Dong Su-zhen

Final Pr. ID: Poster #: EDU-010

1. Review the safety, limitations and advantages of fetal cardiac MR (CMR)
2. Discuss potentialindications of fetal CMR
3. Describe the technique of fetal CMR, including imaging sequences, imaging planes, the method
of overcoming motion artifact
4. Illustrate the appearance of normal fetal cardiac structures and present a modified anatomic
segmental approach of congenital heart disease (CHD) at prenatal CMR
5. Demonstrate examples of fetal CMR in the evaluation of various cardiovascular anomalies Read More

Authors:  Dong Su-zhen

Keywords:  Fetus ,  cardiac magnetic resonance ,  congenital heart disease

Whitehead Matthew,  Lee Bonmyong

Final Pr. ID: Poster #: EDU-012

The posterior fossa houses the brainstem and cerebellum. These vital and complex parenchymal structures contain many important white matter tracts, nuclei, and neurons responsible for both basic fundamental and higher-level functions. A number of disease processes can interfere with rhombencephalic development, including genetic malformations and disruption such as hypoxia, toxins, infections, trauma, and vascular disorders. Structural changes associated with fetal imaging pathology that deviate from the normal gestational-age specific developmental patterns can define the etiology, improve our understanding of the disease, and help with prognostication. A comprehension of basic embryology and developmental anatomy is necessary to achieve a true understanding of posterior fossa anomalies and normal variants. In this exhibit, we aim to illustrate common and rare anomalies of the brainstem, cerebellum, meninges, and meningeal spaces visible on fetal MRI, presented in a temporal manner based on the embryologic development of the posterior fossa. Read More

Authors:  Whitehead Matthew,  Lee Bonmyong

Keywords:  Posterior fossa ,  cerebellum ,  brainstem

Blagdon Ryan,  Thompson Deborah,  Schmit Pierre

Final Pr. ID: Poster #: EDU-014

The ductus venosus is a part of the fetal circulation that permits oxygenated blood in the umbilical vein to bypass the liver and provide oxygenated blood to the fetal brain and heart. Absence of the ductus venosus is a rare anomaly associated with a number of serious, life-threatening and often deadly conditions. Studies have evaluated the use of ultrasound for prenatal evaluation and detection of absent ductus venosus; however, no studies have reported non-ultrasound postnatal radiological findings of absent ductus venosus. Here, we describe the expected anatomy in those with absent ductus venosus and present abdominal x-rays of 3 infants to illustrate an expected but abnormal course of umbilical venous lines in these patients. As many as 15.6% of patients with absent ductus venosus have it in isolation and with 67-100% postnatal survival when occurring in isolation. Thus, the postnatal incidental identification of absent ductus venosus is a clinical possibility for pediatric radiologists that review abdominal x-rays to check catheter/line placement. Familiarity with this abnormal course of umbilical venous lines may assist in making this rare postnatal diagnosis and avoid potentially life-threatening complications secondary to line malposition/repositioning. Read More

Authors:  Blagdon Ryan,  Thompson Deborah,  Schmit Pierre

Keywords:  Ductus venosus ,  Vascular ,  Congenital

Farkas Amy,  Roda Manohar

Final Pr. ID: Poster #: EDU-015

As an inexpensive modality that does not require ionizing radiation, ultrasound is the preferred method for screening for fetal anomalies. When an abnormality is detected on ultrasound, the limitations of the modality often elicit further evaluation with MRI, as MRI can provide more detail and information to the radiologist and clinician. Chest and cardiac pathologies are among the most common findings on prenatal ultrasound and often warrant additional imaging. Consequently, an understanding of these findings and how they appear on different modalities is essential to the pediatric imager.
This electronic exhibit features fetal ultrasound and MRI of mediastinal lymphangioma, type I-III congenital pulmonary airway malformations, intralobar, extralobar, and subdiaphragmatic sequestrations, left and right sided congenital diaphragmatic hernias, hypoplastic left heart, heterotaxy, AV canal defect, and rhabdomyoma. In addition to reviewing the correlation of findings on ultrasound and MRI, prognosis as well as conditions and syndromes commonly associated with these chest and cardiac anomalies will be examined.
The goal of this exhibit is to provide an overview of common fetal cardiopulmonary abnormalities on different, complementary imaging modalities. Familiarity with these conditions is necessary for the radiologist to provide critical information to clinicians to allow prompt intervention in the postnatal period. These findings can additionally serve as an indication to the radiologist to search for associated findings, allowing prognostication and appropriate counseling of parents. Read More

