The purpose of this review is to provide an overview of applications of Eovist in the pediatric population, as well as pitfalls. We will begin with an introduction on the origins of Eovist and how it and other hepatocyte specific contrast agents (HSCAs) differ from conventional gadolinium based contrast agents (GBCAs). We will then provide a sample of imaging protocols when Eovist is used for hepatic mass evaluation and for biliary indications. We will review benefits of Eovist in characterizing a variety of pediatric hepatic neoplasms, including hepatoblastoma, hepatocellular carcinoma, focal nodular hyperplasia, hepatic adenomas, and regenerative nodules, with mention of pathologies that do not follow traditional patterns (i.e., inflammatory adenomas). After this, we will cover biliary applications, including choledochal cysts, biliary obstruction, and postoperative bile leak. Finally, we will review some limitations of Eovist; notably, we will mention several scenarios where the hepatobiliary phase could not be achieved, and recommendations for how to approach these cases. Read More

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

Authors: Shet Narendra, Flynn John, Maloney Ezekiel, Iyer Ramesh

Keywords: Liver, Biliary, MRI

<b>Many institutions include a scout radiograph in the protocol for pediatric upper gastrointestinal (UGI) fluoroscopic studies. Recently, it has been shown that the scout radiograph does not add to the interpretation of VCUG examinations. Given that the scout radiograph is a significant portion of the total radiation exposure of the study, we sought to determine if the scout radiograph contributes to the interpretation of the outpatient pediatric UGI study.</b> Read More

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

Authors: Abdullah Selwan, Shet Narendra, Watkins Runa, Kim Jane

Keywords: Scout radiograph, Upper GI Series, Radiation Exposure

Meckel’s diverticulum is the most common congenital gastrointestinal tract abnormality, with a small minority of patients presenting with symptoms related to complications. The aim of this educational exhibit is to provide a pictorial overview of the common and uncommon imaging manifestations of symptomatic Meckel’s diverticulum, with an emphasis on CT findings, though scintigraphic, sonographic, radiographic, and fluoroscopic features will also be detailed. Read More

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

Authors: Shet Narendra, Chen Wengen, Strauch Eric, Kim Jane

Keywords: Meckel's diverticulum, Computed Tomography, Scintigraphy

Postoperative intussusception is a rare complication with a reported rate of 0.01-0.25% in children following laparotomy, accounting for 5-10% of postoperative bowel obstruction. We present a case of a 6-month-old infant with increasing abdominal fullness over several weeks who was found to have a large left renal mass. Following surgical resection of an atypical cellular form of Congenital Mesoblastic Nephroma, the patient developed abdominal distension and was presumed to have a postoperative ileus. Due to unexplained persistent hypertension following surgery, MR Angiogram of the Abdomen was performed to evaluate the renal arteries. On this MR exam, a right lower quadrant ileocolic intussusception was identified. Air enema intussusception reduction attempt was unsuccessful, and laparotomy was performed with successful reduction. We review the literature on pediatric postoperative intussusception including the variety of initial surgical operations, clinical symptoms, intussusception type, treatment, and patient outcomes. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Kim Jane, Chun Jeannie, Kim Wendy, Morin Cara, Shet Narendra

Keywords: Intussusception, Postoperative, MRI

In 2014, a new classification system for prenatal and postnatal urinary tract dilatation (UTD) was introduced via a multidisciplinary consensus statement. We have created an easy to use web-based calculator for the prenatal and postnatal UTD classification system which can be used to generate the risk category and the current recommendations for each group. We aim to simplify the overall process for physicians who are either unfamiliar with details of the classification system or apply the classification system infrequently, making it difficult to remember the criteria each time. Moreover, the final risk stratification group and the corresponding current recommendations are automatically copied to the clipboard and can be pasted directly into the imaging report, facilitating the reporting process. Read More

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

Authors: Thomas Jason, Shet Narendra, Lumpkins Kimberly, Mendley Susan, Kim Jane

Keywords: Urinary Tract Dilatation, Classification, Hydronephrosis

Late-presenting or recurrent diaphragmatic defects can pose a diagnostic challenge due to varying clinical presentations. Current diagnostic approaches include plain film radiograph for initial assessment, with other imaging modalities such as fluoroscopy, ultrasound, CT and MRI mainly employed for troubleshooting. As a radiation-free modality, MRI can provide a more definitive diagnosis in particular cases due to its ability to visualize discontinuity of the diaphragm (distinguishing it from eventration), hernia contents, defect location and size. In this exhibit, we will: 1. Review the normal appearance of the diaphragm. 2. Share our institutional MRI protocol for optimal evaluation of the diaphragm, including use of CINE steady state free precession sequences and use of negative slice spacing in T2 weighted images. 3. Discuss important postnatal MR imaging findings of late presenting and recurrent diaphragmatic hernias in children. 4. Describe potential diagnostic pitfalls in the imaging of the diaphragm. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Kim Wendy, Courtier Jesse, Morin Cara, Shet Narendra, Strauch Eric, Kim Jane

Keywords: Diaphragmatic hernia, MRI, Hiatal hernia, Bochdalek hernia, Morgagni hernia

This electronic poster discusses the various clinical and imaging features of pediatric hyperthyroidism, including Graves’ disease and toxic nodule. Imaging modalities reviewed include ultrasound and molecular imaging. We will provide an overview of I-131 hyperthyroid therapy with focus on guideline-based practices of patient preparation, I-131 dosing and post-therapy radiation precautions. A pressing concern for patients and families following I-131 therapy is how long radiation precautions must be followed and when the patient may return to school or work. We have developed and implemented a table listing the appropriate duration of post-therapy radiation precautions based on the administered I-131 dose. We propose the use of such tables for ease of consultation and standardization of discharge procedures. Read More

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

Authors: Mirza Sobia, Shalaby-rana Eglal, Kovats Catalina, Loomis Judyta, Vyas Pranav, Shet Narendra, Fricke Stanley, Cielma Tara, Bush Ebony, Grecco Krystal

Keywords: hyperthyroid, I-131, iodine