Almanza-aranda Judith

Final Pr. ID: Poster #: EDU-001 (S)

El circuito Fontan es el resultado de una serie de procedimientos paliativos que resultan en la anastomosis directa de las venas sistémicas a las arterias pulmonares, sin pasar por cavidades cardiacas. Los avances en las técnicas quirúrgicas han llevado a mejorar los resultados a largo plazo y una mayor esperanza de vida en los pacientes con corrección univentricular. Esto se debe en parte a las imágenes preoperatorias que identifican múltiples parámetros correlacionados con los resultados postquirúrgicos. La resonancia magnética cardiaca (RMC) ha sido utilizada con éxito durante años para evaluar pacientes con ventrículo único, es una excelente herramienta no invasiva para evaluar la anatomía, la función ventricular y el flujo. El propósito de este póster educacional es utilizar una presentación gráfica y cargada de imágenes de RMC de pacientes evaluados con circuito Fontan o pre Fontan para familiarizar al lector con las secuencias básicas y avanzadas utilizadas, las características anatómicas identificadas en los diferentes estadios de la cirugía, los cálculos hemodinámicos obtenidos a partir de las secuencias de contraste de fase y los tipos de anatomía linfática en los pacientes evaluados en nuestra institución. Read More

Authors:  Almanza-aranda Judith

Keywords:  Fontan ,  RMC ,  Anatomía linfática

Gramaglia Lucila

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

Las ciliopatás son un grupo de enfermedades que afcetan los genes que codifican proteínas que se localizan en los cilios primarios. Cualquier defecto en la estructura o en la función del cilio primario puede conducir a fenotipos quísticos. Dichos fenotipos son muy heterogéneos, y las características ciliopáticas pueden manifestarse por la variación de un solo lucus. En éste trabajo presentaremos un síndrome de Zellwger, entidad poco frecuente que se caracteriza por defectos en la migración neuronal, rasgos craneofaciales dismórficos, convulsiones, quistes renales y disfunción hepática. Read More

Authors:  Gramaglia Lucila

Keywords:  Zellweger ,  quistes ,  ecografía

Innocente Natalia,  Pelizzari Mario,  Perez Ricardo,  Ledesma Ricardo

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

Representa una de las patologías más requeridas en los exámenes de ultrasonido de la piel, solicitados por médicos pediatras clínicos o dermatólogos.
Habitualmente se realiza el diagnostico ecográfico ante la presencia de un nódulo cutáneo con calcificaciones; pero ello no es siempre así.
En este poster educativo, mostraremos los cinco (5) tipos de pilomatrixoma que se pueden identificar al ultasonido Doppler Read More

Authors:  Innocente Natalia,  Pelizzari Mario,  Perez Ricardo,  Ledesma Ricardo

Keywords:  Pilomatrixoma

Di Puglia Elazir,  Correa Joao Antonio,  Penna Claudia

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

-To review the etiopathogenesis of biliary atresia;
-To review the techinique, describing and ilustratins typical and atypical sonographic findings ob biliary atresia, comparing them to the normal anatomy, to help the radiologist in the differencial diagnosisof cholestasis;
-To correlate the sonographic findings with laparoscopic cholangiography. Read More

Authors:  Di Puglia Elazir,  Correa Joao Antonio,  Penna Claudia

Keywords:  cholestasis ,  biliary atresia ,  ultrasound

Zabala-travers Silvina,  Sattler Juan,  Perdomo Jose

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

Detailed understanding of complex patients in CT and MRI can be challenging, particularly to non-radiologists. 3D modeling is a new language available to radiologists through which relevant details from an imaging study can be presented to readers in a straight-forward, easier to interpret way. Our Innovation Department in Pediatric Radiology has included 3D models in current practice. We briefly present how this models are built, some cases and a short review of 3D models contribution to a better practice of medicine. Read More

Authors:  Zabala-travers Silvina,  Sattler Juan,  Perdomo Jose

Keywords:  3D modeling ,  patient-specific medicine ,  3D printing

Nketiah Linda,  Taragin Benjamin,  Silva Cicero,  Andronikou Savvas,  Otero Hansel

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

CT can be a powerful tool for the evaluation of the chest and abdominal pathology in children. While not as commonly used as in the USA, CT studies represented approximately 15% of cases received from low- and lower-middle income Countries for expert second opinion by a pediatric radiologist in the WFPI teleradiology platform, over the last 4 years. This pictorial review lists the indications, details the technical parameters, and exemplifies imaging findings of CT studies from this setting. Read More

Authors:  Nketiah Linda,  Taragin Benjamin,  Silva Cicero,  Andronikou Savvas,  Otero Hansel

Keywords:  Outreach ,  teleradiology ,  CT

Kinariwala Dhara,  Daugherty Reza,  Park Auh Whan

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

Comprehensive radiologic evaluation and accurate diagnosis of vascular malformations is vital to guide optimal treatment. Technical approaches and sclerotic agents used by interventional radiology vary by the type of malformation, anatomic location, and architecture of the malformation. Proper pre-procedural characterization of hard-to-treat lesions impacts procedural success and long-term outcomes.

