Truncus arteriosus is a rare congenital cardiac anomaly characterized by failure of conoseptal separation resulting in a single arterial trunk supplying both the pulmonary and systemic circulation. Diagnosis has historically been made with fetal echocardiography, and palliative surgery performed frequently in the neonatal period. Cross-sectional imaging is typically reserved for post-operative complications. However, due to lower dose radiation and faster scanners, preoperative CT angiography imaging is becoming more common with the increasing use of cardiac EKG-gated CT angiograms, requiring pediatric imagers to be familiar with the diagnosis of the truncus arteriosus spectrum. Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Romberg Erin, Bhutta Sadaf

Keywords: congenital, cardiac, ct

Airway and chest ultrasonography in pediatric patients encompasses a wide spectrum of diagnostic applications, broadly categorized into evaluation of vocal cords, trachea, lungs, diaphragm, and pleura. Vocal cord ultrasonography is increasingly employed for the assessment of vocal cord motion and detection of palsy, particularly in post-intubation or postoperative settings. Tracheal ultrasonography represents an evolving field, currently utilized at our institution for identification of tracheal cartilaginous sleeve—a condition characterized by replacement of segmented tracheal rings with a continuous cartilaginous sheath, often associated with craniosynostosis syndromes. Lung and pleural ultrasonography are well-established techniques increasingly familiar to radiologists and can be useful for evaluating a wide range of pathologies, including consolidation, edema, fibrosis, interstitial pneumonia, lung abscess, pleural effusion, empyema, pneumothorax, and lung tethering. Diaphragmatic ultrasonography is also routinely performed to assess diaphragmatic motion abnormalities such as paralysis, paresis, and eventration—conditions that can be challenging to differentiate by radiograph. A solid understanding of normal lung, pleural, airway, and diaphragmatic anatomy, along with mastery of proper sonographic technique, is essential for accurate diagnosis and interpretation across all levels of radiology practice. As air-filled lungs limit acoustic penetration, radiologists must also recognize common pitfalls and artifacts encountered in pediatric chest ultrasound, including reverberation artefacts, B-lines, M-mode artifacts, and misinterpretation of peritoneal fluid as effusion. Although radiography remains the first-line modality for thoracic evaluation, its utility is constrained by complex, overlapping anatomy of the mediastinum and hidden pulmonary areas. Computed tomography (CT), while diagnostically powerful, exposes young patients to ionizing radiation and should be reserved for cases in which sonography and radiography are inconclusive. This educational exhibit aims to highlight optimal techniques, review relevant anatomy, and illustrate the spectrum of airway and chest pathologies detectable by ultrasound. It further emphasizes recognition of artifacts and comparison with radiographic and CT findings, with goal to promote use of ultrasonography as a radiation-free, readily accessible, and accurate diagnostic tool for pediatric thoracic evaluation. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Kumar Tushar, Romberg Erin, Otjen Jeffrey

Keywords: Chest, Ultrasound, Dynamic Ultrasound

CT with 4D cine imaging can non-invasively and dynamically characterize airways for various pathologies, such as airway caliber fluctuations in tracheobronchomalacia, intermittent compression by cardiovascular or other mediastinal structures, or constriction from anatomic anomalies like those associated with craniofacial syndromes. However, optimal interpretation of dynamic airway CT studies requires an understanding of the impact of such extrinsic factors as the presence of support apparatus (e.g., endotracheal tube, enteric tube), level of required respiratory support (e.g., positive end-expiratory pressure), and differences in positioning (e.g., with jaw thrust). We have performed more than 100 pediatric cases of dynamic airway CT under a variety of conditions, in patients who range from free-breathing to ventilator-dependent, and for a variety of pathologies. In this educational exhibit, we will consider how to balance and tailor extrinsic factors when using dynamic CT for the guidance of airway management, in order to meet diagnostic considerations and supplement other cardiopulmonary investigations, including cases with bronchoscopic and surgical correlates. Read More

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

Authors: Tang Elizabeth, Menashe Sarah, Romberg Erin, Perez Francisco, Otjen Jeffrey

Keywords: Airway, Cine, CT