Vaping associated pulmonary injury (VAPI) has recently received national attention as an epidemic resulting in cases of significant morbidity and mortality from electronic cigarette use. The purpose is to present the clinical and imaging findings in adolescents with pulmonary symptoms from suspected VAPI. Read More

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

Authors: Hook Marcus, Barrera Ambika, Biko David, Dennis Rebecca, Rapp Jordan

Keywords: Vaping, Lung injury, Pneumonia

Dynamic Airway CT (DACT) has risen in popularity in recent years, however, studies of Tracheobronchomalacia (TBM) are hindered by inconsistent definitions which variously rely on airway area, airway diameter, and qualitative measures. We explore the interrater reliability of these measures. Read More

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

Authors: El-ali Alexander, Davis James, Otero Hansel, Biko David, Rapp Jordan

Keywords: dynamic airway imaging, CT, tracheobronchomalacia

Magnetic resonance imaging (MRI) has historically been restricted for patients with pacemakers, defibrillators, or other cardiac implantable electronic devices (CIEDs) due to safety concerns. Despite the introduction of MR conditional pacemakers in 2008, access to MRI in patients with CIEDS remains limited. MRI remains the diagnostic imaging study of choice for many indications and is necessary to prevent delayed diagnosis and the decision to proceed with MRI should follow a rigorous risk benefit assessment: Risks of: Lead heating causing injury at their tips Increased pacing thresholds Sudden battery depletion Inappropriate sensing/pacing The location of the image should be considered because if the request includes the area of the CIED then potential artifacts may decrease the diagnostic quality. However, an MRI remote from the location of the CIED entails a negligible risk of lead heating and MRI may be performed safely with continuous patient monitoring throughout the scan. In addition, in pediatric patients the necessity of anesthesia or sedation must be well-thought-out as it conveys additional risk to the patient. There is growing evidence from adult literature that MRI may be performed safely in patients with CIEDs with transvenous leads when appropriate protocols are followed. The Heart Rhythm Society (HRS) 2017 expert consensus statement indicates that MRI is reasonable in patients with MR non-conditional transvenous CIEDs if there are no fractured, epicardial, or abandoned leads. The Pediatric and Congenital Electrophysiology Society (PACES) of 2021 included that MRI may be considered in pediatric patients with epicardial or abandoned leads on a case-by-case basis. However, performing MRI in patients with CIEDs is a resource-intensive service and requires rigorous implant investigation, preparation, and planning as well as close coordination between treating physicians and radiologist. This educational exhibit summarizes current literature on the safety of MRI in patients with CIEDs and takes examples from our practice to build an evaluation program that allows for safe access to MRI in patients with CIEDs Read More

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

Authors: De Leon-benedetti Laura, Ramirez Suarez Karen, Otero Hansel, Rapp Jordan, Biko David, Smith Christopher, Serai Suraj, White Ammie

Keywords: Cardiac, Magnetic Resonance

To report on our initial experience with the use of mesenteric dynamic contrast MR lymphangiography (DCMRL) for evaluation of the lymphatics in patients with concern for mesenteric lymphatic flow disorders and compare these findings to intranodal (IN) DCMRL and intrahepatic (IH) DCMRL. Read More

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

Authors: Biko David, Pinto Erin, Krishnamurthy Ganesh, Escobar Fernando, Dori Yoav, Smith Christopher, Dewitt Aaron, Gillespie Matthew, Rome Jonathan, Glatz Andrew, Rapp Jordan, Otero Hansel, O'byrne Michael

Keywords: MR lymphangiography, mesenteric imaging

Review imaging findings on static and dynamic contrast enhanced magnetic resonance lymphangiogram (DCMRL) in young infants who presented with chylothorax and correlate these imaging findings with clinical outcomes. Read More

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

Authors: Gaballah Marian, Otero Hansel, Rapp Jordan, Rome Jonathan, Biko David, Dori Yoav, Pinto Erin, Krishnamurthy Ganesh, Smith Christopher, Escobar Fernando, Dewitt Aaron, Taha Dalal, Edgar James

Keywords: lymphatic, Lymphangiogram, chylothorax