Most vascular malformations located superficially on the extremities and trunk, and can be evaluated with ultrasound and color Doppler. However, evaluation can be complicated by unusual locations and difficulty in characterization, requiring MRI and/or MRA. We present interesting pediatric vascular malformations challenging for both imaging diagnosis and treatment.

The objectives of this poster include:
1. To review the classification and nomenclature of vascular malformations.
2. To present multimodal imaging findings of vascular malformations.
3. To discuss diagnostic imaging approaches of vascular malformations.modalities used.
4. To describe the treatment approaches for these malformations and outcomes including technical considerations and follow up. Read More

Authors:  Kinariwala Dhara,  Daugherty Reza,  Park Auh Whan

Keywords:  Vascular Malformations

Guillen Gutierrez Cinthia,  Rodriguez Garza Claudia,  De Luna Vega Raul,  Hernández Grimaldo Edgar,  Elizondo Riojas Guillermo

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

Vascular abnormalities are commonly observed in pediatric patients, with an estimated prevalence of at least 4.5%.
The current classification scheme for vascular anomalies was developed in 2014 by ISSVA (International Society for the Study of Vascular Abnormalities) and is based on the work of Mulliken and Glowacki of 1982.
This classification emphasizes the fundamental difference between vascular tumors and vascular malformations.
The diagnosis of vascular abnormalities is based on clinical history and physical examination.
US: Screening, proper characterization
TC: It allows assessing the extent of the lesion and the relationship with adjacent structures
MRI: It's the ideal imaging study and reflects its histological composition.

The most commons anomalies are:
Hemangiomas:
The most frequent vascular tumors are lobed and highly vascular lesions.
They have significant enhancement to the administration of contrast medium, but only moderate T2 hyperintensity that reflects their highly cellular nature.

Venous Malformation:
Malformed venous channels with slow blood flow with thrombosis and flebolite formation
Important, often heterogeneous and peripheral enhancement with central progression.
Hyperintense T2 signal reflects low cellularity

Lymphatic malformations:
Dilated lymphatic channels and cysts. They can be macro or microcystic
Macrocystic variants appear as cysts with a very bright T2 signal and minimal enhancement (if any), bleeding is a common complication with liquid-liquid level formation.

Arteriovenous Malformations:
The main finding is empty flow due to high flow, which infiltrate the tissues without evidence of a free mass.
There may be a mild enhancement and T2 hyperintensity that reflects tissue edema

Treatment:
In most cases, conservative treatment is recommended, but when a patient suffers from clinical complications sclerotherapy of the nidus becomes mandatory.
A multidisciplinary approach is needed.

Sclerosing agents
Alcohol 98%: Strong endothelial damage, high response rate, less expensive, easy to obtain. Painful during the procedure, high complication rate, penetrative effect on the deep vascular layer
Ethanolamine oleate: Excellent thrombogenic effect, chemical damage to the vascular wall, less toxic effect than absolute ethanol. It can induce acute renal failure due to hemolytic effect, less endothelial damage than absolute ethanol.
Polidocanol: Overhydration of endothelial cells, almost painless procedure. May induce reversible cardiac arrest Read More

Authors:  Guillen Gutierrez Cinthia,  Rodriguez Garza Claudia,  De Luna Vega Raul,  Hernández Grimaldo Edgar,  Elizondo Riojas Guillermo

Keywords:  Hemangioma ,  Lymphatic Malformation ,  Venous Malformation

Infante Ignacio,  Mackintosh Cecilia,  Anoni Clara,  Otero Eduardo,  Galeano Monica

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

The objective of this review is to summarize the earliest radiological findings of AMC (arthrogryposis multiplex congenital), detail the most frequently affected joints, identify associated syndromes, and expose the radiological findings in children whose therapy was delayed. Read More

Authors:  Infante Ignacio,  Mackintosh Cecilia,  Anoni Clara,  Otero Eduardo,  Galeano Monica

Keywords:  joint contractures ,  associated syndromes ,  pediatric radiology

Thapa Mahesh,  Ojeda Patricia,  Otjen Jeffrey,  Ngo Anh-vu,  Callahan Michael

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

The purpose of this educational presentation is to demonstrate ultrasound technique and characteristic sonographic findings of common superficial pediatric extremity soft tissue lesions. We also offer advice on how to differentiate benign from malignant lestions. Children frequently present with unexplained “lumps and bumps” on their extremities. These lesions are often invisible on radiography; MRI might require use of sedation; and CT exposes the child to radiation and often requires iodinated contrast. Ultrasound (US) is a cost-effective, radiation-free, and dynamic method to evaluate superficial soft tissue lesions.

