Congenital lung malformations are a heterogeneous group of developmental disorders whose etiology is not well stablished. Since they represent a spectrum of anomalies, diverse imaging appearance and clinical manifestations can be found. Although rare, their clinical importance is remarkable. Some of them can be a source of important morbidity and mortality in infants and children. Others, however, remain asymptomatic and may be incidentally detected in adulthood. Nowadays, these malformations are usually diagnosed in utero by prenatal imaging. In order to optimize diagnostic accuracy and disease management, it is imperative for radiologists to be familiar with the imaging characteristics of each lesion and the proper methods employed in their evaluation. The purpose of this exhibit is: - To describe the postnatal radiological appearance of some congenital lung diseases on conventional radiography, ultrasound (when available) and cross-sectional imaging methods; - To conduct a brief review of the literature regarding etiology, epidemiology, clinical features and adequate diagnostic approach; - To highlight the key imaging findings of each abnormality and their differential diagnoses; - To briefly discuss management and follow-up of each condition. Illustrative cases from our Radiology Department will be used to demonstrate the following entities: 1. Parenchymal anomalies: - Lung hypoplasia; - Congenital bronchial atresia; - Congenital lobar emphysema; - Congenital pulmonary airway malformation (previously known as congenital cystic adenomatoid malformation); - Pulmonary bronchogenic cysts; - Tracheal bronchus; - Accessory cardiac bronchus. 2. Vascular anomalies: - Interruption of a main pulmonary artery; - Pulmonary artery stenosis; - Anomalous pulmonary venous drainage. 3. Combined parenchymal and vascular anomalies: - Bronchopulmonary sequestration; - Hypogenetic lung (scimitar) syndrome. Read More

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

Authors: Defendi Larissa, Yokoo Patricia, Shoji Hamilton, Balancin Marcelo, Chate Rodrigo

Keywords: Congenital, Vascular, Lung

Although clinical history seems the most important diagnostic information in gastroesophageal reflux (GER), it is less reliable in pediatric practice, mainly under 2 years old. Diagnostic tests are needed to document the presence of GER and exclude associated conditions. Gastroesophageal ultrasonography (US) is a widely available, noninvasive and sensitive method that provides morphological and functional information in GER diagnosis. The purpose of this exhibit is: 1. To highlight the main points in the pathophysiology of GER in children; 2. To review the ultrasonographic technique employed in the evaluation of reflux episodes and in the assessment of gastroesophageal junction morphology; 3. To discuss current state of the literature concerning US and pediatric GER. Ultrasonography cases from our Radiology Department will be employed to illustrate the following topics: - Clarifying GER and GER disease (GERD) concepts; - Pathophysiology of GER in children; - Clinical presentation of GER according to age; - Diagnostic approaches to pediatric GER; - The role of US in the management of children with suspected GER; - The US technique in GER evaluation; - Understanding the normal gastroesophageal morphology on US; - Recognizing reflux episodes in US; - Sonographic assessment of abdominal esophageal length and His angle; - Literature divergences and recommendations regarding each step of the technique. Read More

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

Authors: Defendi Larissa, Sameshima Yoshino, Yamanari Maurício, Neto Miguel José, Queiroz Marcos

Keywords: Esophageal, Ultrasound

Small Round Blue Cell Tumors comprises a group of highly aggressive malignant tumors with overlapping morphological pattern and immunophenotypic characteristics. They represent a challenge for surgical pathologists, as they require a broad panel of antibodies, mostly not used in the routine work of most pathology laboratories. In the required multidisciplinary approach, radiologists play a vital role in narrowing the diagnosis. The aim of the presentation is to describe the imaging appearance of several Small Round Blue Cell Tumors, mainly in Magnetic Resonance (MR). Teaching cases from our Radiology Department will be used to illustrate the following: a) Ewing sarcoma; b) Peripheral primitive neuroectodermal tumor; c) Neuroblastoma; d) Wilms tumor; e) Hepatoblastoma; f) Embryonal Rhabdomyosarcoma; g) Medulloblastoma; h) Pineoblastoma; i) Retinoblastoma; j) Central Nervous System primitive neuroectodermal tumor; k) Neuroepithelioma; l) Desmoplastic small round cell tumor. Read More

Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022

Authors: Defendi Larissa De Andrade, Balancin Marcelo, Tostes Rodrigo De Oliveira, Rodriguez Larry Marden Rabindranath Alpaca, Regacini Rodrigo, Lederman Henrique

