Neck masses are commonly encountered in children. The evaluation of neck mass by ultrasound is the purpose of this educational exhibit. Read More

Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022

Authors: Shadmani Ghazal, Don Steven, Tao Ting

Keywords: Cervical masses, ultrasonography, pediatric patients

The case report will present imaging findings from two companion cases of adolescent athletes presenting with palpable thigh masses. Patient A underwent ultrasound and MR and was diagnosed with a degloving injury of the rectus femoris. Patient B also presented with a thigh mass, and following MR underwent attempted aspiration and biopsy. The patient was then diagnosed with inflammatory myositis based on pathology from the biopsy and subsequently evaluated by rheumatology. Following review of the imaging by pediatric radiologists, a degloving injury was then diagnosed and the patient was referred to orthopedics for further management. The exhibit will review the imaging features of this uncommon injury as well as review the complex anatomy of the rectus femoris muscle. A degloving injury represents an injury to the rectus femoris in which the inner bipennate portion of the indirect myotendinous complex is separated from the surrounding outer unipennate portion of the muscle, which results in separation and retraction of the inner muscle belly from the outer muscle belly. It differs from typical injury to the indirect myotendinous junction in in which there is no dissociation of the inner and outer components of the muscle. Awareness of this injury will help avoid misdiagnosis of soft tissue mass and unnecessary interventions. Images included in the case report will include ultrasound and two MRs. Read More

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

Authors: Steinberg Julie, Kristeva Mariya, Barhaghi Krystle, Tao Ting

Keywords: myotendinous injury, rectus femoris, musculoskeletal

Pediatric body MRI is a highly effective imaging modality that enables precise characterization of diverse medical conditions. However, it comes with daily challenges, including accommodating variations in patient size, managing breath-hold difficulties, potential sedation needs, addressing patient comfort and anxiety, and the importance of minimizing RF energy deposition and contrast agent use. To become proficient in interpreting body MRI, it is essential to understand the techniques and clinical applications of each pulse sequence and learn how to use them for accurate tissue characterization. In this ABC guide, we employ the structured approach of “clinical images - techniques – physics” to bridge the gap between practical application and the theoretical foundation of pediatric body MRI. It serves as a comprehensive roadmap, helping learners gain a profound understanding of not only what they are observing in the images but also the underlying reasons and mechanisms that give rise to these images. We will present body MRI techniques in 4 categories: qualitative MRI sequences, quantitative MRI sequences, artifact recognition, and “how to”. In each category, our approach will encompass data acquisition, fundamental physical principles, imaging characteristics, and the essential groundwork for interpretation. These teachings are firmly grounded in our institutional MRI protocol for pediatric body MRI, providing a comprehensive and practical understanding of the subject. The education poster will be divided as follows: 1. Qualitative MRI Sequences: - T2-Weighted and Heavy T2-Weighted Imaging - Pre- and Post-Contrast T1-Weighted Imaging - Mixed T2/T1 Contrast Imaging: - Cartesian, Radial, or Spiral-based k-space data acquisition: Detailed explanations of various k-space sampling methods will be provided. - The Role of Magnetization Preparation Techniques - The Role of Physiological Control 2. Quantitative MRI Sequences: - Measurement of T1 and T2 Relaxation Times - Measurement of ADC and Diffusion MRI Techniques - Measurement of Stiffness of Liver and MR Elastography Techniques - Liver Iron Quantification 3. Common Body MRI Artifacts in Pediatric Patients: A wide array of artifacts, including motion artifacts, susceptibility artifacts, and aliasing artifacts, among others, will be thoroughly covered. 4. How to… - Address Body MRI Image Quality Issues - Safely Scan Pediatric Patients with Implants Read More

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

Authors: Zhang Zhongwei, Barhaghi Krystle, Tao Ting, Murray Kari

Keywords: Body MRI, Physics, Pediatric Imaging