Authors:  Farkas Amy,  Roda Manohar

Keywords:  Cardiopulmonary ,  Fetal MRI

Mata-mbemba Daddy,  Daneman Alan

Final Pr. ID: Poster #: EDU-021

Background:
There are a variety of masses in neonates, infants and young children that may disappear spontaneously without active intervention. However, there has been no published review of what type of masses could disappear and what the spectrum of their imaging features is. It is essential for radiologists to understand imaging features of these entities in order to provide pediatrician and pediatric surgeons with critical information that will enable them to manage these patients expectantly without surgical intervention.
Purpose:
The entities that will be illustrate in this review include, among others: multicystic dysplastic kidneys, suprarenal masses (including intraabdominal sequestration, neuroblastoma and adrenal hemorrhage), ovarian cyst and torsion, duplication cyst of gastrointestinal tract, cyst of liver and kidneys. We will:
1. Review the clinical and imaging features of these masses including their changes during follow-up imaging studies.
2. Emphasize the imaging features that are helpful in differentiating these entities from other entities that require active intervention
3. Describe an appropriate approach to deal with uncertain diagnoses. Read More

Authors:  Mata-mbemba Daddy,  Daneman Alan

Keywords:  disappear mass ,  neonate ,  infant and young children

Hanna Carolyn,  Rajderkar Dhanashree,  Baxi Ameya,  Sharma Priya

Final Pr. ID: Poster #: EDU-022

In this educational exhibit we plan:
1. To identify and illustrate the spectrum of blastomas on various imaging modalities
2. To review the pathogenesis of these tumors
3. To describe and illustrate the typical and atypical imaging appearances and organ-wise differential diagnosis Read More

Authors:  Hanna Carolyn,  Rajderkar Dhanashree,  Baxi Ameya,  Sharma Priya

Keywords:  Blastomas ,  Rare neoplasms ,  Primitive tissues

Uricchio Joseph,  Sharma Priya,  Rajderkar Dhanashree

Final Pr. ID: Poster #: EDU-023

In this educational exhibit we will present a series of gastrointestinal (GI) emergencies encountered in the neonatal period. We will focus on typical presentations but will also include atypical cases and discuss multi-modality approach to imaging these patients.
Read More

Authors:  Uricchio Joseph,  Sharma Priya,  Rajderkar Dhanashree

Keywords:  NICU ,  Emergency ,  Gastrointestinal

Joshi Hena,  Alazraki Adina,  Rostad Bradley

Final Pr. ID: Poster #: EDU-024

Ulcerative colitis (UC) and Crohn disease are chronic, immune-mediated, inflammatory disorders of the gastrointestinal tract collectively referred to as inflammatory bowel disease (IBD). As many of 20-25% of patients with IBD initially present in childhood or adolescence, and the incidence of pediatric IBD is increasing. IBD primarily affects the bowel, but other organs can be involved. Nearly one-third of patients will have at least one extra-intestinal manifestation. Some extra-intestinal manifestations, such as that between UC and primary sclerosing cholangitis (PSC), are well-established. Others are less understood and may mimic more common pathology, particularly infection. Therefore, pediatric radiologists must become familiar with these extra-intestinal manifestations and consider the diagnosis of IBD as the etiology for their pathology. Read More

Authors:  Joshi Hena,  Alazraki Adina,  Rostad Bradley

Keywords:  inflammatory bowel disease ,  ulcerative colitis ,  Crohn disease

Finkle Joshua,  Feinstein Kate

Final Pr. ID: Poster #: EDU-026

Kids put all sorts of things in their mouths. Foreign body ingestion is a common occurrence in children, and diagnostic imaging plays an important role in determining the nature of the foreign body and the need for emergent removal.

