Hemolytic uremic syndrome (HUS) is a recognized but still uncommon disease with an incidence varying between 1 to 3 cases per 100,000 annually. It consists of a triad of acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia, with this triad resulting from endothelial cell damage, intravascular hemolysis, platelet activation, and subsequent microthrombi with multi-organ involvement. Classical cases involve a school age child with diarrhea with diarrhea and acute renal failure. This form of HUS is post-infectious from exposure to a Shigella toxin-producing E. coli (STEC) and was previously called typical HUS. A newer understanding of the condition and pathophysiology has brought about changes into the classification, which the radiologist should be aware of. HUS can now be best divided into: - Hereditary HUS (where there are gene-related changes affecting the body’s coagulation regulation) - Acquired HUS, which can be post-infectious (as in STEC, pneumoccous, HIV), from autoantibodies or drug-related. As understanding of the condition has changed, this review aims to bring the imaging features in line for hereditary HUS and acquired HUS. This cross-center educational review will focus on multi-modality and multi-system imaging findings, which have typical features on ultrasound, CT and MRI. It will also highlight differences that occur in the presentation and findings in three large centers that are positioned in different parts of the world. We will focus on early recognition to aid the clinician; however, we will also detail the significant complications in the genitourinary, gastrointestinal, and central nervous systems that can occur. Learning Points: - Understand the evolution of HUS classification and appreciation of how this is important for the radiologist to aid diagnosis. - Learn the imaging findings in classical HUS as well as the rarer forms of HUS, in addition to how these conditions present across different countries. - Appreciation of the use of multimodality imaging to facilitate earlier detection to aid the clinician and child with earlier diagnosis. - Recognition of the multisystem organ involvement and complications associated with HUS. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Chotai Heena, Liu Amanda, Durand Rachelle, Courtier Jesse, Davda Sunit

Keywords: Anemia, Renal Failure

Three-dimensional (3D) imaging has emerged as a valuable tool in diagnosing pediatric Müllerian duct anomalies (MDAs), offering superior anatomical visualization and assessment compared to traditional imaging techniques with two-dimensional ultrasound. MDAs are frequently associated with other congenital anomalies of the cervix, vagina, or urinary tract, and are a common cause of infertility and pregnancy loss after adolescence. In pediatric patients, MDAs are often discovered incidentally during imaging for other conditions. Magnetic resonance imaging (MRI) is the preferred modality for evaluating MDAs in children, providing multiplanar capabilities and detailed soft tissue characterization while avoiding ionizing radiation. MRI protocols for MDAs typically include T2-weighted sequences for visualizing uterine morphology and T1-weighted sequences to detect blood products in cases of associated endometriosis or hematometra . The use of 3D MRI techniques allows for enhanced depiction of uterine and vaginal anatomy, and is particularly advantageous in differentiating complex anomalies such as septate and bicornuate uteri. Additionally, 3D reconstructions can provide a virtual hysterosalpingogram (MR-HSG), offering a comprehensive assessment of the reproductive tract without the need for invasive procedures. 3D imaging's accuracy extends to the detection of associated renal anomalies, given the concurrent development of the urinary and reproductive systems. Identifying these anomalies early is crucial for planning surgical interventions that may involve both gynecologic and urologic components . Overall, 3D imaging significantly enhances the diagnostic accuracy and management of pediatric Müllerian duct anomalies. By providing detailed anatomical insights and allowing for non-invasive classification, it plays a critical role in guiding treatment strategies, reducing the need for repeat surgeries, and improving long-term reproductive outcomes for affected patients. The purpose of this educational exhibit is to: 1. Review the embryology, classification, and imaging features of Müllerian duct anomalies using 3-dimensional imaging 2. Review the indications and techniques for surgical management of Müllerian duct anomalies in pediatric patients 3. Provide sample cases and clinical courses of patients with specific Müllerian duct anomalies with tips for implementation of 3-D imaging 4. Allow learners to test their knowledge with a quiz. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Cheng Jocelyn, Leesmidt Kantheera, Liu Amanda, Young Victoria, Davda Sunit, Berger-chen Sloane, Courtier Jesse

Keywords: MRI, Mullerian Duct Anomalies, 3D Imaging