Showing 13 Abstracts.
The principle of ALARA and its application in the pediatric population serves as the focus of the Image Gently campaign. Tertiary care institutions dedicated to the care of children are well situated to be regional leaders in maximizing the ALARA concept. This study compares the size-specific dose estimates of computed tomography (CT) studies performed at our institution to those from outside facilities referring patients for emergent care. Read More
Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019
Authors: Cao Joseph, Pfeifer Cory
This study evaluates the value of radiologist-driven imaging education in a pediatric residency program. The primary goals of this educational program were to provide pediatric residents with resources such as the American College of Radiology Appropriateness Criteria, support optimal resource utilization and patient care, increase resident understanding of radiation risk, and determine the value of integrating radiologists into pediatric education. Read More
Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019
Authors: Pfeifer Cory, Castillo Samantha
Keywords: education, appropriateness, utilization
Lymphoma (including both Hodgkin’s and non-Hodgkin’s) is the third most common pediatric malignancy. Treatment requires distinct definitions of bulky disease, response to therapy, and organ involvement. In this way, pediatric radiologists form a center role in the medical care of affected children. This educational exhibit examines pediatric lymphoma diagnosis and response to therapy by detailing the varying classification systems, including the newer PET-related Deauville and Lugano classification systems. The Ann Arbor staging classification system for Hodgkin’s lymphoma was initially developed in the 1970’s and anatomically classifies lymphoma by site and number of lymph nodes affected, cross-diaphragmatic disease, and extralymphatic organ dissemination. More recently, after the introduction of PET/CT, newer classification systems which incorporated tumor metabolism were developed - including Deauville and Lugano. Notably, these systems are commonly applied to both Hodgkin’s and non-Hodgkin’s lymphoma. This educational exhibit includes a discussion of these various systems as well as annotated examples. Additionally, risk stratification is discussed using strata defined by the Children’s Oncology Group (COG), EuroNet, and Pediatric Hodgkin Consortium. After review, the pediatric radiologist should feel more comfortable staging and classifying response to treatment of lymphoma using PET assessment principles. Read More
Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019
Authors: Leake James, Pfeifer Cory
In 2017, children under the age of 15 accounted for only 10% of the 10 million Mycobacterium tuberculosis (TB) infections estimated by the World Health Organization. Child carriers of TB pose health risks to their adult caregivers, and children can exhibit greater susceptibility to significant health risks from the infection. Nontuberculous mycobacterial (NTM) infection presents disparate health risks and can generate imaging specific findings. This presentation addresses radiologic manifestations of mycobacterial disease as a means to educate pediatric radiologists given the medical significance of mycobacterial infection. Read More
Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019
Authors: Alian Ali, Pfeifer Cory
Keywords: tuberculosis, infection, multi-system
Head CT is not recommended as a first test to evaluate non-traumatic headaches in children unless the headache is acutely severe. While CT can provide important diagnostic information, they expose children to radiation and increase healthcare costs. The purpose of this investigation is to evaluate the association between insurance type and the likelihood of receiving a head CT scan for headache in a single pediatric hospital system. Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Chan Donald, Karbhari Nishika, Pfeifer Cory
There are 2 types of transcranial Doppler ultrasound. In the non-imaging technique, vessels are identified and interrogated based on sound, waveform, and sample depth, often using a transorbital window. The imaging technique involves the use of color Doppler to visualize the vessels themselves, commonly via a transtemporal window. Non-imaging transcranial doppler has long been used as diagnostic tool to assess for intracranial vasospasm in critically ill adults. Imaging transcranial Doppler is a common tool used in the surveillance of children with sickle cell anemia to evaluate for risk of stroke. This presentation describes the use of the imaging transcranial Doppler technique to monitor the intracranial circulation in critically ill children in neurocritical care setting. Read More
Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019
Authors: Yin Chen, Pfeifer Cory, Clarke Rebekah
Keywords: Imaging Transcranial Doppler, Pediatric, Neurocritical Care Unit
