultrasound allows expedited diagnosis of traumatic epidural hematoma after failed lumbar puncture and facilitates ultrasound-guided CSF collection. Read More
Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017
Authors: Cielma Tara, Bandarkar Anjum
Keywords: Spine Ultrasound, Epidural Hematoma, Lumbar Puncture
Background: Volume acquisition in ultrasound is recognized as a helpful tool in prenatal sonography, but notorious for having a steep learning curve. At times, utilizing this technology may be the <i>only</i> way to visualize anatomy due to factors such as maternal body habitus or fetal position. Our goal is provide the audience with the information and techniques required to take a volume sweep acquisition and obtain numerous rendering modes to evaluate the fetal craniofacial area. Aims: 1. To describe utility and benefit of acquiring volume ultrasound in detection of craniofacial anomalies in prenatal patients. 2. To describe tips, tricks, and current technology to optimize imaging and assist in minimizing equivocal exams. 3. Provide examples of soft tissue lesions, hydrocephalus, craniosynostosis, micrognathia and midline cleft cases. 4. To look into future technology and potential applications. Read More
Meeting name: SPR 2018 Annual Meeting & Postgraduate Course , 2018
Authors: Cielma Tara, Linden Kadine
Adnexal torsion is one of the most common gynecologic surgical emergencies. Delayed diagnosis could result in tissue necrosis, leading to loss of ovarian function and impaired fertility. The goals of this exhibit are: 1. Review the anatomy of the female pelvis. 2. Discuss the incidence, risk factors, and clinical characteristics of adnexal torsion. 3. Describe the technical approach of performing pelvic ultrasound. 4. Illustrate the sonographic imaging spectrum of adnexal torsion. 5. Discuss diagnostic criteria of adnexal torsion. Read More
Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022
Authors: Cielma Tara, Adeyiga Adebunmi, Bandarkar Anjum
Keywords: adnexal torsion, ovarian torsion, fallopian tube
Background: Infantile hypertrophic pyloric stenosis (IHPS) is a condition affecting young infants in which the circular muscle layer of pylorus becomes thickened, leading to narrowing and elongation of the pyloric channel. The pyloric mucosa becomes redundant and appears hypertrophic. On ultrasound, the thickened pylorus is often seen adjacent to the gallbladder and anteromedial to the right kidney. Infants with IHPS are asymptomatic at birth but, in the first few weeks of life, develop nonbilious forceful vomiting described as “projectile emesis” and present with partial gastric outlet obstruction. Surgical pyloromyotomy is curative. Standard sonographic criteria include measurement of pyloric muscle >3 mm and elongation of pyloric canal >14 mm. Normal pyloric muscle thickness measures <2 mm. When pyloric muscle thickness measures between 2-3 mm, the exam is called as equivocal or borderline. Factors leading to equivocal exam may include incorrect technique that involves over measuring the pyloric muscle thickness, obliquely oriented section of pylorus and transient pylorospasm. Purpose: The goals of this exhibit are- 1. To review the sonographic anatomy of normal and abnormal pylorus. 2. To illustrate our technical approach to diagnose IHPS with specific attention on how to accurately measure the muscle thickness and channel length. 3. To describe tips and tricks to minimize equivocal exams. Read More
Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017
Authors: Cielma Tara, Bandarkar Anjum, Adeyiga Adebunmi
Keywords: Infantile hypertrophic pyloric stenosis, ultrasound, muscularis externa
Vocal cord paralysis (VCP) is a common cause of respiratory and feeding problems in the pediatric population. The goals of this exhibit are: 1. Review the anatomy of the larynx and recurrent laryngeal nerve 2. Discuss the incidence, risk factors, and clinical characteristics of pediatric vocal cord paralysis 3. Describe the technical approach of performing laryngeal ultrasound 4. Illustrate the sonographic appearance of vocal cord paralysis 5. Discuss diagnostic criteria of pediatric vocal cord paralysis Read More
Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022
Authors: Sanchez Ramon, Cielma Tara, Mudd Pamela
Keywords: Vocal cord, recurrent laryngeal nerve, larynx
Dermoid cysts are a sequestration of ectoderm containing secondary skin structures, usually at characteristic locations of embryologic fusion lines. The midventral suprasternal fusion line is one such location in the developing embryo with both simple and complicated dermoids of this region reported in the literature. We reviewed our academic pediatric institutional experience with dermoid cysts of the suprasternal notch, focusing on the initial presentation as a palpable nodule referred for sonographic evaluation. The purpose of this educational exhibit is to depict the ultrasound imaging features of suprasternal notch dermoid cysts in the pediatric population. Secondary purposes are to describe the anatomy of the suprasternal notch, demonstrate CT and MR correlates of the these dermoids, and depict regional inflammatory complications. Read More
Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019
Authors: Molto Jose, Loomis Judyta, Cielma Tara, Whitehead Matthew
Keywords: Dermoid, neck, Suprasternal
Venous thromboembolism (VTE) is a multifactorial disease and a significant source of morbidity. Though the incidence of VTE, composed of deep venous thrombosis (DVT) and pulmonary emobolism (PE), is more common in adults, an increasing number of children are being diagnosed. Children who are critically ill are at greatest risk of developing VTE. Duplex sonography is a critical front line tool in the detection and evaluation of venous thrombosis. Serial surveillance examinations allow real-time assessment of thrombosis including propagation and progression. Recognizing the presentation and sonographic appearance of venous thrombosis assists the clinician in timely therapeutic decision-making and clinical management. The goals of this exhibit are: 1. Describe the technical approach of performing duplex vascular ultrasound, including tips and technology that assist in optimizing studies. 2. Discuss the incidence, risk factors, and clinical characteristics of pediatric VTE. 3. Depict the sonographic appearance of thrombosis with emphasis on correlation to other modalities. 4. Discuss prognosis and long-term outcomes of VTE in children. 5. Describe future techniques and applications. Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Cielma Tara, Hill Cara, Mirza Sobia, Sanchez Ramon
Keywords: Deep venous thrombosis, Venous thromboembolism, Pulmonary embolism
Background: Hemophilia is a rare X-linked recessive bleeding disorder characterized by the absence of one of the coagulation factors including factor VIII in hemophilia A and factor IX in hemophilia B. Amongst the complications, muscle hemorrhage is the second most common type of hemorrhage in hemophilia, second only to hemarthrosis. Bleeding may be precipitated by trauma or fractures or may be spontaneous. Hemorrhage into the large muscle groups of the upper and lower extremities, can cause tissue compartment syndrome, nerve compression, and potential tissue death. A child with hemophilia and muscle hemorrhage may present with focal swelling, pain, or refusal to use the affected body part. Early recognition and treatment of muscle hemorrhages can prevent compartment syndrome and longterm complications, reduce pain, and allow a quick return to normal function and activity. Aims: 1. To describe utility of rapid ultrasound in detecting muscle hemorrhages in children with hemophilia. 2. To illustrate sonographic appearances of muscle hemorrhages in various locations in the body. Read More
Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017
Authors: Bandarkar Anjum, Cielma Tara, Holley Danyelle, Adeyiga Adebunmi
Keywords: Hemophilia, Muscle hemorrhage, Hematoma
The diaphragm is the major muscle used during quiet breathing and abnormalities of diaphragm motion are a source of significant morbidity, especially in infants and young children. Diaphragm motion can be either normal, decreased, absent or paradoxical. Diaphragmatic paralysis may present with unexplained respiratory distress, difficulty in weaning the patient from mechanical ventilation and persistent elevated hemidiaphragm on chest radiographs. Early diagnosis of diaphragmatic paralysis is critical to minimize prolonged ventilatory support and consider surgical plication. Objectives: 1. To discuss our experience with diaphragm ultrasound (US) in suspected diaphragmatic paralysis. 2. To illustrate sonographic technique and protocol to perform diaphragm US. 3. To present a case-based review of the spectrum of normal and abnormal diaphragmatic motion. Read More
Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017
Authors: Smith Benjamin, Otero Hansel, Cielma Tara, Bandarkar Anjum
Keywords: diaphragm, diaphragmatic motion, ultrasound
Background: Duplex sonography is a critical portion of intracranial hemodynamics evaluation. Serial Doppler examination allows real-time assessment of disease progression or improvement. The goals of this exhibit are: 1. Describe the technical approach of performing neonatal/infant transcranial Doppler ultrasound. 2. Review tips, and up to date technology that assist in optimizing studies. 3. Discuss changes in flow patterns with various pathologies, providing examples of clinical indications. 4. Review future potential techniques and applications. Read More
Meeting name: SPR 2018 Annual Meeting & Postgraduate Course , 2018
Authors: Cielma Tara, Bandarkar Anjum, Demshur Lesley, Bulas Dorothy
Keywords: Neurosonography, Cerebral Doppler, Hypoxic Ischemic Encephalopathy
