Buckland Christopher,  Potts James,  Mawson John,  Culham James

Final Pr. ID: Poster #: EDU-001

Abstract: The Ductus Arteriosus (DA) plays an important role during fetal circulation. Failure to close at birth is a common event. In this poster we demonstrate the many other roles of the DA in cardiovascular and pulmonary disease. These lesions may impact the systemic circulation, the pulmonary circulation, or the airway and include coarctation, ductus-dependent pulmonary artery, and vascular rings. Read More

Authors:  Buckland Christopher,  Potts James,  Mawson John,  Culham James

Keywords:  Ductus arteriosus ,  Fetal circulation ,  Medical imaging

Sideris Georgios,  Tenenbaum Mary,  Catanzano Tara

Final Pr. ID: Poster #: EDU-005

Embryogenesis is a complicated process that requires fine-tuning of multiple factors. Certain transient vestigial structures play a key role in the development and maturation of the developing organs. Persistence or incomplete regression of these primitive structures can give rise to numerous disease entities that may vary from incidental findings to potentially life-threatening conditions. Knowledge of these embryonic remnants is critical for radiologists, as they are encountered in daily practice and can often mimic other pathologies. The purpose of this educational material is to provide a comprehensive presentation of the most important embryonic remnants that radiologists and trainees need to be aware of. The structures that will be discussed, along with their related pathologies, include: aortic arches, cardinal veins, branchial arches, thyroglossal duct, thymopharyngeal duct, nasopalatine duct, Rathke’s cleft, allantois, vitelline duct, Mullerian duct, Wolfian duct, cloaca, notochord, neurenteric canal, falcine sinus, septum pellucidum and primary vitreous. Facts about their embryological background, anatomical location and clinical manifestations will be provided, as well as representative radiological images and differential considerations. Read More

Authors:  Sideris Georgios,  Tenenbaum Mary,  Catanzano Tara

Keywords:  Embryology

Aboughalia Hassan,  Oztek Murat Alp,  Noda Sakura

Final Pr. ID: Poster #: EDU-008

A whirlpool describes rotating water created by opposing currents or upon an encounter with an obstacle. On imaging, it refers to a twist of the vascular pedicle of an organ, with a subsequent characteristic appearance on color Doppler images. Multiple abdominal pediatric emergencies are associated with a whirlpool sign, including midgut and other intestinal volvulus, testicular torsion, and ovarian torsion. This exhibit aims to review the underlying embryologic mechanism predisposing to this characteristic appearance, the role of this sign in the diagnosis of these conditions, the supporting imaging features that can help further define the diagnosis, as well as some pitfalls and differential diagnoses that can lead to a fallacious diagnosis. Read More

Authors:  Aboughalia Hassan,  Oztek Murat Alp,  Noda Sakura

Keywords:  Whirlpool sign ,  Midgut malrotation ,  Testicular torsion

Canelas Caroline,  Kucera Jennifer

Final Pr. ID: Poster #: EDU-009

Meckel’s diverticulum is the most common congenital anomaly involving the omphalomesenteric duct. While patients may be asymptomatic, the clinical manifestations of Meckel’s diverticulum can be nonspecific, and the entity may be discovered only after the onset of complications. The purpose of this exhibit is to characterize the imaging manifestations of the different omphalomesenteric duct anomalies, with a focus on Meckel’s diverticulum, and describe their complications. Read More

Authors:  Canelas Caroline,  Kucera Jennifer

Keywords:  Omphalomesenteric Duct ,  Meckel's Diverticulum

Burger Matthew,  Lindsay Aaron

Final Pr. ID: Poster #: EDU-011

Educational goals: Highlight epidemiology, clinical presentation, radiographic findings, and treatment for common neonatal obstructions considered high in the intestinal tract including malrotation with midgut volvulus, duodenal atresia, duodenal web, annular pancreas, and proximal jejunal atresia.

