As an inexpensive modality that does not require ionizing radiation, ultrasound is the preferred method for screening for fetal anomalies. When an abnormality is detected on ultrasound, the limitations of the modality often elicit further evaluation with MRI, as MRI can provide more detail and information to the radiologist and clinician. Chest and cardiac pathologies are among the most common findings on prenatal ultrasound and often warrant additional imaging. Consequently, an understanding of these findings and how they appear on different modalities is essential to the pediatric imager. This electronic exhibit features fetal ultrasound and MRI of mediastinal lymphangioma, type I-III congenital pulmonary airway malformations, intralobar, extralobar, and subdiaphragmatic sequestrations, left and right sided congenital diaphragmatic hernias, hypoplastic left heart, heterotaxy, AV canal defect, and rhabdomyoma. In addition to reviewing the correlation of findings on ultrasound and MRI, prognosis as well as conditions and syndromes commonly associated with these chest and cardiac anomalies will be examined. The goal of this exhibit is to provide an overview of common fetal cardiopulmonary abnormalities on different, complementary imaging modalities. Familiarity with these conditions is necessary for the radiologist to provide critical information to clinicians to allow prompt intervention in the postnatal period. These findings can additionally serve as an indication to the radiologist to search for associated findings, allowing prognostication and appropriate counseling of parents. Read More

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

Authors: Farkas Amy, Roda Manohar

Keywords: Cardiopulmonary, Fetal MRI

Encephaloceles are neural tube defects less commonly encountered in clinical practice. While often sporadic, genetic causes and TORCH infections are factors that predispose patients to encephaloceles. The majority of encephaloceles present at birth; however, some encephaloceles may demonstrate a more delayed presentation with cerebrospinal fluid rhinorrhea, nasal obstruction, or feeding difficulties. This electronic exhibit reviews various encephaloceles--occipital, sincipital, parietal, and basal encephaloceles--including antenataland postnatal cases. The distinction between nasoethmoidal,nasofrontal, and naso-orbital encephaloceles will be reviewed. The differential diagnosis of encephaloceles, especially of the sincipitallesions, will be detailed. Atretic cephaloceles will also be discussed. Read More

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

Authors: Farkas Amy, Joyner David

Keywords: Encephalocele

Genitourinary abnormalities are frequently detected on prenatal ultrasound, with findings detected on 1 in 500 routine prenatal sonograms. Early detection of abnormalities of the genitourinary system is essential as it allows planning for further work-up and intervention and appropriate counseling of parents. Findings on prenatal ultrasound often trigger further evaluation with fetal MRI, as MRI can provide superior anatomic detail and better assess for associated findings. An understanding of the appearance of genitourinary abnormalities on fetal MRI is important to enable accurate diagnoses and effectively guide clinicians in patient management. This educational poster highlights fetal MRI cases that demonstrate genitourinary abnormalities including bilateral renal agenesis with Potter sequence, crossed fused renal ectopia, multicystic dysplastic kidney, duplex collecting system, posterior urethral valves, patent urachus, allantoic cyst, prune belly syndrome, congenital megaureter, cloaca, bladder exstrophy, ureteropelvic junction obstruction, horseshoe kidney, and sirenomelia. The goal of this exhibit is to provide familiarity with these findings and their clinical implications, which is particularly important for those with less fetal MRI experience. In addition, the exhibit will provide an overview of the embryology of the genitourinary system as it relates to the abnormalities to provide further context of the pathophysiology of these complex congenital conditions. Read More

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

Authors: Farkas Amy, Roda Manohar

Keywords: Genitourinary, Fetal MRI

Familiarity with the American College of Radiology appropriateness criteria (ACR AC) is important to properly counsel clinicians and ensure patients receive optimal imaging evaluation. While clinicians have become increasingly aware of the ACR appropriateness criteria (AC), residents may not, often becoming involved in a case following the decision on what imaging study to perform. The purpose of this study was to assess resident knowledge of ACR AC regarding pediatric patients at a residency with training at a tertiary care children’s hospital. Read More

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

Authors: Farkas Amy, Dillard Austin

Keywords: Appropriateness, ACR

Congenital heart diseases alter the normal flow of blood through the heart. Conditions range in severity, from those that may simply require routine monitoring, to devastating lesions whose natural history is fatal. These complex conditions often require complicated surgically created cardiac shunts as treatment. Various diseases are often managed with the same procedure, with the goal of altering the abnormal hemodynamics. These surgeries may attempt to repair the lesion and restore normal physiology, or palliate the lesion as a bridge to future treatment including transplantation. This electronic poster provides a case based review of surgically created cardiac shunts. Cases include patients who have undergone bidirectional Glenn, Fontan completion, Rastelli, and Norwood procedures and the Blalock-Taussig shunt. The poster will review the congenital heart abnormalities corrected by these procedures and the anatomy of the shunts on CT and MRI. Read More

