The objective of this prospective study was to determine the accuracy of MR Enterography (MRE) in the assessment of mucosal healing in patients with Pediatric Crohn’s Disease (PCD) after starting treatment. MARIA and Clermont scores are MRE scores that were originally developed in adult population for the assessment of severity of Crohn's Disease (CD) in correlation to Crohn's Disease Endoscopic Index of Severity (CDEIS). MARIA score has shown close correlation to disease severity of colonic CD and Clermont score has shown close correlation to terminal ileum disease. A few reports have shown correlation of mucosal heling when assess by MRE scores and CDEIS in Adult population, but not work is available in pediatrics. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Davila Jorge, Highmore Kerri, Miller Elka

Keywords: MR Enterography, pediatric crohn's disease

Describe the anatomy and regional difference in brain maturation of various brain structures comparing 3 and 1.5 Tesla fetal MRI. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Priego Gema, Hurteau-miller Julie, Fontalvo Lucia, Miller Elka

Keywords: Fetal MRI

Advances in Neonatal Intensive Care have led to substantial improvement in survival of preterm infants of extremely low gestational age (ELGA) between 22+0 and 23+6 weeks gestation. ELGA newborns are more susceptible to several complications of prematurity. Recognition of the sonographic features of the normal brain and identification of potential short and long-term complications of these infants is paramount. High resolution transfontanellar ultrasonography is the baseline “gold standard” of care imaging modality to assess the integrity of the neonatal brain and potential complications encountered in ELGA newborns. Color and spectral Doppler US allows high reliability and precision in the evaluation of the intracranial vasculature. The purpose of this exhibit is 1. To illustrate a spectrum of the sonographic features of the normal developing brain in ELGA infants. 2. To characterize the sonographic findings of short and long-term brain anatomical complications. 3. To describe common pitfalls when imaging these infants. Read More

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

Authors: Taori Abhijeet, Ferretti Emanuela, Miller Elka, Martinez-rios Claudia

Keywords: Ultrasound, Neonatal, Brain

Imaging requisitions are the legal documents that health professionals use to communicate to radiologists and Medical Radiation Technologists (MRT(R)s) the relevant clinical information to guide their requested radiographic examination. Inadequate or incomplete information may have a substantial impact on patient care. Since the implementation of our electronic medical record system, EPIC (Epic Systems Corp.), we have the ability to track the number of errors on requisitions; the most common error is having the incorrect body parts selected or multiple unnecessary exams being ordered. The MRT(R)’s identify these errors and correct the inconsistencies following departmental protocols. Without such vigilance on the MRT(R)’s part, inappropriate radiographs could have been performed and could lead to additional, unnecessary radiation exposure. To help select the most appropriate protocol, educate and guide the health professionals at our hospital, an electronic software tool, “EDI” has been created. <b>EDI</b> (<b>E</b>xamine the patient, <b>D</b>etermine the correct radiograph, <b>I</b>nput the order with pertinent and relevant clinical information) is an interactive tool that includes the exam protocol with the associated views per body part. Each exam also includes EDI with the field of view that will be exposed to radiation during the exam. Our goal is that EDI will serve health professionals to better understand what order needs to be selected in the electronic system and which radiographs will be provided. Ultimately, this will reduce any unnecessary exams and reduce pediatric radiation exposure. Read More

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

Authors: Boileau Caroline, Treanor Lee, Kapoor Cassandra, Highmore Kerri, Miller Elka

Keywords: Appropriateness Criteria, Image Gently, ALARA

The purpose of this exhibit is to describe the expected physiological post-mortem changes in the fetus and children using different imaging modalities. These post-mortem changes are affected by a variety of antemortem and postmortem factors, amongst all, the age of the fetus or child, the organ system in question, and the extent of fluid shifts and tissue changes are the most crucial and help to guide the imaging modality of choice in post-mortem period. It is imperative to understand organ-system-specific post-mortem changes for satisfactory reporting of post-mortem imaging in children. When in doubt, a review of perimortem clinical details and a correlation with antemortem/antenatal imaging findings may assist in reaching the final diagnosis. Read More

Meeting name: SPR 2023 Annual Meeting & Postgraduate Course , 2023

Authors: Gupta Neetika, Snyder Elizabeth, Victoria Teresa, Arthurs Owen, Miller Elka

Keywords: Postmortem Imaging, Physiological changes, Expected changes

Extremely low gestational age (ELGA) infants are those born before 23 + 6 weeks of gestation. These infants are prone to multiple complications. Frequent complications affect the brain. Transfontanellar brain ultrasound (US) is the standard of care imaging modality to assess the brain during the first weeks of life. An appropriate ultrasound technique includes assessment of the brain in gray scale, color and spectral Doppler. Doppler US should be interpreted in correlation with the neonate’s clinical and systemic hemodynamic state, postnatal age, blood gas concentrations, respiratory or cardiovascular complications, amongst others. Prior literature focuses on the sonographic characteristics of premature, near term and term infants. However, Doppler US characterization of the intracranial vessels of ELGA infants is lacking. The purpose of this exhibit is to describe the resistive index (RI) and peak systolic velocities (PSV) of the anterior cerebral artery and the PSV of the superior sagittal sinus of a cohort of ELGA infants, and to assess their correlation with complications encountered in these infants. Read More

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

Authors: Acosta-izquierdo Laura, Dien-esquivel Maria, Miller Elka, Ferretti Emanuela, Martinez-rios Claudia

Keywords: Brain Doppler, Resistive index, Prematurity

Extremely low gestational age (ELGA) infants are those born before 23 + 6 weeks of gestation. Continued advances on therapy and supportive care in the neonatal intensive units have allowed for an improved survival of these infants. Transfontanellar brain ultrasound (US) is the standard of care imaging modality to assess the integrity of the brain during the first weeks of postnatal life, as it provides a closer direct look to the brain. The purpose of this exhibit is to illustrate detailed US characteristics of the normal development and complications of the evolving premature brain of ELGA infants. Read More

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

Authors: Acosta-izquierdo Laura, Dien-esquivel Maria, Miller Elka, Ferretti Emanuela, Martinez-rios Claudia

Keywords: Brain anatomy, Prematurity, Neurodevelopment

Diffusion weighted images (DWI) have the potential to provide valuable information on the diffusion and perfusion properties of the human placenta and therefore has the capability for detection of early developmental fetal anomalies. The purpose of this study was to determine if DWI of the placenta demonstrates differences between fetuses with and without central nervous system (CNS) abnormalities. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Valdez Quintana Melissa, Caro Dominguez Pablo, Grynspan David, Hurteau-miller Julie, Davila Jorge, Moretti Felipe, Miller Elka

Keywords: Placenta, Fetal, DWI, ADC, CNS Abnormalities

Blastomycosis is a rare granulomatous fungal infection, endemic to Canada and Midwest of the North America. The clinical features of blastomycosis are extremely variable, since the disease may involve any organ or system. Pediatric blastomycosis is uncommon, and the diagnosis is often delayed, which results in severe and disseminated disease by the time of diagnosis. Imaging studies plays an important role in the diagnosis and management of pediatric patients with blastomycosis. The purpose of our educational exhibit is to describe the imaging features of pulmonary and extrapulmonary blastomycosis in the pediatric population. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Rozovsky Katya, Higgins Rick, Moffatt Hayley, Wrogemann Jens, Al-somali Faisal, Miller Elka, Alqublan Lina, Bunge Martin

Keywords: blastomycosis, multi system manifestation, rare granulomatous fungal infection