This presentation uses a question and answer format to provide high-yield clinically relevant information on the most commonly encountered foreign bodies including management guidelines for things like coins, batteries, and magnets. Both GI and airway foreign bodies are discussed. The presentation is catered mostly to trainees, but even experienced radiologists will enjoy challenging themselves to identify uncommon foreign bodies on imaging. Read More

Authors:  Finkle Joshua,  Feinstein Kate

Keywords:  Foreign Body

Lambert Elena,  Andronikou Savvas

Final Pr. ID: Poster #: EDU-036

Background:
Malrotation is an important diagnosis that needs to be identified on routine imaging and in the emergency setting. In our institution it is always surgically corrected and therefore accurate diagnosis is essential. Current teaching, supported by research, states that a lateral view on an upper gastrointestinal contrast study (UGIS) can satisfactorily demonstrate normal anatomy and a diagnosis of malrotation. The diagnosis must be made with confidence in this position because any delay in turning the patient into the AP plane can result in contrast progressing into the jejunum with overlapping bowel loops compromising the diagnosis.
Read More

Authors:  Lambert Elena,  Andronikou Savvas

Keywords:  Malrotation ,  Midgut volvulus

Chan Alvin,  Lin Jonathan,  Ghahremani Shahnaz,  Chawla Soni

Final Pr. ID: Poster #: EDU-039

Children, especially toddlers, are the most frequent victims of foreign body (FB) ingestion because of their natural curiosity, tempting them to put everything into their mouths. Anything within arm’s reach is fair game, from simple coins to the more dangerous button batteries and magnets. This study aims to provide a thorough review of plain radiographic findings of a myriad of foreign bodies (FBs) and associated complications. With the “Rule of 3–5”, we aim to help radiologists and clinicians develop a rationale and systematic approach in managing FB ingestions. Read More

Authors:  Chan Alvin,  Lin Jonathan,  Ghahremani Shahnaz,  Chawla Soni

Keywords:  Foreign Body

Lin Jonathan,  Chawla Soni

Final Pr. ID: Poster #: EDU-040

Fidget spinners (FS) have become an increasingly popular toy among children of all ages since April 2017. This toy comprises of a central bearing attached to two or more prongs made of plastic or metal and is designed to be spun between a user’s fingers. With its popularity, FS have grown diverse in design, featuring additional components including light-emitting diode units, Bluetooth speakers, and button batteries. With its multiple small components, FS pose a risk of ingestion and aspiration among young children. This may be incidental or accidental due to the rapidly spinning nature of the toy. Since May 2017, there has been a growing number of cases of FS ingestions among young children internationally. Recognition of the different components of a FS on imaging, especially plain radiography, is important in the early diagnosis and prompt and accurate management of foreign body ingestion. To date, there is no available educational resource to aid and guide radiologists and clinical providers in identifying FS as a foreign body. The purpose of this educational exhibit is to assist radiologists and clinicians to identify the imaging findings associated with FS-related foreign body ingestions. Read More

Authors:  Lin Jonathan,  Chawla Soni

Keywords:  Foreign Body ,  Fidget Spinner

Goldwasser Bernard,  Kazmi Faaiza,  Urbine Jacqueline,  Poletto Erica,  Malik Archana,  Mallon Mary

Final Pr. ID: Poster #: EDU-048

There is a wide array of pathologies which can cause diffuse changes in the pediatric kidney. The purpose of the presentation is to show a multimodality pictorial review of characteristic findings of a wide variety of diffuse renal abnormalities in the pediatric patient. Read More

Authors:  Goldwasser Bernard,  Kazmi Faaiza,  Urbine Jacqueline,  Poletto Erica,  Malik Archana,  Mallon Mary

Keywords:  renal mass ,  congenital renal abnormalities ,  syndromes affecting the kidney

Wallace Jacob,  Desilet-dobbs Debbie

Final Pr. ID: Poster #: EDU-052

Learning the skills used to master pediatric fluoroscopic exams can be challenging. Hand-eye coordination and specific timing is required while at the same time being mindful of radiation dose and interpreting the images generated in real time. Training on live neonates will often mean less diagnostic exams and increased radiation dose for those exams.

