Showing 4 Abstracts.
Purpose Post-hemorrhagic ventricular dilatation (PHVD) is a common sequela of severe neonatal intraventricular hemorrhage (IVH), often necessitating cerebrospinal fluid (CSF) shunt placement. Despite advances in shunt technology and neonatal neurosurgical care, shunt malfunction remains a leading cause of morbidity and repeat surgical intervention in this population. After reviewing this exhibit, participants will be able to: 1. Describe the pathophysiologic mechanisms and imaging manifestations of shunt failure following neonatal intraventricular hemorrhage. 2. Apply a structured, multimodality diagnostic algorithm integrating ultrasound, MR ventricular check examinations, and rapid MRI techniques for shunt assessment. 3. Recognize imaging considerations for programmable and nonprogrammable shunt valves and identify key features predicting recurrent or multiloculated hydrocephalus. Content Organization - Pathophysiologic mechanisms unique to the post-IVH brain—including septations and ependymal scarring, predispose to both mechanical and functional shunt failure. Common causes include proximal or distal obstruction, valve dysfunction, and secondary complications such as infection or pseudocyst formation. - Multimodality examples (ultrasound, MRI, CT) are used to illustrate key imaging findings and subtle differentiating features. - A stepwise diagnostic algorithm is presented, beginning with cranial ultrasound in newborns and younger infants, followed by rapid-sequence MRI (single-shot T2, 3D DRIVE/CISS) for ventricular morphology and catheter assessment, with CT reserved for problem solving. Phase-contrast MRI assists in evaluating CSF flow and shunt patency. - Programmable and non-programmable shunt valves are reviewed, highlighting imaging appearance, verification techniques, and implications for longitudinal surveillance. Recommended imaging intervals and markers of evolving multiloculated hydrocephalus are summarized. Conclusion Early, accurate recognition of shunt malfunction after neonatal IVH depends on understanding its imaging signatures and etiologies. This exhibit provides a step-by-step, multimodality algorithm, anchored in rapid MRI vent checks and informed by shunt hardware variability with illustrative cases to guide pediatric radiologists in assessment and follow-up, and to support coordinated care with neurosurgery and neonatology. Read More
Meeting name: SPR 2026 Annual Meeting , 2026
Authors: Sahu Asutosh, Prabhu Sanjay
Keywords: Intracranial Hemorrhage, Shunts
Background: The germinal matrix (GM) is a transient, highly vascular zone that involutes between 24–34 weeks’ postmenstrual age. In extremely preterm infants (≈22–28 weeks), maturational changes in size, echogenicity, and symmetry can mimic or mask hemorrhage, leading to grading variability and inconsistent follow-up. Purpose: To present a developmentally tuned, imaging atlas enabling radiologists to distinguish physiologic GM maturation from germinal matrix hemorrhage (GMH) using standardized cranial ultrasound (US) and MRI techniques and terminology. Educational Objectives 1. Summarize GM anatomy, vascular “hot spots,” and week-by-week involution. 2. Standardize US across anterior, posterior, and mastoid windows for optimal assessment of the caudothalamic groove and posterior fossa. 3. Specify age-related normal variants vs hemorrhage on US and MRI (T1/T2, SWI, DWI), with key sequence-specific pitfalls. 4. Provide a concise measurement/reporting lexicon to improve reproducibility and inter-reader agreement. Content Highlights: - Anatomy & Maturation Map: Caudothalamic groove, subependymal region, ganglionic eminence; gestational-week echogenicity charts. - Acquisition Essentials: Minimal-variance US (required planes, cine sweeps, gain/depth); a 12–15-minute, sedation-sparing MRI set (3D T2, axial T2/T1, DWI/ADC, SWI) with neonatal parameter tips. - US Pattern Library: Early symmetric subependymal echogenicity; benign choroid plexus prominence; venous plexus near the foramen of Monro; beam-angle/anisotropy effects that simulate clot. - MRI Pattern Library: Age-appropriate T1/T2 at the caudothalamic notch; SWI venous blooming vs microbleed; diffusion pitfalls along the ventricular wall. - Mimics & Traps: Choroid plexus lobulations, mineralizing