Cielma Tara,  Bandarkar Anjum,  Demshur Lesley,  Bulas Dorothy

Final Pr. ID: Poster #: EDU-002 (T)

Background: Duplex sonography is a critical portion of intracranial hemodynamics evaluation. Serial Doppler examination allows real-time assessment of disease progression or improvement.

The goals of this exhibit are:
1. Describe the technical approach of performing neonatal/infant transcranial Doppler ultrasound.
2. Review tips, and up to date technology that assist in optimizing studies.
3. Discuss changes in flow patterns with various pathologies, providing examples of clinical indications.
4. Review future potential techniques and applications. Read More

Authors:  Cielma Tara,  Bandarkar Anjum,  Demshur Lesley,  Bulas Dorothy

Keywords:  Neurosonography ,  Cerebral Doppler ,  Hypoxic Ischemic Encephalopathy

Cielma Tara,  Linden Kadine

Final Pr. ID: Poster #: EDU-003 (T)

Background: Volume acquisition in ultrasound is recognized as a helpful tool in prenatal sonography, but notorious for having a steep learning curve. At times, utilizing this technology may be the only way to visualize anatomy due to factors such as maternal body habitus or fetal position. Our goal is provide the audience with the information and techniques required to take a volume sweep acquisition and obtain numerous rendering modes to evaluate the fetal craniofacial area.

Aims:
1. To describe utility and benefit of acquiring volume ultrasound in detection of craniofacial anomalies in prenatal patients.
2. To describe tips, tricks, and current technology to optimize imaging and assist in minimizing equivocal exams.
3. Provide examples of soft tissue lesions, hydrocephalus, craniosynostosis, micrognathia and midline cleft cases.
4. To look into future technology and potential applications.
Read More

Authors:  Cielma Tara,  Linden Kadine

Keywords:  3D volume ,  4D volume ,  STIC

Morgan Trudy,  Poznick Laura,  Back Susan,  Darge Kassa

Final Pr. ID: Poster #: EDU-004 (T)

Contrast enhanced ultrasound is a radiation free, highly sensitive imaging modality for detection of focal liver lesions in children. CEUS uses ultrasound (US) technology and an US contrast agent (UCA) that is administered intravenously. This educational exhibit provides step-by-step instructions of our institutional protocol for performing CEUS exams. Read More

Authors:  Morgan Trudy,  Poznick Laura,  Back Susan,  Darge Kassa

Keywords:  Ultrasound ,  Liver ,  Contrast

Ulikowska Ewelina

Final Pr. ID: Poster #: EDU-005 (T)

Necrotizing enterocolitis (NEC) is one of the most leading causes of morbidity and mortality in premature infants. It usually develops within the first days following birth. NEC is a gastrointestinal disease, that can affect any part of the large or small bowel but most commonly affects the terminal ileum and colon. It causes inflammation and tissue death of the affected area and can lead to bowel perforations and a need for surgical resections. In severe cases, bacteria and waste products can pass through the perforated intestine and enter the baby’s bloodstream or abdominal cavity which can cause a life threatening infection and shock. In a pediatric hospital, that treats premature infants, signs and symptoms of necrotizing enterocolitis are very important to diagnose quickly. Most common symptoms include poor feeds, bloating or swelling in the abdomen, bloody stools and diarrhea. In order to manage the disease medically and surgically, prompt diagnostic tests such as ultrasounds and xrays need to be performed. Abdominal X-rays are the gold standard of diagnosis and treatment planning. Therefore it is crucial, to recognize the radiographic signs of NEC. The purpose of this abstract is to describe radiographic appearances associated with NEC, which include: dilated bowel loops, thickened bowel walls with edema, pneumatosis intestinalis, abdominal free air, portal venous gas, absence of bowel gas. I will present confirmed cases that show radiographic signs of NEC. Read More

Authors:  Ulikowska Ewelina

Keywords:  Necrotizing Enterocolitis ,  Radiographic findings

Gazzi Lynn

Final Pr. ID: Poster #: EDU-006 (T)