An inexpensive reusable simulator model was devised to allow residents practice of upper GI fluoroscopic exams to increase efficiency using ALARA principles and utilizing 3D printing technology off-the-shelf dolls. Generic gastrografin provided a cost effective contrast medium as its concerns in real UGI studies are of no issue on the training models. A 30ml bottle of generic gastrografin can be purchased for less than $20, which would last for several simulated exams.

The 3D model was based on a computer generated imagery (CGI) mesh of a stomach which was modified in Blender™ to try to best replicate the full duodenum and effect of the ligament of Treitz. The final iteration of the model was printed in polylactic acid polymer (PLA) in a size that would fit inside the plastic doll, which already contained portions of the necessary tubing. The model was sealed to be watertight.

Testing under fluoroscopy showed that the model behaved similar enough to an infant when placed in various positions then filled with an appropriate volume contrast.

There are several limitations of this model including the lack of the distractions of a real pediatric patient. Also, the flow of contrast is purely gravity dependent without the effects of sphincters and peristalsis. Overlying skeletal structures and bowel gas are not represented, however these could also be simulated in various ways.

Future work on this and similar projects could include expansion into other organ systems such as the colon. Read More

Authors:  Wallace Jacob,  Desilet-dobbs Debbie

Keywords:  ALARA ,  3D ,  Simulation

Osman Radya,  Ahmed Ilham,  Yagoub Shima,  Bakeit Mohamed Salih,  Mustafa Elrayah,  Gabir Abdalla,  Marine Megan,  Karmazyn Boaz,  Gunderman Richard,  Heitkamp Darel,  Hibbard Roberta,  Miller Aaron,  Mohammed Alaaeldeen,  Satti Satti

Final Pr. ID: Poster #: EDU-053

To assess the awareness and knowledge of Radiologists, Pediatricians, Orthopedists and Emergency Physicians regarding child abuse incidence, imaging, and management in Sudan, Africa. Read More

Authors:  Osman Radya,  Ahmed Ilham,  Yagoub Shima,  Bakeit Mohamed Salih,  Mustafa Elrayah,  Gabir Abdalla,  Marine Megan,  Karmazyn Boaz,  Gunderman Richard,  Heitkamp Darel,  Hibbard Roberta,  Miller Aaron,  Mohammed Alaaeldeen,  Satti Satti

Keywords:  Child Abuse ,  Africa ,  Imaging

Degnan Andrew,  Chung Chul,  Duszak Richard,  Alson Mark

Final Pr. ID: Poster #: EDU-055

Coding and billing processes are complex, costly, and generally poorly understood by radiologists and other physicians. Despite the direct implications of radiology documentation on reimbursement, residents, fellows, and practicing radiologists receive little or no training in coding-related issues. It is thus important to understand the fundamentals of documentation, coding, billing, and reimbursement as they apply to the practice of pediatric radiology. Read More

Authors:  Degnan Andrew,  Chung Chul,  Duszak Richard,  Alson Mark

Keywords:  Coding ,  Billing ,  Documentation

Willard Scott,  Kaye Robin,  Schaefer Carrie,  Aria David

Final Pr. ID: Poster #: EDU-060

To describe alternative routes of Nusinersen administration in patients in whom traditional lumbar puncture is limited secondary to spinal hardware and bony fusion. Read More

Authors:  Willard Scott,  Kaye Robin,  Schaefer Carrie,  Aria David

Keywords:  Spinraza ,  Spinal muscular atrophy SMA ,  nusinersen

Joshi Aparna,  Kalra Kunal

Final Pr. ID: Poster #: EDU-062

The number of reconstruction surgeries of the anterior cruciate ligament (ACL) in pediatric patients has risen dramatically over the past two decades as a result of changes in treatment philosophy and perhaps frequency of injury. It is therefore important for pediatric radiologists to recognize the normal postoperative appearance of the different surgeries as well as their complications. This educational exhibit will review the types of reconstructive methods used in both skeletally immature and mature patients (physeal-sparing, partial transphyseal and transphyseal), complications (growth disturbances, graft failure, impingement, arthrofibrosis, intra-articular bodies) and relevant imaging findings on plain radiography and MRI. Read More