We discuss choice of transducer based on lesion location. We explain why a multifrequency transducer, which allows for the evaluation of both superficial (higher frequency spectrum of the transducer) and deeper (lower frequency spectrum of the transducer) components of the lesion is important. The use of compound imaging is explained, as multiple angles of insonation are combined to provide a more complete image of the structure being interrogated. For lesions involving the hands or feet, we explain the water-bath technique. Water is an excellent medium for ultrasound waves and will minimize artifacts from air and inadequate surface contact that plague evaluation of the distal extremities.

We then discuss characteristic sonographic appearance of the following conditions: vascular anomalies, osteomyelitis and subperiosteal abscess, hematoma, subcutaneous granuloma annulare, Pilomatricoma, lipoma, ganglion and Baker cyst, muscle hernia, osteochondroma, foreign bodies, and malignant conditions. Read More

Authors:  Thapa Mahesh,  Ojeda Patricia,  Otjen Jeffrey,  Ngo Anh-vu,  Callahan Michael

Keywords:  ultrasound ,  benigh ,  malignant

Motta Giovanna,  Chiovatto Alessandra,  Chiovatto Eduardo,  Rocha Lucas,  Abdala João,  Iared Wagner

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

Hip ultrasonography is now considered the main method for screening, diagnosing and monitoring the treatment of development dysplasia of hip (DDH) in children, considering the advantages of the method and the excellent characterization of the anatomical elements of the infant hip which, at this stage of life, consists largely of cartilage. In 1980, Reinhard Graf, an Austrian pediatric orthopedist published child hip study work from about 20,000 stillbirths. He evaluated and studied through hip ultrasound the hip joint and determined in a single coronal section the hip classification. The purpose of this article is to explain in a didactic and detailed way the method of Graf, focusing on the reference points for its realization and proper interpretation. Read More

Authors:  Motta Giovanna,  Chiovatto Alessandra,  Chiovatto Eduardo,  Rocha Lucas,  Abdala João,  Iared Wagner

Keywords:  Hip Dysplasia ,  Ultrasonography ,  Graf Method

Almanza-aranda Judith,  Terrazas Estefania

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

Identificar los patrones anatómicos de afección de la mielina descritos por Loes y cols. mediante Resonancia Magnética.
Identificar las estructuras anatómicas y la localización de los tractos afectados para establecer el puntaje de severidad acorde a la escala de Loes. Read More

Authors:  Almanza-aranda Judith,  Terrazas Estefania

Keywords:  Loes ,  X-ADL ,  Resonancia Cerebral

Acosta-izquierdo Laura,  Dien-esquivel Maria,  Miller Elka,  Ferretti Emanuela,  Martinez-rios Claudia

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

Extremely low gestational age (ELGA) infants are those born before 23 + 6 weeks of gestation. These infants are prone to multiple complications. Frequent complications affect the brain. Transfontanellar brain ultrasound (US) is the standard of care imaging modality to assess the brain during the first weeks of life. An appropriate ultrasound technique includes assessment of the brain in gray scale, color and spectral Doppler. Doppler US should be interpreted in correlation with the neonate’s clinical and systemic hemodynamic state, postnatal age, blood gas concentrations, respiratory or cardiovascular complications, amongst others. Prior literature focuses on the sonographic characteristics of premature, near term and term infants. However, Doppler US characterization of the intracranial vessels of ELGA infants is lacking. The purpose of this exhibit is to describe the resistive index (RI) and peak systolic velocities (PSV) of the anterior cerebral artery and the PSV of the superior sagittal sinus of a cohort of ELGA infants, and to assess their correlation with complications encountered in these infants. Read More

Authors:  Acosta-izquierdo Laura,  Dien-esquivel Maria,  Miller Elka,  Ferretti Emanuela,  Martinez-rios Claudia

Keywords:  Brain Doppler ,  Resistive index ,  Prematurity

Acosta-izquierdo Laura,  Dien-esquivel Maria,  Miller Elka,  Ferretti Emanuela,  Martinez-rios Claudia