Malrotation with midgut volvulus occurs when abnormally rotated and fixated small bowel twists about the superior mesenteric artery. This often presents with bilious vomiting in the first month of life and requires emergent surgical repair. Abdominal radiographs may be normal or show distention of the stomach and proximal duodenum with some distal bowel gas seen. An upper GI fluoroscopy exam (UGI) demonstrates a spiral/corkscrew sign or abrupt beaking with small bowel malrotation. Duodenal atresia is usually the result of incomplete recanalization of the duodenum. This presents at birth with abdominal distention and bilious or non-bilious vomiting depending on the segment of duodenum affected. Treatment is surgical resection of the atresia and reanastomosis. Classically on radiograph there is a double bubble sign, which may be seen on an antenatal ultrasound. Duodenal web results from an incomplete diaphragm/web within the lumen which causes intermittent complete or partial obstruction. There may be mild symptoms, or it may present similarly to duodenal atresia. It usually presents after the first week of life but may present in any age. Treatment is usually surgical or endoscopic resection. Abdomen radiographs may show mild proximal dilation or a double bubble sign distal bowel gas. UGI classically shows a windsock sign or duodenal dimple sign. Annular pancreas results from incomplete rotation of the ventral pancreatic bud leading to pancreatic tissue encasing the descending duodenum. The presentation and age of onset varies, in neonates and children it causes similar symptoms of duodenal obstruction. Cross-sectional imaging shows the duct draining the pancreatic head encircling the duodenum. Symptomatic cases of annular pancreas are usually treated surgically to alleviate obstructive symptoms. Jejunal atresia results from a vascular injury in utero causing one or more areas of stenosis/atresia. Proximal jejunal atresia presents with abdominal distention and bilious emesis. Abdominal radiographs classically show a triple bubble sign. Treatment is surgical resection of the involved segments of bowel. Read More

Authors:  Burger Matthew,  Lindsay Aaron

Keywords:  Bowel obstruction ,  Neonatal

Chilukuri Sanjeev,  Molleston Jean,  Karmazyn Boaz

Final Pr. ID: Poster #: EDU-013

Management of incidentally discovered pediatric liver lesions can be challenging. As compared with adults, no formal guidelines exist on this subject. Our purpose is to suggest an approach to the management of incidental pediatric liver lesions based on review of the literature and our institutional multidisciplinary experience.

Outline:
- Main considerations when evaluating incidental liver lesions in children (including age, alpha fetoprotein level, lesion size, imaging characteristics differentiating benign and malignant tumors, role of contrast-enhanced US, role of hepatobiliary contrast MRI)
- Suggested approach to the management of incidental liver lesions detected by US, CT, and MRI
- Examples of common incidental liver lesions (cyst, hemangioma, focal nodular hyperplasia, hepatocellular adenoma, focal fatty infiltration and sparing) Read More

Authors:  Chilukuri Sanjeev,  Molleston Jean,  Karmazyn Boaz

Keywords:  Incidental ,  Liver ,  Lesion

Khan Muhammad,  Prasad Preeti,  Sandhu Preet

Final Pr. ID: Poster #: EDU-014

Abnormalities of the portal venous system are a heterogenous group which include congenital anomalies and changes in portal vein secondary to iatrogenic causes or inflammatory and neoplastic conditions. Detailed knowledge of the normal embryology, anatomy of the portal vein and its variants is crucial in the understanding of portal vein anomalies. Identification of normal or variant portal vein anatomy is important part of pre surgical and pre liver transplant evaluation and helps minimize post-surgical/interventional complications. Read More