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

Authors: Farkas Amy, Howard-claudio Candace

Keywords: Congenital heart

Epilepsy can be a progressive and debilitating illness in the pediatric population. There is a large range of congenital conditions that present with seizures in neonatal patients, which are essential for the radiologist to accurately characterize on imaging. Accurately diagnosing the cause of epilepsy can not only allow appropriate treatment, but also provide important information on prognosis and associated abnormalities. The goal of this educational poster is to provide an overview of different congenital etiologies of epilepsy. This case based review includes congenital malformations of the brain such as focal cortical dysplasia, schizencephaly, heterotopias, hemimegalencephaly, and polymicrogyria. Cases highlighting neurocutaneous conditions associated with epilepsy including tuberous sclerosis and Sturge-Weber are reviewed. Cortical injuries from insults such as congenital infection, hypoxic-ischemic injury, or hemorrhage are also included. Familiarity with the imaging findings of epilepsy is essential for the radiologist, especially the trainee and those with less experience with pediatric neuroimaging. After reviewing this educational poster, viewers will be able to describe the imaging features of congenital causes of epilepsy and understand the treatment and prognoses of these conditions. Read More

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

Authors: Farkas Amy, Patel Niki, Joyner David

Keywords: Epilepsy, Congenital, Seizures

The clinical implications of craniosynostoses reach far beyond their striking cosmetic deformities. If untreated, craniosynostoses can lead to increased intracranial pressure, restriction of brain growth, and developmental delay, making the recognition of the findings and appropriate diagnosis critical. This electronic poster will provide an overview of various craniosynostoses including trigonocephaly, scaphocephaly, plagiocephaly, brachycephaly, and the various combinations of abnormally fused sutures, with an emphasis on 3D reconstruction imaging. In addition, the expected timing of the fusion of sutures will be described, as well as potential pitfalls in the interpretation of craniosynostosis, including metopic ridge. A brief review of Crouzon, Pfeiffer, and Apert syndromes, those syndromes most commonly associated with craniosynostosis, will be provided. Read More

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

Authors: Farkas Amy, Hooker Jeffrey, Joyner David

Keywords: Craniosynostosis

Epilepsy can be a progressive, debilitating illness, particularly in the pediatric population. More than half of brain tumors are associated with epilepsy, and 30% of these tumors will not respond to pharmacologic therapy. Recognizing lesions that cause seizures is imperative, as providing an accurate diagnosis can identify patients with surgically treatable disease. In the appropriate patient population, epilepsy surgery can be an effective management option that prevents significant morbidity and mortality from epilepsy and dramatically improves quality of life. This electronic poster will provide an overview of pediatric epileptogenic tumors including gangliogliomas, dysembryoplastic neuroepithelial tumors, pleomorphic xanthoastrocytoma, papillary glioneuronal tumor, pilocytic astrocytoma, and oligodendroglioma. Cases featuring these tumors and their distinguishing characteristics will be reviewed, as both tumor subtype and location contribute to the epileptogenicity of pediatric brain tumors. The goal of this poster is to provide a framework for the evaluation of pediatric epileptogenic tumors to establish a focused differential diagnosis when these lesions are identified. This is particularly important for trainees and well as those who do not commonly encounter epileptogenic tumors in their practice. Read More

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

Authors: Farkas Amy, Hooker Jeffrey, Joyner David

Keywords: Epilepsy, Brain tumor

The phakomatoses, or neurocutaneous syndromes, are the classically described congenital disorders with involvement of structures derived from the ectoderm. While the cutaneous manifestations of these conditions often establish their diagnosis, imaging characteristics can indicate the extent of disease and signify prognosis and potential complications related to the disorders. This educational poster reviews key multimodality imaging features and examples of infrequently encountered phakomatoses, including Sturge-Weber, von-Hippel Lindau disease, hereditary hemorrhagic telangiectasia, neurocutaneous melanosis, PHACES syndrome, basal cell nevus, and Parry-Romberg in pediatric patients. This case-based review of these syndromes will focus on relevant imaging findings with self-testing. After this electronic exhibit, residents will be able to describe the common imaging features of the less common phakomatoses. Read More

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

Authors: Farkas Amy, Hooker Jeffrey, Joyner David

Keywords: Phakomatoses

Critical alert systems have been implemented to assist radiologists in contacting clinicians and documenting critical findings on imaging. These systems serve as a safety net for patients, facilitating timely, accurate communication of findings. The purpose of this study was to review the critical findings sent through the messaging system at a children’s hospital to determine utilization by radiologists and providers. Read More

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

Authors: Farkas Amy, Lirette Seth, Powell Stella, Howard Candace, Dillard Austin

Keywords: Critical finding, Safety