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

Extremely low gestational age (ELGA) infants are those born before 23 + 6 weeks of gestation. Continued advances on therapy and supportive care in the neonatal intensive units have allowed for an improved survival of these infants. Transfontanellar brain ultrasound (US) is the standard of care imaging modality to assess the integrity of the brain during the first weeks of postnatal life, as it provides a closer direct look to the brain. The purpose of this exhibit is to illustrate detailed US characteristics of the normal development and complications of the evolving premature brain of ELGA infants. Read More

Authors:  Acosta-izquierdo Laura,  Dien-esquivel Maria,  Miller Elka,  Ferretti Emanuela,  Martinez-rios Claudia

Keywords:  Brain anatomy ,  Prematurity ,  Neurodevelopment

Guillen Gutierrez Cinthia,  Rodriguez Garza Claudia,  Elizondo Riojas Guillermo,  Hernández Grimaldo Edgar,  Garza Acosta Andrea

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

Myelination it's a dynamic process through which a lipoprotein sheath that covers the axons develops. It begins at the 4th month of gestation and reaches its maximum at 24 months and occurs from caudal to rostral, from dorsal to ventral, from central to peripheral

Normal myelination by MRI

Sequences
T1 key sequence to evaluate myelination <1 year. The signal reflects the presence of proteins
T2 key sequence to evaluate myelination 1 and 2 years As the myelin sheaths thicken the surrounding interstitial water moves
FLAIR, DP, DTI complementary sequences

T1WI
RN Brain stem, optical tracts, anterior commissure, ventral thalamus, posterior limb of the internal capsule, rolandic and perirolandic gyrus
2 months deep white matter and anterior limb of internal capsule
4 months Splenium, optical radiations become more evident, cerebellar white matter
6 months Genu, body and splenus of the corpus callosum
8 months U fibers in occipital lobes progressing slowly to frontal and temporal at one year of age.
10-12 months Appearance of myelination with adult pattern in T1WI

T2WI
RN Dorsal brain stem, posterior limb of the internal capsule, ventral thalamus, perirolandic gyrus
2 months Posterior internal capsule arm, semiovale centrum and optical tracts
4 months Optical radiation and subcortical white matter
6 months Splenium
8 months Genu, body and splenic corpus callosum, anterior arm of the internal capsule
12 months cerebellar white matter and occipital subcortical U fibers
18 months Frontal white matter. Some residual hyperintense signals around the trigons of the lateral ventricles
36 months Myelination appearance with adult pattern in T2WI

Myelination Terminal Zones
Normal variant of development
Zones of incomplete myelination
Hyperintense, bilateral and symmetric foci in dorsolateral WM to the atrium of the lateral ventricle

Abnormal Patterns
Delayed myelination Situations in which myelination is slow but present.Usually bilateral and symmetric

Hypermyelination Rare pathology, it can be local or generalized. Sturge Webber, epilepsy and late sequelae of perinatal hypoxia.

Hypomyelinization Permanent deficit of the myelin deposit. Unlike the delay of myelination these do not present myelination over time
It can be seen as normal myelination in T1 but with deficit in T2

White matter diseases
Demyelinating diseases They are acquired and have destruction of normal myelin
Demyelinating diseases Hereditary enzyme deficiency that causes abnormal myelin formation, destruction or turnover Read More

Authors:  Guillen Gutierrez Cinthia,  Rodriguez Garza Claudia,  Elizondo Riojas Guillermo,  Hernández Grimaldo Edgar,  Garza Acosta Andrea

Keywords:  Development ,  white matter

Di Puglia Elazir,  Fazecas Tatiana,  Penna Claudia,  Porto Miriam,  Guedes Bianca,  Waksman Maria Gabriela

Final Pr. ID: Poster #: EDU-019 (S)

- To review the ethiopathogenesis of tuberculosis (TB);
- To discuss clinical and epidemiological variables, as well the radiological findings seen in radiography, ultrasound (US), computed tomography (CT) and magnetic resonance (MR) imaging performed due to clinical suspicion of TB;
- To review and widely ilustrated in this paper the imaging findings in TB.

Read More

Authors:  Di Puglia Elazir,  Fazecas Tatiana,  Penna Claudia,  Porto Miriam,  Guedes Bianca,  Waksman Maria Gabriela

Keywords:  Tuberculosis ,  disseminated ,  pulmonary

Guillen Gutierrez Cinthia,  Rodriguez Garza Claudia,  Elizondo Riojas Guillermo,  Hernández Grimaldo Edgar,  Garza Acosta Andrea

Final Pr. ID: Poster #: EDU-020 (S)

Cystic fibrosis (CF) is caused by autosomal-recessive mutations in the CF transmembrane regulator (CFTR) gene. Results in production of abnormally viscous mucus and secretions in the lungs of patients
It is the most common genetic disorder leading to chronic pulmonary disease in children.

