Showing 8 Abstracts.
Administering oral contrast less than two hours before sedation/anesthesia is often needed for computed tomography (CT) studies of the abdomen in children, but violates the American Society of Anesthesiologists (ASA) nothing-by-mouth guidelines and may increase the risk of aspiration pneumonia.<b> </b>ASA guidelines are based on gastric aspiration.<b> </b>Oral contrast is best administered 1 hour prior to imaging for optimal abdominal CT evaluation. The aim of our study was to measure residual gastric fluid volume (RGV) by CT and with manual aspiration in subjects undergoing general anesthesia (GA) less than 2 hours after oral contrast. Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Afonya Boma, Kandil Ali, Mahmoud Mohamed, Das Bobby, Fleck Robert
Keywords: Anesthesia, Enteric Contrast, Safety
The indications for high resolution CT (HRCT) and bronchoscopy often coincide in patients with recurrent respiratory tract infections, chronic cough and wheezing, symptoms often related to tracheomalacia (TM). However, the efficacy for detecting TM in young children by HRCT has not been investigated. The aim of this investigation is to evaluate the ability to detect TM on clinical HRCT relative to bronchoscopy as a reference standard and compare several quantitative methods of determining the presence of TM on CT. Read More
Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017
Authors: Xia Christina, Das Prasnjeet, Thomen Robert, Woods Jason, Fleck Robert
Keywords: Tracheomalacia, Bronchoscopy, Computed Tomography
CT is often performed and advocated in patients with risk factors for or symptoms of tracheomalacia (TM). However, TM is traditionally defined as a 50% decrease in the cross-sectional area of the airway during a forced expiratory maneuver. This basis for detecting TBM was never meant for use in CT and leads to the under diagnosis of TM in young children by CT and typically requires inspiratory/expiratory CT (IECT). Additionally, some pictures archiving systems do not have tools to measure area. The aim of this investigation is to show that TM is under diagnosed by IECT relative to bronchoscopy and to develop a “view box” parameter to improve sensitivity while maintaining specificity in identifying the trachea as normal or affected by TM. Read More
Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016
Authors: Das Prasnjeet, Thomen Robert, Halula Sarah, Woods Jason, Fleck Robert
Keywords: Bronchoscopy, trachea, bronchomalacia, airway, dynamic CT
Large airway obstruction, subglottic stenosis, tracheal narrowing, and tracheomalacia are common morbidities associated with prematurity secondary to prolonged intubation. Laryngotracheoplasty is often required to alleviate subglottic stenosis and allow a patient to be decannulated from their tracheostomy. Patients will often have continued airway and voice issues despite being able to live without a tracheostomy. The clinical conundrum in treating this patient is whether vocal folds can be surgically moved closer together to improve vocalization without compromising the airway further and increasing resistance. Here we demonstrate how this clinical conundrum can be informed by CT-derived CFD modeling in a 15-year-old male former 31-week preterm infant with dysphonia and subglottic airway narrowing at the cervical trachea and narrow vocal cords. Read More
Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024
Authors: Elma Alexander, Bates Alister, Xiao Qiwei, De Alarcon Alessandro, Fleck Robert
Keywords: compurtational fluid dynamics, airway modeling, subglottic stenosis
Congenital lung lesions continue to be diagnosed prenatally with increasing frequency. While the etiologies frequently encountered have been well described, there are contradictions in the literature about the prevalence of pathologies. Additionally, no gender or lobar predilection has been confidently reported. The goal of this study was to delineate the epidemiology of congenital lung lesions and their mimickers at our institution to provide comparison to published data. Read More
Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017
Authors: Ledbetter Karyn, Adler Elena, Subramanyam Rajeev, Mahmoud Mohamed, Kline-fath Beth, Fleck Robert
Keywords: bronchial atresia, Congenital, CPAM
Demonstrate a rare cause of respiratory distress in a full-term newborn to illustrate the importance of chest radiography (CXR) in guiding the work up. Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Rodriguez Ruiz Felipe, Benscoter Dan, Tiao Gregory, Feng Christina, Hart Catherine, Fleck Robert
Keywords: Bronchogenic Cyst, Chest MRI, hyperlucent lung
BPD is associated with pulmonary hypertension (PH) and patients with BPD-associated PH (BPD-PH) have increased morbidity and mortality. Noninvasive assessment of BPD-PH has traditionally relied on echocardiograms. However, recent advances have allowed the use of MRI in the assessment of respiratory and cardiac disease in infants with BPD. In adults and older pediatric patients, increased left ventricular eccentricity index (MR-EI) and decreased MRI septal curvature correlate with increased mean pulmonary artery pressure and pulmonary vascular resistance. The current study sought to determine the relationship of MR-EI and septal curvature in neonates with BPD and BPD-PH with short term respiratory outcomes and need for pulmonary vasodilator therapies. Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Critser Paul, Higano Nara, Kingma Paul, Fleck Robert, Lang Sean, Hirsch Russel, Taylor Michael, Woods Jason
Tracheomalacia (TM) is a common morbidity associated with prematurity and manifests as dynamic collapse of the trachea lumen due to cyclic changes of intrathoracic pressure during breathing. Premature infants often have elevated work of breathing (WOB) related to their distal, small airway and lung abnormalities. The large airway contribution to WOB can be determined using computational fluid dynamics (CFD), which is a well-known technique to calculate the resistance and WOB in the human airway. However, previous studies are based on static airway geometry without motion. Using the novel technique of ultrashort echo time (UTE) magnetic resonance imaging (MRI), the tidal volume and airway motion can be used to create a dynamic model for use in CFD. Our aim is to calculate the estimated WOB in a dynamic trachea with neonatal TM compared with a stable, static trachea. Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Gunatilaka Chamindu, Bates Alister, Higano Nara, Hahn Andrew, Fain Sean, Hysinger Erik, Fleck Robert, Woods Jason
Keywords: Bronchopulmonary Dysplasia, MRI, Prematurity