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Society for Pediatric Radiology – Poster Archive

Yoshino Sameshima

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Showing 6 Abstracts.

Beyond Birthmarks: Vascular Anomalies in Pediatrics, A Review Based on the New Classification

Vascular anomalies represent a spectrum of disorders ranging from simple "birthmarks" to life-threatening entities. Incorrect nomenclature and misdiagnosis are common in patients with these anomalies. The objectives of this educational presentation are to provide radiologists with a comprehensive understanding of the ISSVA (International Society for the Study of Vascular Anomalies) classification and to enhance their familiarity with the clinical and imaging features of commonly encountered soft tissue vascular anomalies in pediatric patients. Special emphasis is placed on emphasizing the practicality of ultrasound as an effective diagnostic tool. The ISSVA has been updated with the recognition of causal genetic mutations, most recently revised in May 2018. The main organizational principle of this classification divides vascular lesions into: vascular tumors (neoplastic): benign, locally aggressive/borderline, and malignant; vascular malformations (non-neoplastic): simple, combined, major named vessels, and associated with other anomalies; unclassified anomalies (unclear whether tumor or malformation). Read More

Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024

Authors: Gual Fabiana, Lima Natalia, Matsuoka Marcia, Sameshima Yoshino

Keywords: vascular anomalies, hemangioma, vascular malformations

Typical Features of Atypical Lymph Nodes

Ultrasound is a valuable tool for evaluating lymph nodes in the context of an inflammatory response. Lymph nodes are crucial in the body's immune system, and changes in their size, shape, and echogenicity can provide valuable information about the underlying pathology. What is expected in the inflammatory response is the maintenance of its typical characteristics such as dimension, fatty hilum, thin cortex and hilar flow, however, some pathologies may present atypical lymph node enlargement. These findings are not considered pathognomonic manifestations but they can give us very important tips to direct us to the correct diagnosis as we describe in our case series: 1. Cat-scratch disease: male patient, 10-year-old, with painful epitrochlear, cervical and axillary lymph nodes for 3 months. Ultrasound (US) showed enlarged hypoechogenic lymph nodes (local lymph nodes in the same region as the cat scratch). Serological test confirmed cat scratch disease diagnosis. 2. Bacille Calmette–Guérin lymphadenitis: male patient, 7-months-old, with post vaccination right axillary lymphadenopathy. US revealed right enlarged axillary lymph node, hypoechogenic, containing tiny hyperechoic foci. 3. Lymphomatous lymph nodes: male patient, 17 years old, with painless cervical node for 4 months. US showed enlarged, heterogeneous lymph node, with loss of fatty hilum and well-defined walls, with typical findings by color Doppler study, as we will show. Immunophenotyping: non-Hodgkin's lymphoma. 4. Streptococcus Lymphadenitis: 6-year-old female patient with cervical lymph nodes. US showed Streptococcus lymphadenitis common findings: enlarged hypoechoic lymph nodes, oval-shaped, with thick capsule and hyperechogenicity of adjacent tissue. Increased central and peripheral blood flow by color Doppler. Swab test confirmed Streptococcus. 5. Thyroid tumor metastasis: 17-year-old male patient with a palpable cervical nodule. US showed a solid hypoechoic thyroid nodule and local lymph node with calcifications. Biopsy confirmed papillary thyroid carcinoma with secondary involvement of lymph node. Learning points: 1. Anatomical review of the cervical lymph node chains by ultrasound. 2. Learn typical sonographic features of atypical lymph nodes; 3. Value the importance of correlation of imaging findings with clinical data, tests and biopsy; 4. Assess the pediatric cases from our pediatric radiology group that will be useful for your future atypical cases. Read More

Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024

Authors: Carvalho Yago, Sameshima Yoshino, Lima Natalia, Gual Fabiana

Keywords: atypical lymph nodes, ultrasound evaluation

Ultrasonography in the Assessment of Pediatric Gastroesophageal Reflux

Although clinical history seems the most important diagnostic information in gastroesophageal reflux (GER), it is less reliable in pediatric practice, mainly under 2 years old. Diagnostic tests are needed to document the presence of GER and exclude associated conditions. Gastroesophageal ultrasonography (US) is a widely available, noninvasive and sensitive method that provides morphological and functional information in GER diagnosis. The purpose of this exhibit is: 1. To highlight the main points in the pathophysiology of GER in children; 2. To review the ultrasonographic technique employed in the evaluation of reflux episodes and in the assessment of gastroesophageal junction morphology; 3. To discuss current state of the literature concerning US and pediatric GER. Ultrasonography cases from our Radiology Department will be employed to illustrate the following topics: - Clarifying GER and GER disease (GERD) concepts; - Pathophysiology of GER in children; - Clinical presentation of GER according to age; - Diagnostic approaches to pediatric GER; - The role of US in the management of children with suspected GER; - The US technique in GER evaluation; - Understanding the normal gastroesophageal morphology on US; - Recognizing reflux episodes in US; - Sonographic assessment of abdominal esophageal length and His angle; - Literature divergences and recommendations regarding each step of the technique. Read More

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

Authors: Defendi Larissa, Sameshima Yoshino, Yamanari Maurício, Neto Miguel José, Queiroz Marcos

Keywords: Esophageal, Ultrasound

Thoracic Ultrasound - Say What? A Special Diagnostic Tool in Pediatric Population

Ultrasonography is a very powerful non-invasive diagnostic tool widely employed for examining multiple organs and systems located both superficially and deeply. This is possible thanks to a wide range of transducers that work on different frequencies and sound lengths to explore all layers of anatomical structures. Nowadays, the reduction of exposure to ionizing radiation in children is advocated by the “as low as reasonably achievable” (ALARA) principle, and therefore, ultrasound (US) has become the main investigation tool in many assessments of lung pediatric disorders. The purpose of this educational exhibit is to describe the normal artefacts produced by LUS in a healthy lung to distinguish them from pathologic patterns and the application of LUS in pediatric diseases and procedures (ultrasound-Guided Lung Recruitment). Read More

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

Authors: Gual Fabiana, Sameshima Yoshino, Otto Debora, Braga Fernanda, Cardoso Mariana, Fernandes-ferreira Rafael, Souza Antonio

Keywords: Ultrasonography, Lung Diseases, ALARA

McCune-Albright Syndrome from Pathophysiology to Imaging: Why Radiologists Matter

McCune Albright syndrome (MAS) is a rare disease with a broad spectrum of clinical manifestations that may include café-au-lait macules, hyperfunctioning endocrinopathies and fibrous dysplasia. The latter is an uncommon and debilitating skeletal disorder that leads to fractures, deformity, functional impairment and pain. Since bone imaging provides essential data for diagnosis, prognosis evaluation and follow-up, the radiologist plays a crucial role at all steps of MAS management – and sometimes becomes the first health professional to assess non-skeletal associated conditions in routine exams. The present study proposes a practical approach for imaging McCune Albright syndrome. The main findings on various imaging modalities will be discussed according to their topography, bringing together relevant information to enhance the diagnostic, prognostic and follow-up procedures. Case material from our institution will be used to illustrate the following topics: 1. Brief review of MAS pathophysiology; 2. Clinical features and differential diagnosis of MAS; 3. MAS and polyostotic fibrous dysplasia; 4. Craniofacial fibrous dysplasia: imaging features, prognosis and follow-up; 5. Role of various imaging methods in non-skeletal manifestations. Read More

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

Authors: Defendi Larissa, Sameshima Yoshino, Lee Henrique, Naves Erica, Ribeiro Suheyla, Yamanari Maurício, Neto Miguel José, Queiroz Marcos

Keywords: Fibrous Dysplasia