Before the germinal matrix (GM) begins to recede at approximately 26 weeks gestational age (GA), it extends along the floor of the lateral ventricles far posterior to the thalamocaudate grooves. As extremely premature infants (EPIs) as young as 23 weeks GA survive with current advances in neonatology support, germinal matrix hemorrhage (GMH) can occur along these sites from which the GM has not yet involuted and should be recognized. Further, such Grade I posterior GMH may be mistakenly diagnosed as an intraparenchymal grade IV event, particularly on coronal US or other axial images, with parasagittal images demonstrating the correct diagnosis. The aim of this study is to document and describe this phenomenon, differentiate it from traditional GMH findings, and assess its prevalence in this population. Read More

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

Authors: Snyder Elizabeth, Pruthi Sumit, Hernanz-schulman Marta

Keywords: Ultrasound, Germinal Matrix Hemorrhage, prematurity

Magnetic resonance imaging (MRI) is an increasingly utilized tool for evaluating congenital anomalies of the fetus. While the utility of fetal MRI has most thoroughly been described for assessment of the fetal central nervous system, it is progressively used for imaging anomalies of the chest, abdomen and pelvis. Because of the high inherent tissue contrast and its varied sequences, MRI can provide valuable information about the fetus and has been shown to assist parental counseling as well as prenatal and postnatal management. MRI protocols should be tailored to the specific clinical question at hand, which requires effective integration of pediatric radiologists within the fetal therapy team. The purpose of this educational exhibit is to highlight the role of fetal MRI in evaluating various congenital anomalies of the fetal chest, abdomen and pelvis, and discuss how fetal MRI findings may influence prenatal counseling and management. Read More

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

Authors: Snyder Elizabeth, Baschat Ahmet, Huisman Thierry, Tekes-brady Aylin

Keywords: fetal MRI, fetal management

Vascular anomalies comprise both vascular tumors and vascular malformations which can occur anywhere in the body; the trunk and extremities being the second most common location following the head and neck. Accurate identification of these anomalies is important for proper clinical evaluation and management, particularly since these patients often require multidisciplinary care. The International Society for the Study of Vascular Anomalies (ISSVA) classification, recently updated in 2014, is widely accepted and offers comprehensive classification for all medical subspecialties involved in the care of these complex anomalies, thus providing common language among caregivers. The purpose of this educational exhibit is to highlight the most important MRI and MRA imaging findings in order to identify these lesions according to the 2014 ISSVA classification. Read More

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

Authors: Snyder Elizabeth, Puttgen Kate, Mitchell Sally, Tekes-brady Aylin

Keywords: vascular anomalies, MRI/MRA, time-resolved MRA

Although head ultrasound (HUS) is most often used in the neonatal intensive care unit (NICU) setting as a screening exam for emergencies such as hydrocephalus, intracranial hemorrhage, and ischemic injury, a spectrum of congenital brain abnormalities may also be diagnosed, especially with state-of-the-art US technology that enables detection of more subtle malformations. While brain MRI remains the gold standard for comprehensive evaluation of congenital CNS anomalies, knowledge of the appearance of such pathologies on HUS is vital: HUS is often the first exam performed, and some infants are too critically ill to undergo MRI. Identification of congenital anomalies by the radiologist may generate prognostic information that can impact critical medical decision-making and patient/family counseling in the NICU. The goals of this educational poster are to provide a systematic approach to evaluating congenital brain anomalies on HUS and illustrate the ultrasound appearance of common and less common congenital abnormalities with MRI comparisons, as well as highlight potential pitfalls in making these diagnoses. Covered entities include: Posterior fossa malformations: e.g., Chiari II, Dandy-Walker Midline anomalies: e.g., Holoprosencencephaly, agenesis of the corpus callosum, pericallosal lipoma Cortical malformations: e.g., Gray matter heterotopia, schizencephaly, lissencephaly Vascular malformations: e.g., Vein of Galen malformation Congenital infections: e.g., Congenital cytomegalovirus Read More

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

Authors: Snyder Elizabeth, Sarma Asha, Krishnasarma Rekha, Engelstad Holly, Pruthi Sumit

Keywords: Head ultrasound, Congenital anomalies, Ultrasound MRI correlation