Keywords: Small Round Blue Cell Tumors

Computed Tomography (CT) is still recommended as the first-line imaging method for the evaluation of premature closure of cranial sutures. The aims of this exhibit are: 1. To present the anatomy and physiology of cranial sutures; 2. To discuss technical aspects of CT imaging and structured report in craniosynostosis; 3. To present the main imaging findings of isolated and syndromic craniosynostosis. Teaching cases from our institution will be employed to illustrate the following topics: 1. Cranial sutures: anatomy and time of closure; 2. Imaging evaluation of cranial sutures: sonography (US), radiograph (XR) and CT - technique and protocols; 3. Recognizing a patent suture and distinguishing a normally closed suture from synostosis; 4. Craniosynostosis: pathophysiology, clinical features and associated genetic conditions; 5. Multi-modality imaging appearance of: - Dolichocephaly; - Brachycephaly; - Trigonocephaly; - Posterior plagiocephaly. 6. The role of imaging in evaluating positional plagiocephaly 7. Syndromic craniosynostosis - main CT imaging features of: - Crouzon syndrome - Apert syndrome - Pfeiffer syndrome - Saethre-Chotzen Syndrome 8. What matters for surgery planning? Tips on how to organize your report. Read More

Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022

Authors: Defendi Larissa De Andrade, Sbardelotto Monique, Rodriguez Larry Marden Rabindranath Alpaca, Tostes Rodrigo De Oliveira, Camargo Marcos, Monteiro Soraya, Regacini Rodrigo

Keywords: Craniosynostosis

McCune Albright syndrome (MAS) is a rare disease with a broad spectrum of clinical manifestations that may include café-au-lait macules, hyperfunctioning endocrinopathies and fibrous dysplasia. The latter is an uncommon and debilitating skeletal disorder that leads to fractures, deformity, functional impairment and pain. Since bone imaging provides essential data for diagnosis, prognosis evaluation and follow-up, the radiologist plays a crucial role at all steps of MAS management – and sometimes becomes the first health professional to assess non-skeletal associated conditions in routine exams. The present study proposes a practical approach for imaging McCune Albright syndrome. The main findings on various imaging modalities will be discussed according to their topography, bringing together relevant information to enhance the diagnostic, prognostic and follow-up procedures. Case material from our institution will be used to illustrate the following topics: 1. Brief review of MAS pathophysiology; 2. Clinical features and differential diagnosis of MAS; 3. MAS and polyostotic fibrous dysplasia; 4. Craniofacial fibrous dysplasia: imaging features, prognosis and follow-up; 5. Role of various imaging methods in non-skeletal manifestations. Read More

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

Authors: Defendi Larissa, Sameshima Yoshino, Lee Henrique, Naves Erica, Ribeiro Suheyla, Yamanari Maurício, Neto Miguel José, Queiroz Marcos

Keywords: Fibrous Dysplasia

Masses of both benign and malignant origin can occur in the spine and vertebrae, as well as in the paravertebral region, with subsequent vertebral and/or spine invasion. Although definitive diagnosis is established through anatomopathological evaluation, imaging appearance may help narrow the diagnosis and allow prompt management. The aims of this presentation are: - To discuss the several entities affecting the spine and vertebrae regarding their pathophysiology, clinical presentation and treatment; - To demonstrate their radiological appearance, mainly in computed tomography (CT) and magnetic resonance (MR) imaging; - To propose an illustrative guide for reference, highlighting their differential diagnoses in imaging. The following teaching cases from our radiology department will be presented: - Medullary Ganglioneuroblastoma; - Medullary Astrocytoma; - Medullary Myxopapillary Ependymoma; - Medullary Lipoma; - Medullary Epidermoid Cyst; - Spinal Canal Shwannoma; - Spinal Canal Metastasis of Ependymoma; - Spinal Canal Relapse of Medulloblastoma; - Vertebral Ewing Sarcoma; - Vertebral Osteoid Osteoma; - Vertebral Chordoma; - Vertebral Aneurysmal Bone Cyst; - Vertebral Osteochondroma; - Vertebral Fibrous Dysplasia; - Osteoblastoma; - Vertebral Hemangioma; - Paravertebral Extrarenal Rabdoid Tumor; - Paravertebral Plexiform Neurofibroma; - Paravertebral Osteosarcoma Relapse; - Neuroblastoma with spinal canal invasion. Read More

Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022

Authors: Defendi Larissa De Andrade, Nishimura Victor Dyego Mena Romeiro, Yamanoe Claudio Massayuki Nakao, Camargo Marcos, Silva Frederico Adolfo Benevides, Pozzi Iona Grossman, Regacini Rodrigo, Lederman Henrique

Keywords: Spine