vasculopathy speckles, dependent ventricular debris, partial-volume at the groove, posterior fossa venous plexus on mastoid views. - Consistency Toolkit: Correct caliper placement for ventricular indices; elements (location, side, extent, confidence). Conclusion Germinal matrix appearance is gestation-dependent; interpretations must be age-calibrated. Meticulous acquisition, appropriate window selection and optimized probe technique, including routine posterior/mastoid views reduces posterior fossa misses. Sequence-aware MRI reading (3D T2, SWI, DWI) limits venous and anisotropy misclassification. Standardized terminology and measurements improve report clarity, interobserver agreement, and reliability of follow-up imaging. Read More
Meeting name: SPR 2026 Annual Meeting , 2026
Authors: Sahu Asutosh, Prabhu Sanjay
Keywords: Intracranial Hemorrhage, Ultrasound and MRI
Purpose: CT is the default for many pediatric lung questions, yet MRI is radiation-free but still can answer the clinical problem and is preferable forfor children needing serial follow-up. This exhibit provides an indication-driven, clinically usable guide for when MRI should replace, complement, or defer to CT and an overview of sequences and areas needing r further research. Clinical applications: Children who undergo repeated imaging accrue radiation. In the right scenarios, MRI enables tighter follow-up intervals, captures dynamic airway/diaphragm abnormalities that static CT may miss, and combines soft-tissue and vascular assessment in a single visit. Clinical applications where MRI may add value: - Longitudinal parenchymal and airway assessment in broncho-pulmonary dysplasia (BPD), chronic lung disease, cystic fibrosis (CF), bronchiolitis obliterans (BO): radiation-free monitoring with morphology + functional surrogates - Dynamic disorders: cine/real-time MRI for tracheo/bronchomalacia and diaphragm dysfunction, offering a radiation-free complement to bronchoscopy or CT. - Congenital lesions & vascular anomalies: single-session MRI/MRA road-mapping (CPAM, sequestration; rings/slings). - Transplant/oncology surveillance: safer serial monitoring when cumulative CT exposure reduction is desirable. MRI sequence essentials: 3D UTE (stack-of-spirals / radial “kooshball”): improved lung signal and motion robustness for free-breathing isotropic morphology; helpful in neonates and toddlers, though spatial resolution remains lower than CT. - Standard T2 (2D/3D TSE): edema, secretions, pleura/mediastinum. - PREFUL (free-breathing 1H V/Q surrogate): non-contrast regional ventilation/perfusion maps, correlates with hyperpolarized-Xe metrics; promising for CF/BO/BPD trends and therapy response. - Hyperpolarized 129Xe MRI: sensitive quantitative ventilation/gas-transfer metrics; consider for advanced CF or as a research reference. - Breathing strategy: default free-breathing for UTE/PREFUL; add navigator/self-nav for longer 3D blocks; brief breath-holds in older kids for targeted T2/cine. Teaching points: While MRI cannot universally replace lung CT, it provides actionable, radiation-free information in selected conditions that changes management. Clear indications, streamlined workflows, and structured reporting enable adoption now, while targeted research will standardize when MRI should lead, complement, or defer to CT. Read More
Meeting name: SPR 2026 Annual Meeting , 2026
Authors: Sahu Asutosh, Afacan Onur, Kurugol Sila
To illustrate the developmental, genetic, and imaging spectrum of malformations of cortical development (MCD) from fetal life through adolescence by integrating principles of normal corticogenesis, key genetic pathways, and evolving MRI patterns. This exhibit emphasizes: 1. Normal neuronal proliferation, migration, and post-migrational organization. 2. Developmental stage–specific MRI features linked to corresponding disruptions in these processes. 3. Major molecular pathways (LIS1/DCX, TUBB2B, MCPH1, CDK6, PIK3, PTEN, HEPACAM, mTOR) associated with characteristic imaging phenotypes. 4. The role of longitudinal imaging in evaluating cortical maturation, prognosis, and presurgical planning. Read More
Meeting name: SPR 2026 Annual Meeting , 2026
Authors: Sahu Asutosh, Tripathy Priyadarshini, Kandemirli Sedat, Prabhu Sanjay
Keywords: Magnetic Resonance Imaging, Genetics, Epilepsy