Contrast-enhanced ultrasound (CEUS) for the evaluation of the neonatal brain provides additional diagnostic information when compared to conventional gray scale ultrasound through the detection of perfusion abnormalities associated with injury. When compared to cross-sectional imaging, CEUS has many advantages given its relative low cost and ability to be performed at the bedside, without the need for sedation or exposure to ionizing radiation. Diagnostic information is yielded through the qualitative evaluation of parenchymal enhancement patterns as well as quantification of microbubble perfusion kinetics from which time intensity curves are derived and additional perfusion parameters can be extrapolated. Given the 2-dimensional nature of the modality, a strategically designed scanning protocol is necessary to obtain the aforementioned quantitative values. The purpose of this exhibit is to demonstrate the current understanding of brain CEUS and educate on the brain CEUS protocol used for the diagnosis of neonatal brain pathology. Read More

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

Authors: Cort Kayla, Piskunowicz Maciej, Hwang Misun

Keywords: hypoxic ischemic injury

MRI of the abdomen faces several technical challenges owing to respiratory motion, bowel peristalsis, and the need for large volumetric coverage. In adult patients, imaging is typically performed during multiple breath holds to avoid motion artifact; however pediatric patients may be unable to perform consistent breath holds or remain motionless during MRI acquisition. Although techniques such as child life specialists, MRI video goggles, and dedicated MR suite environments have reduced the need for anesthesia in MRI, general anesthesia may be necessary in some patients. Simulating breath holds in anesthetized patients is a technically difficult procedure requiring timed ventilation of the patient's abdomen during MRI acquisition, and results in progressive image degradation due to retained air artifact. Dynamic Scan Optimization (DISCO) combines 3D DCEMRI + 2 pt Dixon + Parallel Imaging + Temporal Acceleration to provide high spatiotemporal resolution while drastically reducing scan time. Because pediatric patients have relatively low respiratory volumes, this technique enables acquisition of diagnostic quality images without breath-holding. The purpose of this exhibit is to: (1) provide a guide for successful application of navigated spontaneous breathing multiphase DISCO sequence (2) review common use cases of the DISCO sequence (3) provide practical suggestions for troubleshooting DISCO Read More

Meeting name: SPR 2023 Annual Meeting & Postgraduate Course , 2023

Authors: Cheng Jocelyn, Durand Rachelle, Zapala Matthew, Cort Kayla, Bhuller Jeanie, Courtier Jesse

Keywords: Dynamic contrast enhanced MRI, DIfferential Sub-sampling with Cartesian Ordering, pediatric abdominal MRI