Intra-articular osteoid osteomas are uncommon and occur in only 10-13% of cases. Intra-articular osteoid osteomas may not demonstrate typical clinical features and feature subtle radiographic differences when compared to extra-articular osteoid osteomas. Radiofrequency ablation (RFA) has been found to be a safe and reliable method of treating osteoid osteomas. The possible complications of RFA include bleeding, muscle burn, and in cases of intra-articular osteoid osteoma, septhic arthritis. In this study, we evaluated the efficacy of radiofrequency ablation (RFA) of intra-articular osteoid osteomas at a single tertiary pediatric center. Read More

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

Authors: Akhter Talal, Cahill Anne Marie, Vatsky Seth, Krishnamurthy Ganesh, Keller Marc, Shellikeri Sphoorti, Srinivasan Abhay

Keywords: Osteoid osteoma, Radiofrequency ablation, Musculoskeletal

Neonates with prolonged hospitalization often require PICCs. The concern for PICC-related complications, including venous thrombosis, infection, catheter migration and breakage, often prompts Doppler ultrasound (US) evaluation. However, peri-catheter thrombus in a neonate can be challenging to evaluate, as the accessed peripheral veins in neonates are small, some less than 1mm in luminal diameter. Small-bore catheters may occupy the entirety of the vessel lumen, which can produce absence of peri-catheter flow, which is confounding for thrombus. This distinction has implications for hematologic management. Read More

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

Authors: Durand Rachelle, Acord Michael, Srinivasan Abhay, Krishnamurthy Ganesh, Saade-lemus Sandra, Cahill Anne Marie, Kaplan Summer

Keywords: PICC, Thrombosis, Neonate

Inguinal lymph node identification using ultrasound is critical in performing intranodal lymphangiography. We routinely utilize a 15 MHz “hockey stick” linear high resolution ultrasound probe (Philips Epic 7) for identification as well as to gain needle access into the inguinal lymph node. However in children with severe body wall edema and in low weight premature babied identification of lymph nodes can be difficult and sometimes impossible. Higher frequency ultrasound transducers offer the potential for improved identification of lymph nodes in such cases. The aim of this study was to compare imaging finding of high resolution US probe to the traditional 15 mHz probe in patients undergoing lymph node access for lymphangiography. Read More

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

Authors: Krishnamurthy Ganesh, Escobar Fernando, Srinivasan Abhay, Smith Christopher, Biko David, Pinto Erin, Dewitt Aaron, Dori Yoav

Keywords: Ultra high frequency, lymph nodes, lymphatic intervention

Percutaneous interventions are increasingly being performed under MR-guidance due to the absence of ionizing radiation, the ability to visualize target lesion and the capability to monitor real-time treatment effect. Here we outline our experience with developing an interventional MRI (iMRI) service at a pediatric institution. Read More

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

Authors: Shellikeri Sphoorti, Setser Randolph, Acord Michael, Srinivasan Abhay, Vatsky Seth, Escobar Fernando, Whitaker Jayme, Cahill Anne Marie

Keywords: Interventional MRI, MR-guided procedures

Percutaneous lymphatic interventions (PLI) target the pulmonary lymphatic abnormalities seen in patients with plastic bronchitis (PB). Existing data in patients with congenital heart disease(CHD)indicates poor transplant-free survival after the diagnosis of PB. We describe various techniques of PLI and characterize intermediate-term survival and complications after PLI. Read More

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

Authors: Krishnamurthy Ganesh, Srinivasan Abhay, Smith Christopher, Savla Jill, Biko David, Pinto Erin, Dewitt Aaron, Dori Yoav, Escobar Fernando

Keywords: Plastic bronchitis, percutaneous lymphatic intervention

Pediatric Contrast Enhanced Ultrasound (CEUS) is a safe and patient-friendly imaging modality. It improves the diagnostic capability of gray-scale and Doppler ultrasound without sedation, ionizing radiation and no use of iodinated or gadolinium-based contrast agents. Pediatric CEUS was originally used to detect vesicoureteral reflux, evaluate indeterminate focal liver lesions, assess and follow up solid-organ injuries sustained during blunt abdominal trauma. In 2016, the approval of Lumason® (Bracco Diagnostics Inc., Monroe Township, NJ) by the United States Food and Drug Administration (FDA) marked the beginning of a new era for CEUS imaging. Since then, clinical requests for pediatric CEUS not only increased in number but also for a variety of examinations covering practically every organ system, including pediatric brain, lungs, solid organs and bowel. In addition, intracavitary applications of pediatric CEUS are now extending beyond the urinary tract, to include urogenital and anorectal malformations. Intravenous and intracavitary CEUS is used in pediatric interventional radiology, to confirm enteric tube placement, guide biopsies and drainage procedures and aide organ vascular mapping (e.g. renal, central vessels). Novel pediatric CEUS applications now used include intranodal CEUS lymphangiography for confirmation of needle position preceding MRI lymphagiography. Pediatric CEUS is performed in a number of clinical settings including inpatient units, outpatient radiology, emergency department, and intraoperative. These evolving indications and uses of CEUS combined with continuous advances in ultrasound technology, such as three-dimensional/four-dimensional ultrasound and improved contrast sensitivity, are establishing pediatric CEUS as an important alternative imaging examination that can complement or supplement fluoroscopy, CT and MRI. This presentation reviews the current wide spectrum of pediatric CEUS applications and imaging findings, according to body part, and the associated imaging findings. Read More

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

Authors: Ntoulia Aikaterini, Back Susan, Hwang Misun, Gokli Ami, Anupindi Sudha, Biko David, Srinivasan Abhay, Poznick Laura, Darge Kassa

Keywords: contrast ultrasound, pediatric applications