The purpose of this educational exhibit is to educate the radiologist regarding the fetal and postnatal imaging findings of Zika Virus (ZikV) in order to include congenital ZikV in the differential diagnosis when the maternal history and geography are compatible. We present a patient who emigrated from Central America during her third trimester of pregnancy with maternal ZikV. Read More

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

Authors: Wermers Joshua, Fickenscher Kristin, Robinson Amie, Dahl Amy

Keywords: Zika Virus, MRI, Ultrasound

Diffuse serosal and soft tissue enhancement (SSTE) is a unique pattern of contrast enhancement seen on abdominal radiographs after cardiac catheterization in newborns. While thought to be benign, SSTE can be misdiagnosed as pneumoperitoneum, resulting in unnecessary and potentially invasive diagnostic procedures. The purpose of this study is to describe the incidence of SSTE on abdominal radiograph performed in infants within 2 days of cardiac catheterization and identify clinical features associated with this imaging finding. Read More

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

Authors: Wermers Joshua, Batlivala Sarosh, Li Yinan, Zhang Bin, Towbin Alexander

Keywords: Radiography, Contrast, Renal

With an incidence of 3.25%, breast masses in the pediatric population are a relatively rare phenomenon. Despite this, breast masses are a substantial source of anxiety and concern for parents and patients alike, largely due to the increased awareness of breast cancer in the adult population. Fortunately, the vast majority of masses are benign, and pediatric breast malignancies constitute less than 1% of all pediatric malignancies. Moreover, malignancy tends to be secondary to metastatic disease from lymphoma, leukemia, or rhabdomyosarcoma, as primary breast carcinoma is exceedingly rare. Although initial sonographic characteristics of breast masses may be nonspecific, recommendation for further evaluation with biopsy and/or excision of the mass is usually not recommended due to the rarity of malignancy, and avoidance of disrupting immature breast parenchymal tissue. In adults, the Breast Imaging-Reporting and Data System classification is quite accurate for dictating management recommendations. However, this system grossly over-emphasizes the risk of malignancy in pediatric patients, as imaging findings are usually discordant with histology. Currently, there are no standardized guidelines for management recommendations of pediatric breast masses, and short-term follow-up ultrasound is usually recommended to evaluate for malignant potential. The purpose of this educational exhibit is to compare the sonographic abnormalities of breast pathologies arising from normal breast development, including but not limited to gynecomastia, mastitis, and abscesses, from those arising from neoplastic processes including fibroadenomas, hemangiomas, arterio-venous malformations, and phyllodes tumors. In addition, the current literature on management recommendations, including indications for MRI and biopsy/excision of breast masses, will be reviewed. Finally, this exhibit will discuss the important role pediatric radiologists play in understanding the epidemiology and natural history of breast pathologies, enabling accurate characterization of masses and appropriate treatment recommendations to further guide patient management. Read More

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

Authors: Saini Rimpi, Wermers Joshua, Larson Shelby, Mitchell Grace, Patel Amy

Keywords: Breast, Ultrasound, hemangioma