Authors:  Joshi Aparna,  Kalra Kunal

Keywords:  Anterior cruciate ligament reconstruction ,  pediatric ,  radiology

Sharp Paige,  Braithwaite Kiery,  Marshall Kelley

Final Pr. ID: Poster #: EDU-066

The coracoid process serves as a crucial anchor for multiple tendon and ligamentous attachments in the shoulder. While glenohumeral and labral pathology are more commonly implicated in shoulder injuries, the coracoid process can also be a primary pain generator within the shoulder. This educational poster will address normal coracoid anatomy and development, as well as pathologic conditions affecting the coracoid in the pediatric population, including fractures, infection, and neoplasm.

The coracoid is a beak-like projection that extends anteriorly from the ventral scapula. It serves as the origin for the pectoralis minor, coracobrachialis, and short head of the biceps. Ligamentous attachments extend from the coracoid to the clavicle (coracoclavicular ligaments), acromion (coracoacromial ligament), and humerus (coracohumeral ligament). Additionally, the transverse scapular ligament attaches to the coracoid base.

The growth plate at the coracoid base is considered a “bipolar growth plate” and is made up of the primary ossification centers of the coracoid and the adjacent ventral scapula, similar to the tri-radiate cartilage of the acetabulum. The coracoid appears within the first year of life with fusion of the coracoid base growth plate occurring by age 14 to 15.

Physeal injuries occur at the base of the coracoid with imaging characteristics similar to other more typical locations (i.e. the proximal humerus in Little Leaguer’s shoulder). Key features include physeal widening with irregular bony margins, thought to be secondary to chronic repetitive pull from the attached musculature. Additionally, coracoid fractures occur in acute trauma and can be easily overlooked as they are frequently associated with other fractures. Direct blunt trauma by either an external object or the humeral head are associated with fractures of the base of the coracoid. Avulsions of the coracoid tip are seen with acromioclavicular separations with injury to the cocacoclavicular ligaments, more commonly seen in the pediatric population as the ligaments are relatively stronger than their osseous attachments.

While tumors of the coracoid are rare and more commonly occur in adults, primary tumors of the coracoid are seen in the pediatric population with case reports of osteoid osteomas, osteoblastomas, giant cell tumors, and aneurysmal bone cysts. Awareness of pathology affecting the coracoid process is helpful to the radiologist and clinician caring for the child with shoulder pain. Read More

Authors:  Sharp Paige,  Braithwaite Kiery,  Marshall Kelley

Keywords:  Physis ,  Fracture ,  Osteoid osteoma

Alsharief Alaa,  Laxer Ronald,  Stimec Jennifer,  Babyn Paul,  Man Carina,  Doria Andrea

Final Pr. ID: Poster #: EDU-069

1. To review the contemporary literature and present an updated list of musculoskeletal and non-musculoskeletal imaging findings of patients with autoinflammatory diseases in our hospital. Most of these patients are found to have a genetic mutation that is responsible for their disease.

2. To present follow-up imaging findings, when available, and correlate those with patients’ symptoms and type of treatment administered in approximately 40 patients with autoinflammatory diseases such as Cryopyrin-associated autoinflammatory syndrome, familial Mediterranean fever, PAPA (pyogenic arthritis, pyoderma gangrenousum, and acne) syndrome and much more. These findings can be related to disease progression, treatment response or treatment-induced changes. Read More

Authors:  Alsharief Alaa,  Laxer Ronald,  Stimec Jennifer,  Babyn Paul,  Man Carina,  Doria Andrea