Intestinal malrotation is a defect that occurs in the 10th week of gestation. During this stage the intestines normally migrate back into the abdominal wall following a brief period where they are temporarily located in the base of the umbilical cord. As the intestines returns to the abdomen it makes two rotations and becomes fixed into its normal position. The small bowel is located in the center of the abdomen and the large intestine drapes around the top and sides of the small intestine. When rotation is incomplete and intestinal fixation does not occur, this creates a defect known as malrotation. Malrotation occurs in one of every 500 births in the United States. Up to 40 percent of patients with this show signs of the disease within the first week of life. By one month of age 50-60 percent are diagnosed. 75 to 90 percent are diagnosed by age 1. The remaining cases are diagnosed into adulthood. Some symptoms of malrotation include vomiting and bilious emesis, fussiness, crying in pain, a swollen abdomen that’s tender to the touch, fever, diarrhea and bloody stool or none at all. If malrotation is not treated, it can lead or turn into a midgut vovulus. This is when the gut twists counterclockwise around the superior mesenteric artery and vein causing a narrowing. This may cause abdominal distention and pain or acute bowel necrosis. It can also be life threatening or lead to a lifelong dependence on total parenteral nutrition, so surgical correction is the dependent treatment. When medical history and physical examination indicate a suspicion of malrotation and vovulus, patients must undergo blood tests and diagnostic imaging studies to evaluate the position of the intestine to determine if there is blockage or twisting. The imaging modality of choice remains the upper GI study. This is a fluoroscopic study using barium contrast to look at the upper and middle sections of the gastrointestinal tract. A radiologist’s knowledge of normal anatomy is important in performing and interpreting the upper GI series. From a technical standpoint common pitfalls during this test that can lead to a misdiagnosis would be imaging quality. Improper patient positioning, nonsufficient images taken and the wrong amount of contrast administered during the most crucial part of the study can lead to false findings. The purpose of this abstract is to present case studies and imaging which mimic intestinal rotation but are a normal variant vs. actual cases of malrotation Read More

Authors:  Gazzi Lynn

Keywords:  malrotation ,  midgut vovulus ,  image findings

Poznick Laura,  Morgan Trudy,  Back Susan,  Darge Kassa

Final Pr. ID: Poster #: EDU-007 (T)

Contrast enhanced voiding urosonography (ceVUS) is a radiation free, highly sensitive imaging modality for vesicoureteral reflux (VUR) detection and urethral imaging in children. CeVUS uses ultrasound (US) technology and an US contrast agent (UCA) that is instilled in the bladder via a catheter. This educational exhibit provides step-by-step instructions of our institutional protocol for performing ceVUS exams.
Read More

Authors:  Poznick Laura,  Morgan Trudy,  Back Susan,  Darge Kassa

Keywords:  Ultrasound ,  Contrast ,  VoidingContrast

Myefski Patty,  Sammet Christina

Final Pr. ID: Poster #: EDU-008 (T)

To recognize imaging artifacts that are unique to digital radiography (DR) and to learn techniques to reduce the most common image quality issues. DR systems in medical imaging have transformed planar xray, one of the oldest imaging modalities. Computed radiography (CR) and DR share some of the same image quality challenges including poor positioning, inappropriate techniques, and motion. There are image quality issues unique to DR that may be unfamiliar to new operators. Although, artifacts have been a part of imaging since the use of film-screen xray, with DR, the technologists have to be aware of new artifacts related to digital acquisition and processing. At times, pediatric DR imaging can present even bigger challenges. Technologists must learn methods to avoid DR imaging artifacts, and how to identify them before sending the image to the Picture Archiving and Communication System (PACS). This exhibit will review how to identify common DR imaging artifacts, explain the reason they occur, and suggest methods to reduce their interference with image quality. Read More

Authors:  Myefski Patty,  Sammet Christina

Keywords:  Artifacts ,  QA

Blake Crystal,  Chastain Laura

Final Pr. ID: Poster #: EDU-009 (T)

Pediatric patients five years and younger often require sedation to successfully complete CT imaging of the thorax and/or abdomen/pelvis. Sedation of pediatric patients poses certain risks and should be avoided when possible. In August of 2017, Children’s Healthcare of Atlanta installed a new CT scanner – a Siemens SOMATOM Force. The SOMATOM Force posesses a Turbo Flash mode which results in sub second scan times for CT imaging of the thorax and/or abdomen/pelvis.
Read More

Authors:  Blake Crystal,  Chastain Laura

Keywords:  sedation reduction ,  Siemens SOMATOM Force

Wright Angie,  Simoneaux Stephen

Final Pr. ID: Poster #: EDU-010 (T)

During a recent CT renovation, a mobile CT scanner had to be used at a major urban children's hospital which also is a Level 1 trauma center. Performing exams while maintaining patient safety and providing quality diagnostic imaging involved the collaborative efforts of the radiology team, the project manager, the construction team, and the hospital service line leaders. The purpose of this exhibit is highlight the anticipated and unanticipated considerations which had to be addressed prior to the use of the mobile CT scanner. Knowing how these environmental and patient safety issues were identified and addressed may be a help with future radiology equipment replacement projects.
Read More

Authors:  Wright Angie,  Simoneaux Stephen

Keywords:  Education ,  Mobile ,  CT

Ramrattan Allister

Final Pr. ID: Poster #: EDU-011 (T)