In the lung, the cystic fibrosis transmembrane regulator (CFTR) is a protein responsible for efflux of chloride and inhibition of the sodium channel's activity which controls the influx of sodium. Pulmonary manifestations of CF includes
Bronchiectasis
Pneumothorax
Recurrent bacterial infection
Pulmonary arterial hypertension

Chest XRAY: is inferior to CT for the assessment of patients with known bronchiectasis. Nevertheless, radiography remains a useful modality for assessing the pulmonary complications associated with bronchiectasis, because of its low cost, availability, low radiation dose, and speed of acquisition

Brasfield scoring system
The score is based on conventional chest radiographic findings and has been reported to have good correlation with pulmonary function.
There is a maximum score of 25 with points subtracted based on the score from each of the following categories:

Air trapping: generalized pulmonary overdistension (sternal bowing, depression of diaphragms, or thoracic kyphosis)
Linear markings Linear opacification due to prominence of bronchi; may be seen as parallel line densities, branching, or “end-on” circular densities (bronchial wall thickening)
Nodular cystic lesions: multiple discrete rounded densities ≥0.5 cm in diameter, with either radiopaque or radiolucent centers (bronchiectasis); does not refer to irregular linear markings; confluent nodules not classified as large lesion
Large lesions: segmental or lobar atelectasis or consolidation, including acute pneumonia.
General severity: impression of overall severity on chest x-ray

HRCT has become indispensable in the monitoring of CF patients and is used to guide therapy and assess response to treatment, as it not only correlates with lung function tests.
Scans are repeated every 6 to 18 months depending on the clinical course.

BHALLA SCORE SYSTEM
Bhalla system can assess the degree of lung involvement and the evolution of the damages caused by lung disease based on various radiological findings. It values
Bronchiectasias
Peribronchial thickening
Extent of bronchiectasias
Extent of mucous plugs
Abscesses or sacculations
Bronchial generations affected
Number of bullae
Extent of emphysema
Collapse or consolidation Read More

Authors:  Guillen Gutierrez Cinthia,  Rodriguez Garza Claudia,  Elizondo Riojas Guillermo,  Hernández Grimaldo Edgar,  Garza Acosta Andrea

Keywords:  Chest CT ,  Chest Xray ,  Education

Ambrosio Miguel Angel,  Hidalgo-tobon Silvia

Final Pr. ID: Poster #: EDU-021 (S)

En este trabajo se expone la instrumentacion basica que tiene un equipo de resonancia magnetica. Los cables que pudieran utilizarse durante un estudio de RM, como oximetros, monitores fisiologicos, o dispositivos electronicos. Se explica la variacion de los campos magneticos de RF al utilizar secuencias de pulsos, el mecanismo de induccion de corriente en el tejido humano. Y se dan recomendaciones para prevenir accidentes y probables quemaduras asociadas a procedimientos mal realizados durante un estudio de RM. Read More

Authors:  Ambrosio Miguel Angel,  Hidalgo-tobon Silvia

Keywords:  safety ,  mri ,  MRI

Schaiberger Gregory,  Sharma Priya,  Rajderkar Dhanashree

Final Pr. ID: Poster #: EDU-022 (S)

The use of computed tomography (CT) in radiology has risen dramatically over the past 2 decades. Over 7 million pediatric CT studies per year are performed in the United States. Children are particularly at risk for the cumulative adverse lifetime effects of ionizing radiation. It is associated with a small but significant increase in lifetime risk of fatal cancer. For this reason, the campaign of “Imaging Gently” was created, whose purpose is to raise awareness of the opportunities to lower radiation dose in the imaging of children. Minimizing the dose in children is a high priority in pediatric radiology, and as a result the use of modalities utilizing non-ionizing radiation is encouraged.

For the reasons discussed above, ultrasound is often the first line tool in the diagnosis of pediatric emergencies. The purpose of this educational article is to further discuss “imaging gently” and the importance of utilizing non-ionizing radiation such as ultrasound to diagnose various pediatric emergencies. These emergencies include but are not limited to acute appendicitis, hypertrophic pyloric stenosis, intussusception, testicular torsion, and ovarian torsion. The imaging technique, pertinent findings, differential diagnosis, imaging pitfalls and treatment will be discussed. Image-rich examples of each diagnosis will be provided. Read More

Authors:  Schaiberger Gregory,  Sharma Priya,  Rajderkar Dhanashree

Keywords:  Ultrasound ,  Image ,  Gently