Keywords:  Autoinflammation ,  fever ,  Rheumatology

Pfeifer Cory,  Miller Jeffrey

Final Pr. ID: Poster #: EDU-071

Chronic cerebrovascular disease is common in pediatric sickle cell patients, and these children often require serial imaging to assess cerebral blood flow perfusion. ASL MRI has been shown to be an effective technique to assess cerebral blood flow, but the evaluation of perfusion reserve is also of value to ordering clinicians. This educational exhibit describes the use of the vasodilator acetazolamide to gauge potential changes in perfusion as determined by ASL MRI. The biochemical basis for cerebrovascular autoregulation and mechanism of acetazolamide are discussed. Read More

Authors:  Pfeifer Cory,  Miller Jeffrey

Keywords:  arterial spin labeling MRI ,  cerebral blood perfusion ,  acetazolamide

Hedlund Alec,  Stern Sara,  Bohnsack John,  Hedlund Gary

Final Pr. ID: Poster #: EDU-075

To familiarize the pediatric radiologist with the important role that the perforin gene plays in lymphocyte cytotoxicity, to discuss the diversity in clinical presentation, and review the scope of neuroimaging abnormalities that may arise in the setting of a missense perforin genetic defect. The brain MRI findings and relevant clinical information of two remotely related children with the same novel missense mutation in the perforin gene represent the basis of this educational poster.

Perforin is a glycoprotein (encoded by the PRF-1 gene) involved in several human cellular functions, including, immune response and stored mainly in CD8-positive T-cells as well as natural killer (NK) cells. Normally, T-cells and NK cells are responsible for attacking dead cells. In the clinical setting of perforin deficiency, T-cells and NK cells attack the healthy immune system. This arises from a missense mutation of the PRF-1 gene. Links between perforin deficiency and the autoimmune clinical syndrome of hemophagocytic lymphohistiocytosis (HLH), have been reported.

MR imaging abnormalities in patients with perforin gene mutations, are diverse and complex as the defect may occur in the setting of familial hemophagocytic lymphohistiocytosis, primary necrotizing lymphocytic CNS vasculitis or associated with CNS infections such as the Epstein Barr virus.

To date, MRI abnormalities that have been reported include mimics of septic cerebral emboli, confluent white matter abnormalities involving the cerebral hemispheres and cerebellum invoking the consideration of diffuse demyelinating disease, and multifocal infratentorial and supratentorial intraaxial lesions with “necrotic-like” character and marginal enhancement. Multifocal sites of perivascular space pathological enhancement has also been reported. Common to many of these reports is cerebellar involvement.

The imaging differential diagnosis includes atypical infection, histocytic disorders of the CNS, lymphomatous granulomatosis, neurosarcoidosis, and primary CNS lymphoma. Read More

Authors:  Hedlund Alec,  Stern Sara,  Bohnsack John,  Hedlund Gary

Keywords:  Perforin defect ,  Chronic encephalitis ,  Necrotizing vasculitis

Finkle Joshua,  Tullius Thomas,  Javadi Ariyan,  Yang Carina

Final Pr. ID: Poster #: EDU-076

Abnormalities of cortical development include a complex and often bewildering variety of pathologies. With substantial overlap in both imaging appearance and terminology, many radiology trainees and other healthcare providers find these entities can be difficult to learn and efficiently retain. We aim to present a clear and streamlined approach to organizing these disorders within a differential. In the process we use high resolution imaging and original artwork to provide:

- A basic overview of the major steps of cortical development.
- A simplified classification of developmental abnormalities based on the affected stage of development.
- An overview of the underlying pathology, imaging appearance, and clinical relevance of each entity discussed.
- Tips for distinguishing malformations with similar imaging appearances and for understanding the nomenclature used in describing the abnormalities.
- Discussion of new and future imaging techniques for evaluating these lesions, including 3T and 3D DIR techniques.