Authors:  Khan Muhammad,  Prasad Preeti,  Sandhu Preet

Keywords:  portal vein ,  congenital ,  anomalies

Obi Chrystal,  Nadel Helen,  Seekins Jayne

Final Pr. ID: Poster #: EDU-015

To identify patterns of calcifications and location on abdominal radiography to help diagnose their disease processes. We retrospectively reviewed abdominal x-rays with abnormal calcifications and correlated the findings with additional imaging such as ultrasound, CT or MR. We grouped calcifications by quadrant or diffuse to correlate with the differential diagnosis and disease process. Assessing the location and characteristics of calcifications on abdominal radiography can be highly useful in aiding in the formation of a differential diagnosis and guide next imaging steps. Read More

Authors:  Obi Chrystal,  Nadel Helen,  Seekins Jayne

Keywords:  Abdominal ,  Calcification

Collins Lee,  Pomeranz Christy,  Cohen Sara,  Baad Michael,  Kovanlikaya Arzu

Final Pr. ID: Poster #: EDU-016

Congenital portosystemic shunts represent a rare congenital malformation which diverts portal blood to the systemic circulatory system. These malformations can either be intrahepatic or extrahepatic. The intrahepatic portosystemic shunts have been classified into four types. Intrahepatic congenital portosystemic shunts demonstrates a persistent communication between the portal and hepatic venous structures, which were derived from the embryonic vitelline veins or between the vitelline and subcardinal veins. A ductus venosus, a normal structure in neonates, represents an intrahepatic congenital portosystemic shunt between the left portal vein and left hepatic vein. It typically closes between 2-17 days of postnatal life. In our institution, since April 2020, there have been five separate cases of intrahepatic congenital portosystemic shunts in newborns. We will review the imaging for each of these cases, as well as review the current literature and classification of portosystemic shunts. Read More

Authors:  Collins Lee,  Pomeranz Christy,  Cohen Sara,  Baad Michael,  Kovanlikaya Arzu

Keywords:  Portosystem Shunt ,  Liver ,  Ultrasound

Hodes Aaron,  Armenta Paul,  Levin Terry

Final Pr. ID: Poster #: EDU-018

Urachal remnants include patent urachus, urachal cyst, urachal sinus and urachal diverticulum. Clinical presentation is variable depending on the type of urachal remnant and the patient’s age. Infants with a patent urachus often present with persistent umbilical discharge or granuloma, while older patients may present with urinary tract infection, or inflammation of the urachal remnant mimicking appendicitis or other intraabdominal inflammatory process. Urachal remnants may also be incidental or may be associated with an existing syndrome such as Eagle Barrett Syndrome. In this presentation, to understand the derivation of the different types of urachal remnants, the embryologic development of the urachus and its relationship to the bladder and allantois is reviewed. Diagnostic ultrasonographic, fluoroscopic and CT images in patients with different types of urachal remnants are shown. Additionally, an unusual case of bladder prolapse presenting as an umbilical mass in a newborn with a patent urachus is presented. Read More

Authors:  Hodes Aaron,  Armenta Paul,  Levin Terry

Keywords:  Urachus ,  Bladder ,  Umbilicus

Montgomery Stormy,  Kodger Nicole,  Johnson Melissa,  Harris Kelly,  Tutman Jeffrey

Final Pr. ID: Poster #: EDU-020

Interrogation of the renal vasculature in the pediatric patient is challenging, requiring meticulous sonographic technique and attention to detail. Ultrasound, and Doppler sonography in particular, plays a key role in evaluation of suspected renal vascular abnormalities given its portability, availability, and lack of ionizing radiation. Attempts must be made to optimize the performance of this technically challenging examination. Additionally, the radiologist must be familiar with the frequently subtle findings in these examinations.