ACTA2 mutation occurs in the alpha-actin gene. Since the gene product is not expressed in brain parenchyma but is a contractile protein of smooth muscle cells that make up vascular walls, structural brain findings in this disorder are postulated to be the result of mass effect from abnormal rigid arteries during development. Presented here are typical imaging findings of ACTA2 mutation to emphasize the radiologist's role in diagnosing this disease prospectively. Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Xie Sophia, Veltkamp Daniel, Pfeifer Cory
Keywords: ACTA2 mutation, cerebrovascular disease
The diagnostic approach to fever of unknown origin (FUO) in a neutropenic child is challenging. Recommendations of the Children's Oncology Group and the ACR provide some guidance, but evidence basis for use of sinus CT in the acutely febrile neutropenic child is poorly established. This presentation assesses baseline paranasal sinus mucosal thickening in children in 2 separate cities and compares them to children with neutropenia undergoing sinus CT in the work-up of FUO. Read More
Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019
Authors: Schmidt Susan, Cao Joseph, Pfeifer Cory
Keywords: Neutropenic Fever, Sinus Mucosal Thickening
Poland Syndrome is a classic differential consideration for a unilateral hyperlucent hemithorax on chest radiograph due to pectoralis aplasia or hypoplasia. Additional associations include brachysyndactyly, simian crease, dextrocardia, and liver/biliary abnormalities. Isolated pectoral hypoplasia or aplasia without limb involvement is generally cosmetic and can be corrected with plastic surgery, but Mobius syndrome should be ruled out due to its association. Children with Mobius syndrome can exhibit an expressionless affect, excessive drooling, and/or eye paralysis due to cranial nerve deficiencies. This educational exhibit discusses the pediatric radiologist's role in the imaging approach to these supposedly separate diseases which may represent a continuum of one pathology. Read More
Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019
Authors: Liu Xiaozhou, Mehta Akshita, Pfeifer Cory
Keywords: Poland, Mobius, Pierre-Robin
The practice of performing dedicated breast ultrasounds in the pediatric emergency department varies according to institution. In the adult population, breast ultrasounds are commonly interpreted by dedicated breast imagers and/or radiologists appropriately qualified to interpret mammograms. Children's hospitals with dedicated pediatric radiology faculty are less likely to have such individuals on staff. This paper examines the practice of breast ultrasounds ordered in the emergency department throughout a large children's health system. Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Gleason Miranda, Moredock Elisabeth, Parish David, Pfeifer Cory
Keywords: Breast Abscess, Breast Ultrasound, Emergency Radiology
The goals of this educational exhibit are to: 1. Explain the basis for the cause of diffusion restriction on brain MRI in children. 2. Discuss the broad differential diagnosis for diffusion restriction in pediatric emergency neuroradiology. 3. Emphasize causes of diffusion restriction unrelated to vascular occlusive disease in the brain. 4. Describe patterns of diffusion restriction commonly encountered in post-ictal states and posterior reversible encephalopathy syndrome. Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Oros Joseph, Moredock Elisabeth, Parish David, Pfeifer Cory
Keywords: Diffusion Restriction, Posterior Reversible Encephalopathy Syndrome, Seizure
E-cigarette/vaping-associated lung injury (EVALI) has been recently reported in the radiology literature and has become an urgent public health matter as stated by the Center for Disease Control and Prevention. As of October 22, 2019, there have been 1,604 cases in the United States territory with 34 confirmed deaths. Patients <20 years represent 36% of EVALI cases. Moreover, the use of vaping among adolescents and teenagers has progressively increased in recent years. Although the exact cause and mechanism of injury remain a subject of investigation, clinical suspicion along with imaging findings and in some cases, bronchoscopic results, remain the mainstay in the diagnosis of EVALI, after excluding infection. Reported imaging patterns of EVALI include hypersensitivity pneumonitis, diffuse alveolar hemorrhage, acute eosinophilic pneumonia, diffuse alveolar damage, lipoid pneumonia, and giant cell interstitial pneumonia. We describe computed tomography (CT) findings of EVALI patients from our institution Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Artunduaga Maddy, Rao Devika, Friedman Jonathan, Kwon Jeannie, Pfeifer Cory
Keywords: Vaping, Vaping-associated lung injury, E-cigarette-associated lung injury
Ultrasound is often the initial imaging modality in evaluation for pediatric appendicitis, but there is concern that the increasing prevalence of pediatric obesity may affect both the sensitivity of ultrasound and the interpretation of an equivocal result. We hypothesized that higher BMI percentile would correlate with lower ultrasound sensitivity, higher equivocal rate, and higher rate of CT acquisition. Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Moredock Elisabeth, Coleman Jay, Chang Alice, Pfeifer Cory, Kwon Jeannie
Keywords: Appendicitis, Obesity, Ultrasound