OUTLINE:

- Cortical development: A basic overview

- Disorders of cell proliferation
— Microcephaly and cortical-related findings
— Hemimegalencephaly
— Focal non-neoplastic processes
— — Focal cortical dysplasia
— — Cortical hamartomas
— Cortical neoplasms
— — Ganglioglioma and gangliocytoma
— — DNET

- Disorders of neuronal migration
— The lissencephalies
— Gray matter heterotopia

- Disorders of cortical organization
— Polymicrogyria
— Schizencephaly Read More

Authors:  Finkle Joshua,  Tullius Thomas,  Javadi Ariyan,  Yang Carina

Keywords:  Cortical Development Abnormalities ,  lissencephaly ,  polymicrogyria

Poot Jeffrey,  Subramanian Subramanian,  Gumus Serter,  Squires Judy

Final Pr. ID: Poster #: EDU-078

Ultrasound is a common screening examination performed in infants prior to closure of osseous posterior elements. Although radiologists with pediatric neuroradiology subspecialty training may be very familiar with many abnormalities encountered sonographically, pediatric radiologists without pediatric neuroradiology subspecialty training are often less familiar. Further, the ultrasound appearance of abnormalities of infant spine may be less well known than appearance on MRI. The purpose of this educational review is to demonstrate normal appearance of infant spine and illustrate abnormalities that are frequently and infrequently encountered during screening ultrasound evaluation, with MRI for comparison. Read More

Authors:  Poot Jeffrey,  Subramanian Subramanian,  Gumus Serter,  Squires Judy

Keywords:  Spine ,  Ultrasound ,  MRI

Sato T Shawn,  Sato Yutaka

Final Pr. ID: Poster #: EDU-084

The 2016 World Health Organization Classification of Tumors of the Central Nervous System has now incorporated molecular and genetic parameters in addition to histology to define many tumor entities. Significant restructuring has occurred for pediatric CNS tumors. For example, medulloblastomas are classified into four genetic subtypes. Other embryonal tumors such as embryonal tumor with multilayered rosettes (ETMR) and atypical teratoid/rhabdoid tumor (ATRT) are further defined by their molecular features. Also new entities have been added defined by both histology and molecular signatures including H3 K27M-mutant diffuse midline glioma, RELA fusion-positive ependymoma and diffuse leptomeningeal glioneuronal tumor (DLGNT).
These more homogeneous and narrowly defined entities are expected to facilitate better classification, prognostication and patient stratification for precision therapy. This also improves the design of clinical trials and experimental models.
In this presentation, we will review the new WHO classification scheme and review the imaging and as well as molecular/genetic features of pediatric CNS tumors.
Radiologists must keep up to date with updates to the WHO classification scheme to be able to better communicate with clinicians ensure optimal patient care and relevant research collaboration.
Read More

Authors:  Sato T Shawn,  Sato Yutaka

Keywords:  WHO ,  Brain tumors

Goldwasser Bernard,  Malik Archana,  Poletto Erica,  Urbine Jacqueline,  Kazmi Faaiza,  Mallon Mary

Final Pr. ID: Poster #: EDU-087

When evaluating the pediatric neuroaxis, it is important to include the extra-axial spaces in the radiologists’ search pattern. The purpose of the presentation is to show a multimodality pictorial review of characteristic findings of extra-axial CNS lesions detected on CT and MRI. Read More

Authors:  Goldwasser Bernard,  Malik Archana,  Poletto Erica,  Urbine Jacqueline,  Kazmi Faaiza,  Mallon Mary

Keywords:  dural mass ,  extra-axial masses

Joshi Aparna,  Saleem Sheena

Final Pr. ID: Poster #: EDU-091

Epidural hematomas are typically seen after accidental head trauma in children, though they can also be seen in abusive head trauma. Most often they are arterial but venous hematomas can occur in posterior fossa and vertex locations.

