1. To review clinical strategies for reducing the anesthesia exposure for magnetic resonance imaging exams. 2. To review magnetic resonance imaging protocols to reduce examination time. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Ngo Anh-vu, Otto Randolph

Keywords: MRI, Anesthesia, Protocol, Sedation

The purpose of this educational presentation is to demonstrate ultrasound technique and characteristic sonographic findings of common superficial pediatric extremity soft tissue lesions. We also offer advice on how to differentiate benign from malignant lestions. Children frequently present with unexplained “lumps and bumps” on their extremities. These lesions are often invisible on radiography; MRI might require use of sedation; and CT exposes the child to radiation and often requires iodinated contrast. Ultrasound (US) is a cost-effective, radiation-free, and dynamic method to evaluate superficial soft tissue lesions. We discuss choice of transducer based on lesion location. We explain why a multifrequency transducer, which allows for the evaluation of both superficial (higher frequency spectrum of the transducer) and deeper (lower frequency spectrum of the transducer) components of the lesion is important. The use of compound imaging is explained, as multiple angles of insonation are combined to provide a more complete image of the structure being interrogated. For lesions involving the hands or feet, we explain the water-bath technique. Water is an excellent medium for ultrasound waves and will minimize artifacts from air and inadequate surface contact that plague evaluation of the distal extremities. We then discuss characteristic sonographic appearance of the following conditions: vascular anomalies, osteomyelitis and subperiosteal abscess, hematoma, subcutaneous granuloma annulare, Pilomatricoma, lipoma, ganglion and Baker cyst, muscle hernia, osteochondroma, foreign bodies, and malignant conditions. Read More

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

Authors: Thapa Mahesh, Ojeda Patricia, Otjen Jeffrey, Ngo Anh-vu, Callahan Michael

Keywords: ultrasound, benigh, malignant

The purpose of this educational exhibit is to demonstrate the lower extermity manifestations of Cerebral Palsy (CP). The focus will be on plain radiographic findings, along with surgical approaches to the various abnormalities. Conditions presented will include the following: equinus, equinocavovarus, equinoplanovalgus, oblique talus, vertical talus, ankle valgus and hallux valgus. In addition, a thorough and systematic approach on how to evaluate pediatric foot abnormalities will also be discussed. CP is caused by abnormalities of the developing fetal or infant brain that result in permanent central motor dysfunction. The prevalence of CP is about 2 in 1000 live births. Although this is higher in pre-term and low birthweight infants. The proposed underlying causes are many and include infection, hypoxia, structural changes, ischemia, and hemorrhage. The underying neural damage is nonprogressive, but the clinical manifestations can change and magnify. Gross Motor Function Classification System (GMFCS) is used to grade the severity of disease. Affecting about 93% of patients with CP, foot and ankle deformities have a huge impact on patient ambulation and GMFCS score. Such lower extremity abnormalities are classified using three “levels” of severity which influnce treatment options. Level I is mild, flexible deformity; level II manifests as soft tissue contracture; and level III causes skeletal remodeling and bony deformity. Only by apprecaiting the clinical and radiological manifestations of CP can we attain a more thorough understanding of the condition and its multitude of presentations. Read More

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

Authors: Thapa Mahesh, Maloney Ezekiel, Menashe Sarah, Otjen Jeffrey, Ngo Anh-vu, Iyer Ramesh

Keywords: Cerebral Palsy, equinus, cavus