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

Liver transplantation is a potentially life-saving procedure for children with liver failure. Pediatric liver transplant recipients are at greater risk for complications such as vascular thrombosis than adults. In addition, children more commonly receive reduced size grafts, which alter the normal liver anatomy. While the postoperative assessment of pediatric liver transplants with sonography has been well studied, less exists in the radiology literature regarding intraoperative Doppler sonography of the graft prior to abdominal closure. We illustrate the intra- and post-operative ultrasound findings in pediatric liver transplants, with an emphasis on normal features, common pitfalls, and frequently encountered vascular complications. Read More

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

Authors: Stanescu Luana, Kamps Shawn, Dick Andre, Phillips Grace

Keywords: Liver Transplantation, Intra-operative, Doppler

Pediatric head CT examinations remain a mainstay imaging modality, frequently utilized to evaluate a wide spectrum of pediatric pathology. Current pediatric head CT protocols aim to use the least amount of radiation while providing imaging of diagnostic quality. Lower radiation doses, along with other factors, can occasionally cause CT artifacts that can affect the quality and the interpretation of images. In this exhibit, we review examples of physics-based, patient-based and scanner-based CT artifacts on head CT exams, while also providing a brief explanation of the underlying physics and ways to mitigate the artifact. Imaging examples include among others: apparent posterior fossa masses due to beam hardening, apparent extra-axial fluid collections due to cupping artifact, apparent brain parenchymal hypodensities concerning for infarct, and apparent beading of intracranial vessels due to lower radiation doses administered. Awareness of these artifacts is critical for radiologists, as they can potentially lead to misdiagnosis. Read More

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

Authors: Otjen Jeffrey, Phillips Grace, Khatri Garvit, Kanal Kalpana, Kim Helen Hr, Stanescu A. Luana

Keywords: Artifacts, CT, Head