The purpose of this exhibit is the educate the audience on the proper performance and interpretation of renal Doppler ultrasound. We will first review the normal vascular anatomy of the kidney and normal arterial and venous waveforms. Sonographic technique will be reviewed, including tips and tricks for optimizing image acquisition and including a review of appropriate technique for color and spectral Doppler interrogation. A case-based pictorial review will then follow, including the following diagnoses:

1. Renal artery thrombosis
2. Renal vein thrombosis
3. Renal artery stenosis, including discussion of congenital vs. acquired causes and associated syndromes
4. Manifestations of systemic processes in the renal vasculature (including patent ductus arteriosis, aortic coarctation, and LVAD)
5. Spectrum of abnormal vascular findings in renal transplants
6. Pseudoaneurysm and AV fistula
7. Nutcracker syndrome Read More

Authors:  Montgomery Stormy,  Kodger Nicole,  Johnson Melissa,  Harris Kelly,  Tutman Jeffrey

Keywords:  Renal ,  Doppler ,  Ultrasound

Cielma Tara,  Adeyiga Adebunmi,  Bandarkar Anjum

Final Pr. ID: Poster #: EDU-022

Adnexal torsion is one of the most common gynecologic surgical emergencies. Delayed diagnosis could result in tissue necrosis, leading to loss of ovarian function and impaired fertility.

The goals of this exhibit are:
1. Review the anatomy of the female pelvis.
2. Discuss the incidence, risk factors, and clinical characteristics of adnexal torsion.
3. Describe the technical approach of performing pelvic ultrasound.
4. Illustrate the sonographic imaging spectrum of adnexal torsion.
5. Discuss diagnostic criteria of adnexal torsion. Read More

Authors:  Cielma Tara,  Adeyiga Adebunmi,  Bandarkar Anjum

Keywords:  adnexal torsion ,  ovarian torsion ,  fallopian tube

Dickson Paula,  Braithwaite Kiery,  Richer Edward

Final Pr. ID: Poster #: EDU-025

To review the anatomy of the Space of Retzius and to highlight the array of disorders that can occur in this space in the pediatric population. These disorders present as abdominal pain and might be missed or misdiagnosed without paying attention to this space and knowing the differential and differentiating factors of pathology that are found there. Read More

Authors:  Dickson Paula,  Braithwaite Kiery,  Richer Edward

Keywords:  Retzius

Infante Juan

Final Pr. ID: Poster #: EDU-026

Renal dysfunction in a transplant kidney is a common clinical problem which is usually attributed to either rejection or arterial stenosis. While the overall incidence of transplant renal artery stenosis is low, the question of stenosis remains after Doppler examinations although abnormal Doppler ultrasounds are often later proven to be false positives. In the author's experience, these false positive cases are almost always associated with high correction angles (at or near 60 degrees). Conversely, repeating a positive Doppler study by maneuvering the transducer to produce a lower correction angle often resolves the apparently elevated velocity.

A contributing factor to the usage of high correction angles is the actual angle of takeoff of the transplant renal artery relative to the external iliac artery. This can make performing the study with a low correction angle a physically challenging task for the sonographer. Nevertheless, proper effort when scanning these cases is indicated to save the patients from unnecessary follow-up studies and possibly unnecessary invasive procedures.


This educational exhibit aims to address the following learning points:

1) The basis for avoiding high correction angles can be traced to back to basic trigonometric principles which we must keep in mind during image acquisition and interpretation
2) The mechanism for false positive Doppler studies in post-transplant renal artery stenosis is often an unnecessarily high Doppler correction angle
3) Repeating a positive Doppler study with the aim of minimizing the correction angle through optimal probe placement can help avoid unnecessary further testing including possibly invasive procedures
4) The angle of takeoff and variable trajectories of transplant renal arteries can pose difficult physical and cognitive problems for the ultrasound operator Read More

Authors:  Infante Juan

Keywords:  renal artery stenosis ,  renal transplant ,  Doppler

Della Grotta Lynn,  Koberlein George

Final Pr. ID: Poster #: EDU-027

Cystic pelvic masses can represent a diagnostic challenge with its broad spectrum of differentials ranging from benign to malignant. Ultrasound is often the preliminary evaluation with MRI a next step when more information is needed. Proper diagnosis provides guidance to the clinical team with management ranging from watchful waiting to surgery. This poster will use a case-based approach to review the variety of cystic pelvic masses in pediatric patients, discuss salient imaging features, an approach to imaging workup, and treatment and prognosis. Read More