This educational exhibit will review the pathophysiology and common imaging features on CT and MR of intracranial and intraspinal epidural hematomas. Illustrative examples of unusual types of epidural hematomas such as retroclival epidural hematoma and epidural hematoma crossing calvarial sutures will be included. Read More

Authors:  Joshi Aparna,  Saleem Sheena

Keywords:  Epidural hematoma

Rapp Jordan,  Saul David,  Kaplan Summer,  Barrera Christian,  Otero Hansel

Final Pr. ID: Poster #: EDU-099

Background: Dual source dual-energy CT scanners (DECT) has allowed for the collection of two data sets with a single scan, opening the potential for functional data acquisition. The technique combines two energy beams at distinct voltages applied concurrently during a single scanning phase. The source data can be combined to generate a single mixed composite image, or iodine can be subtracted to create a contrast map or a virtual non-contrast image. The result is functional information in the setting of decreased radiation dose when replacing a biphasic scan, or dose neutral when compared to conventional single source CT. Post processing lung perfusion software allows for imaging display (qualification) and quantification of iodinated contrast volumes in the lungs, a surrogate for lung perfusion.
Purpose:
This educational exhibit will demonstrate: 1. How to perform DECT in children, 2. How to use postprocessing software, and 3. How to interpret lung perfusion results through clinical examples of current pediatric clinical indications including pulmonary embolism, lung hypoplasia, pulmonary AV malformation, and pulmonary hypertension.
Conclusion:
Through this exhibit, readers will gain familiarity with technical aspects of DECT of the lungs in children, understand the basics of post processing and recognize focal or regional perfusion defects, segmented perfusion analysis, and focal lesion perfusion characteristics as well as identify future applications. Read More

Authors:  Rapp Jordan,  Saul David,  Kaplan Summer,  Barrera Christian,  Otero Hansel

Keywords:  dual energy ,  thoracic ,  perfusion

Degnan Andrew,  Biko David,  White Ammie,  Servaes Sabah,  Otero Hansel,  Fox William,  Shaffer Thomas,  Zhang Huayan,  Saul David

Final Pr. ID: Poster #: EDU-100

With advances in intensive care, increasing numbers of premature neonates with severe respiratory distress have led to major challenges related to prolonged mechanical ventilation and chronic bronchopulmonary dysplasia. Acute lung injury and acute respiratory distress syndrome in children still confer significant morbidity and mortality despite advances in ventilation and resuscitative therapies.

Much of the damage attributed to mechanical ventilation in critically ill infants and children is due to surface tension and ventilation of atelectatic lung. First reported clinically in neonates in 1989, partial liquid ventilation involves the endotracheal administration of an inert volatile perfluorochemical liquid. These perfluorocarbons aid in gas exchange due to their large oxygen and carbon dioxide carrying capacity. In addition, these chemicals possess low surface tension that allows for greater alveolar recruitment and improved lung compliance through clearance of debris and secretions.

Early trials in preterm neonates and neonates with congenital diaphragmatic hernia suggested a role for liquid ventilation as salvage therapy for patients not responding to conventional mechanical ventilation and extracorporeal membrane oxygenation. Currently, efforts are underway to reassess its clinical utility in bronchopulmonary dysplasia. With this renewed clinical interest, it is important for pediatric radiologists at institutions utilizing these perfluorocarbons to be familiar with the clinical use and radiographic appearance of liquid ventilation. Read More

Authors:  Degnan Andrew,  Biko David,  White Ammie,  Servaes Sabah,  Otero Hansel,  Fox William,  Shaffer Thomas,  Zhang Huayan,  Saul David

Keywords:  liquid ventilation ,  chest radiographs

Davis James

Final Pr. ID: Poster #: EDU-104

Stillbirth is a sad complication of pregnancy. Establishing the cause of death in intrauterine fetal demise (IUFD) is important to bring psychological closure to the family and crucial for reproductive counseling. The gold standard to establish the cause of IUFD is perinatal autopsy. However, perinatal autopsy rates are falling worldwide, largely attributed to patients and physicians discomfort with death and discussion of postmortem examinations as well as social and religious reasons. There is a lack of experience with minimally invasive perinatal autopsy in the United States and even more limited publications in the subject. Our main goal was to investigate the added value of postmortem MRI to conventional autopsy in the clinical setting. Our program has had successes and failures, of which learning opportunities exist for other institutions that desire to implement similar programs. This paper will discuss the timeline of our progress and share examples of potential roadblocks and keys to success in implementing such a program. Read More

Authors:  Davis James

Keywords:  Postmortem ,  MRI ,  Fetal