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Society for Pediatric Radiology – Poster Archive

Geetika Khanna

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Showing 7 Abstracts.

Located at the border between the abdomen and the groin, the inguinal region can be a cause for consternation for the practicing radiologist. The inguinal canal can be a site for pathology secondary to abdominal or scrotal pathology. Though lymphadenitis is the most common cause of an inguinal mass in a child, a variety of conditions can result in an inguinal mass. The purpose of our poster is to review the imaging appearance and differential diagnosis of various potential causes of nonmalignant inguinal masses in children. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Farmakis Shannon, Khanna Geetika

Keywords: inguinal, pediatric, congenital, vascular, gonadal

Gadolinium deposition in normal tissues is an increasingly recognized consequence of intravenous gadolinium contrast agents. Children with inflammatory bowel disease (IBD) undergo frequent surveillance imaging with contrast enhanced MR enterography (MRE). Purpose: To determine the benefit (if any) of IV contrast in evaluation of IBD by MRE. Read More

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

Authors: Lanier Michael, Shetty Anup, Salter Amber, Khanna Geetika

Keywords: Enterography, Crohn disease, inflammation

Pulmonary metastases typically present as well-circumscribed, solid nodules of variable size in most pediatric malignancies. Hematogeneous metastases tend to have a basilar and peripheral predilection. Atypical patterns of pulmonary metastases can however occur and lack of recognition can result in understaging or delay in diagnosis. The purpose of this poster is to review the imaging findings of atypical pulmonary metastatic disease in children. Cases from two large tertiary care institutions will be used for illustration. Atypical pulmonary metastatic patterns include: 1. Dilated and beaded peripheral pulmonary vessels secondary to intravascular metastatic disease (e.g. osteosarcoma). Though central tumor embolus or tumor thrombus is easy to recognize, certain tumors such as osteosarcoma can cause intravascular metastatic disease in peripheral pulmonary arteries which has a characteristic imaging appearance and can mimic a "tree-in-bud" pattern. 2. Interstial thickening secondary to lymphangitic spread of tumor (e.g. lymphoma, renal medullary carcinoma, adenocarcinomas in children). This can be seen with or without mediastinal lymphadenopathy and is characterized by nodular septal line thickening. 3. Miliary pulmonary nodules (e.g. papillary thyroid cancer). Papillary thyroid carcinoma, the most common pediatric thyroid malignancy, can present with innumerable tiny pulmonary nodules which maybe mistaken for an infectious etiology secondary to indolent course. 4. Cavitary pulmonary masses (e.g. sarcomas). Cavitary nodules maybe seen at presentation in certain sarcomas or as a consequence of therapy induced central necrosis. 5. Calcified nodules (e.g. osteosarcomas) which can be mistaken for granulomas. 6. Nodules from hypervascular tumors can show hemorrhagic halos (e.g. angiosarcoma, choriocarcinomas). 7. Endobronchial metastasis can present with persistent segmental/lobar collapse. An awareness of the spectrum of imaging findings of atypical pulmonary metastases along with their histopathologic correlates will allow the radiologist to make an accurate diagnosis. Read More

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

Authors: Gagnon Marie-helene, Wallace Andrew, Yedururi Sireesha, Khanna Geetika

Keywords: Metastasis, Tumor thrombus, lymphangitic

Postoperative abscess is the most common complication of perforated appendicitis in children with an incidence of 3-25%. Though the imaging algorithms for diagnosis of pediatric appendicitis have evolved to magnetic resonance imaging (MRI), the use of MRI for post-operative evaluation of these children remains in its infancy. The purpose of our study was to evaluate our experience with a rapid non-contrast MR protocol for evaluation of post-appendectomy cases with concern for abscess. Read More

Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017

Authors: Lee Megan, Eutsler Eric, Sheybani Elizabeth, Khanna Geetika

Keywords: MRI, appendicitis, abscess

Immunoglobulin4 related disease (IgG4RD) is an inflammatory condition involving multiple regions of the body resulting in fibrosis which can lead to eventual organ failure. This entity was originally described with autoimmune pancreatitis. Recently many other previously described lesions have been brought under the umbrella of IgG4RD. These include a spectrum of conditions involving the head and neck region (orbits, salivary and lacrimal glands), thyroid gland (Riedel’s thyroiditis), vasculature (periaortitis), kidneys, lungs, retroperitoneum, mesentery, pituitary gland, biliary tract, pericardium, lymph nodes and pachymeninges. Reports of IgG4RD are quite rare in the pediatric literature, however this may be due to potential unawareness about the condition as well as the variable presentations and non-specific imaging features of IgG4RD. The prevalence in pediatric population is poorly described. The exact pathophysiology of IgG4RD is yet to be completely elucidated. The imaging manifestations are non-specific, and primarily consist of tumefactive enlargement of involved organs and homogenous contrast enhancement and associated lymphadenopathy. IgG4RD may manifest in single organ or may present as widespread disease involving multiple organs. These features overlap with other mass forming conditions like malignancy or lymphoma. However, the presence of multifocal disease with more than one organ involvement may point towards possible IgG4 related disease. Other than IgG4 related autoimmune pancreatitis, there is no consensus on diagnostic criteria based upon imaging. Definitive diagnosis of IgG4RD is made with biopsy and the histology characterized by infiltration of lymphocytes and IgG4 plasma cells with storiform fibrosis and obliterative phlebitis. According to Boston consensus, the ratio of IgG4 /IgG in tissue should be more than 0.4 with more than 10 IgG4+ cells per high power field. Serum IgG4 levels range from normal to elevated. Steroids are effective as first line treatment in majority of patients. Our aim in this presentation is to familiarize radiologists with the spectrum of imaging features, and areas of involvement in IgG4 related disease using cases of IgG4RD collected at three different pediatric hospitals. It is important for pediatric radiologists to be familiar with this relatively newly described disease entity and be aware of the spectrum of manifestations of IgG4RD, ensuring prompt recognition and early treatment. Read More

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

Authors: Priya Sarv, Handa Atsuhiko, Ferreira Da Silva Renato, Lai Lillian, Khanna Geetika, Sato T Shawn

Keywords: IgG4, fibrosis

MR elastography (MRE) is increasingly being used to non-invasively assess diffuse liver disease in children. However, there are limited normal liver stiffness data for MRE in children. The purpose of this study was to determine normal liver stiffness measured by MRE for children and assess for associations with demographic factors, MRI field strength and MRI vendor. Read More

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

Authors: Trout Andrew, Zhang Bin, Dillman Jonathan, Anupindi Sudha, Gee Michael, Khanna Geetika, Xanthakos Stavra, Baikpour Masoud, Calle-toro Juan, Ozturk Arinc, Serai Suraj

Keywords: Elastography, MR, Liver