A whirlpool describes rotating water created by opposing currents or upon an encounter with an obstacle. On imaging, it refers to a twist of the vascular pedicle of an organ, with a subsequent characteristic appearance on color Doppler images. Multiple abdominal pediatric emergencies are associated with a whirlpool sign, including midgut and other intestinal volvulus, testicular torsion, and ovarian torsion. This exhibit aims to review the underlying embryologic mechanism predisposing to this characteristic appearance, the role of this sign in the diagnosis of these conditions, the supporting imaging features that can help further define the diagnosis, as well as some pitfalls and differential diagnoses that can lead to a fallacious diagnosis. Read More

Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022

Authors: Aboughalia Hassan, Oztek Murat Alp, Noda Sakura

Keywords: Whirlpool sign, Midgut malrotation, Testicular torsion

Ventricular shunt failures are common with as many as 40% failing by 1 year and 70% by 10 years. Approximately 15% of these shunt failures are related to shunt disconnections. The typical presenting symptoms of shunt malfunction are nonspecific and include nausea, vomiting, and altered consciousness; therefore, imaging is critical for diagnosis. Conventional radiographs can be used to identify shunt disruption although they can have limited sensitivity. Most children with suspected shunt dysfunction will also undergo CT or MR imaging to evaluate ventricular sizes. In addition, the integrity of the shunt system within the field of view on head CT can be assessed in detail; however, subtle shunt disconnections or fractures can still be difficult to detect on multiplanar CT images. Volume rendered CT images of the shunt apparatus can be used to improve the detection of subtle shunt disruptions Read More

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

Authors: Oztek Murat Alp, Parisi Marguerite, Perez Francisco, Phillips Grace

Keywords: Ventriculoperitoneal shunt, CT, Volume rendering

Aseptic or chemical meningitis is an inflammation of the meninges without an infectious cause. It is a diagnosis of exclusion which is reached only in the appropriate clinical context after a careful search for bacterial or viral pathogens is negative. Aseptic meningitis following transsphenoidal resection of craniopharyngioma has been reported in the neurosurgical literature with an incidence of up to 3%; however, it remains unfamiliar in the radiology literature and there have been only a few case reports describing associated imaging findings. The chemical meningitis is thought to be caused by the release of craniopharyngioma fluid which contains inflammatory cholesterol crystals. Clinical and CSF findings can be identical to bacterial meningitis except for the absence of identifiable bacterial or viral pathogens. Complications can include vasospasm, stroke, and death. The purpose of this report is to describe two cases of aseptic meningitis following craniopharyngioma resection with the hope of improving awareness among pediatric radiologists. Read More

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

Authors: Oztek Murat Alp, Wright Jason, Perez Francisco, Khalatbari Hedieh, Ishak Gisele

Keywords: Craniopharyngioma, Meningitis, MRI