The main purpose is to depict sonographic features of the subpial hemorrhage of the neonate. Secondary purposes are: (1) Review the anatomy of the subpial space, (2) Review proposed pathophysiology, (3) Demonstrate CT and MR correlates of subpial hemorrhages. Read More
Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022
Authors: Molto Garcia Jose Francisco, Cielma Tara, Rao Jhanavi, Czarniecki Marcin B., Sanchez Ramon
Keywords: Hemorrhage, Ultrasound, Brain
Thyroid hemiagenesis (TH) is a rare congenital abnormality associated with a higher incidence of thyroid disease. It is often asymptomatic and an incidental finding. However, TH may present as a palpable thyroid nodule, prompting sonography and thyroid function testing. Ultrasound (US) can differentiate between total absence of the thyroid lobe and severe hypoplasia. It is also useful for guiding fine needle aspiration when warranted. Scintigraphy is useful for determining the presence of ectopic thyroid tissue and to further characterize focal nodular thyroid lesions. Despite their respective roles, imaging findings on both US and scintigraphy can pose diagnostic challenges to the pediatric radiologist. This educational poster will review the embryology of the thyroid gland, frequency of TH, clinical presentation and associations with additional thyroid anomalies such as malignancy, thyroiditis and abnormal gland function. Imaging features of TH will be reviewed with focus on (US) and scintigraphy. The goals of this exhibit are: 1. Review the incidence and clinical presentation of pediatric patients with TH 2. Describe the imaging findings and role of ultrasound and scintigraphy in the diagnosis and follow-up of TH 3. Discuss prognosis and outcomes of TH in children Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Mirza Sobia, Sanchez Ramon, Ma Grace, Cielma Tara, Vaidyanathan Priya
Keywords: thyroid, hemiagenesis, cancer
Bowel ultrasound is a critical component of gastrointestinal evaluation. Serial examination allows real-time assessment of disease progression or improvement, and assists the clinician in therapeutic decision making and clinical management. The goals of this exhibit are: 1. Describe the technical approach of performing bowel ultrasound. 2. Review tips, and up to date technology that assist in optimizing studies. 3. Discuss sonographic appearance of various pathologies. 4. Review future potential techniques and applications including utility of Doppler flow and contrast enhanced ultrasound. Read More
Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019
Authors: Cielma Tara, Durfee Teela, Bulas Dorothy, Loomis Judyta, Adeyiga Adebunmi, Bandarkar Anjum
Keywords: gastrointestinal disorder, inflammatory bowel disease, bowel
Background: Disorders of sexual development (DSD) resulting in ambiguous genitalia are a rare spectrum of anomalies that have the potential to be diagnosed prenatally using a combination of genetic testing and imaging. The incidence of prenatal detection is rising with the increased use of noninvasive prenatal testing, which can reveal discordance between genotype and phenotype. Sonographic and MR imaging contribute to prenatal assessment of disorders of DSD and may narrow the differential diagnosis and facilitate prenatal testing and postnatal evaluation. The goals of this exhibit are: 1. Review imaging features of normal prenatal male and female genitalia. 2. Review imaging patterns of ambiguous genitalia. 3. Discuss changes in appearance with various pathologies, providing imaging examples. 4. Review different categories of disorders of sexual differentiation and see how imaging may narrow the differential diagnosis. Read More
Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019
Authors: Cielma Tara, Blask Anna, Rubio Eva, Loomis Judyta, Menzel Meg, Bulas Dorothy
Keywords: ambiguous genitalia, dsd, prenatal
This electronic poster discusses the various clinical and imaging features of pediatric hyperthyroidism, including Graves’ disease and toxic nodule. Imaging modalities reviewed include ultrasound and molecular imaging. We will provide an overview of I-131 hyperthyroid therapy with focus on guideline-based practices of patient preparation, I-131 dosing and post-therapy radiation precautions. A pressing concern for patients and families following I-131 therapy is how long radiation precautions must be followed and when the patient may return to school or work. We have developed and implemented a table listing the appropriate duration of post-therapy radiation precautions based on the administered I-131 dose. We propose the use of such tables for ease of consultation and standardization of discharge procedures. Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Mirza Sobia, Shalaby-rana Eglal, Kovats Catalina, Loomis Judyta, Vyas Pranav, Shet Narendra, Fricke Stanley, Cielma Tara, Bush Ebony, Grecco Krystal
Keywords: hyperthyroid, I-131, iodine