The purpose of this retrospective observational study is to provide an alternative if not optimal lateral elbow projection method to be considered for use in traumatic injuries with suspected distal humeral fractures and/or observable deformity at the distal humerus.
Abstract: The true lateral radiograph of the distal humerus commonly contributes to the decision of Gartland classification of supracondylar fractures and other distal humerus fractures. This is important when deciding which elbow fractures require invasive surgery and anesthesia as opposed to a reduction with conscious sedation. While the Elbow Lateral Projection (Lateromedial) in current practice typically results in a perfect lateral radiograph for adult patients, this method does not result in a true lateral of the distal humerus in pediatric patients. The condyles are rarely superimposed and the signature “hour glass” sign is imperfect. The Stop Sign Method is a medial to lateral projection that routinely results in a true lateral of diagnostic quality and meeting textbook qualification. Not only is positioning in the Stop Sign method more comfortable for trauma clients, it produces a more consistent radiograph when utilized on follow-up orthopaedic visits and enables clinicians to better track reduction retention and healing. Read More

Authors:  Ramrattan Allister

Keywords:  Elbow ,  Lateral ,  Supracondylar

Harris Chris

Final Pr. ID: Poster #: EDU-012 (T)

Introduction:
Shared governance is a specific leadership style which incorporates commitment to the value of shared decision-making among key stakeholders around issues that affect the work environment. It also provides a dynamic staff-leader partnership that promotes collaboration, shared decision making and accountability for improving quality of care, safety and enhancing work life
Read More

Authors:  Harris Chris

Keywords:  Shared Goverance ,  Employee engagement ,  Professional Practice Model

Brinson Dana,  Butler Nikki

Final Pr. ID: Poster #: EDU-013 (T)

For pediatric patients, the hallway leading to a radiology imaging room may be just as anxiety-inducing as the exam itself. In an effort to counteract a child’s anxiety, rideable remote control cars were purchased to begin the distraction process at the child’s first step towards the Radiology Department. Read More

Authors:  Brinson Dana,  Butler Nikki

Keywords:  Customer Service

Flowers Colleen,  Kaplan Summer,  Zhu Xiaowei

Final Pr. ID: Poster #: EDU-014 (T)

The objective for a low dose imaging protocol was to eliminate patient risks and to reduce radiation doses. Tube placements are confirmed via imaging thereby avoiding utilization of malpositioned tubes. Reduced technical parameters lessen the absorbed skin dose. A limited field of view which includes distal espohagus and airway allows accurate assessment of feeding tube position. The new region of interest eliminates unnecessary exposure to hypersensitive organs including, thyroid and reproductive structures. This coned down view requires a lower image quality thereby allowing a lower dose approach. Read More

Authors:  Flowers Colleen,  Kaplan Summer,  Zhu Xiaowei

Keywords:  Low Dose Protocol ,  Feeding tube confirmation

Karl Barbara,  Sammet Christina,  Maher Caitlin

Final Pr. ID: Poster #: EDU-015 (T)

The goal of this study was to develop and share a consistent policy and procedure for the appropriate use of patient shielding in the pediatric environment. Education was developed to increase the level of awareness and skill sets to properly shield, or not shield, pediatric patients. The education was distributed to adult affiliated hospitals and within our institution to ensure consistency of care and safety measures. Read More

Authors:  Karl Barbara,  Sammet Christina,  Maher Caitlin

Keywords:  shielding ,  pediatric

Carson Robert

Final Pr. ID: Poster #: EDU-016 (T)

Review the set up for a pediatric MRU exam. I will identify what needs to be done to aquire optimal images and functional information. I will
also highlight challenges and pitt falls of the exam. Read More

Authors:  Carson Robert

Keywords:  MR Urogram ,  MRI Urogram ,  MRU

Kozak Brandi,  Chauvin Nancy,  Sankar Wudbav,  Back Susan

Final Pr. ID: Poster #: EDU-017 (T)

Evaluating the alignment and blood flow in the femoral head in patients with congenital hip dysplasia following reduction is essential to the treatment of dysplastic hips. Current practice involves an immediate postoperative contrast enhanced MRI of the casted child to identify hips that may be at risk for avascular necrosis. Contrast enhanced ultrasound (CEUS) is an emerging imaging modality that is feasible to evaluate the perfusion of the cartilaginous proximal femoral epiphysis intraoperatively, after hip reduction and prior to spica casting. This educational exhibit describes the procedure of intraoperative CEUS of the hip from the sonographers’ perspective. Read More

Authors:  Kozak Brandi,  Chauvin Nancy,  Sankar Wudbav,  Back Susan

Keywords:  Ultrasound ,  Contrast ,  Hip Dysplasia

Whitson Dawn

Final Pr. ID: Poster #: EDU-018 (T)

The purpose of this education is to describe Therapeutic Enema reduction of Intussusception using Hydrostatic and Pneumatic methods. The benefits of Delayed Repeated Enema (DRE) instead of immediate surgical intervention after a failed reduction will be reviewed. Read More

Authors:  Whitson Dawn

Keywords:  Intussusception