Authors:  Della Grotta Lynn,  Koberlein George

Keywords:  Pelvic ,  Cystic Mass ,  Pediatric

Betz Lisa,  Dillman Jonathan,  Jones Blaise,  Tkach Jean

Final Pr. ID: Poster #: EDU-029

After reviewing this educational exhibit, radiologists and trainees will have up-to-date knowledge about magnetic resonance imaging (MRI) safety in children with implanted medical devices. The following will be presented: 1) Basic MRI physics relating to safety risks in the presence of implanted (passive and active) medical devices, 2) MR Safety screening challenges specific to children, and 3) Review of newly developed or updated medical devices that present challenging pediatric MRI safety scenarios.

MRI is the imaging modality of choice for assessing many pediatric conditions, providing excellent anatomic and pathologic detail without the use of ionizing radiation. However, there are significant potential hazards in the MR environment related to the static magnetic field and the spatial and time varying gradient fields, as well as the impact of radiofrequency pulses. These concerns may be further complicated/exacerbated by the presence of implanted medical devices.

This educational exhibit will focus on reducing risk for children with implanted medical devices in the MR environment. Such devices may be subject to projectile/torsion forces, induced currents, and heating risks. Barriers to effective screening include limited MRI safety information for new passive and active implanted medical devices, incomplete documentation and patient/family education, and limited referring clinician awareness of potential safety risks. The use of sedation/anesthesia in pediatric patients reduces the ability to detect discomfort during MR imaging. Read More

Authors:  Betz Lisa,  Dillman Jonathan,  Jones Blaise,  Tkach Jean

Keywords:  Implanted medical devices ,  Magnetic resonance imaging ,  Pediatric

Baijal Neha,  Gupta Amit,  D S Dheeksha,  Singh Shivani,  Jana Manisha

Final Pr. ID: Poster #: EDU-030

Congenital urethral anomalies comprise a wide spectrum of developmental disorders. Conventional imaging such as contrast voiding cystourethrography (VCUG) and retrograde urethrography (RGU) are still the first radiological investigations for diagnosis, pre-operative planning based on visualization of urogenital anatomy, and postoperative follow-up.
An understanding of the embryological origin of the urogenital tract is essential for the radiologist to correctly diagnose urethral anomalies. Urogenital sinus is the precursor of bladder, female urethra and posterior urethra in males, which is separated from the hindgut by the urorectal septum. A defect in this septum can give rise to a myriad of anorectal malformations. The anterior urethra in males is derived from fusion of the ventral urethral folds. Any abnormality in proliferation, fusion or canalisation of these embryological structures leads to various congenital anomalies.
Sterile technique and periprocedural antibiotics are essential to avoid introducing or exacerbating urinary tract infection, which can be catastrophic in a child with reflux or bladder outlet obstruction. RGU is typically performed prior to a VCUG.The urethra is cannulated and an iodinated contrast agent such as urografin is injected under fluoroscopic guidance for the evaluation of anterior urethra. The bladder is then catheterised and filled to age-appropriate capacity. The child is allowed to micturate after removal of the catheter to obtain voiding films for evaluation of posterior urethra, and vesicoureteral reflux. A post-void film to look for residual contrast in the bladder completes the study.
In this exhibit, after a review of the embryology and anatomy of the urogenital system, we describe the technique, indications and contraindications of conventional urethrography. This will be followed by a discussion of clinicoradiological features of urethral pathologies in children, including urethral valves, diverticula, megalourethra, Mullerian remnants, persistent cloaca, and syndromic conditions such as Prune belly syndrome. Normal variants and imaging pitfalls will also be discussed.
Conventional urethrography is an age-old, yet simple and useful technique for the evaluation of the pediatric urogenital tract. We revisit this technique and describe its utility in diagnosis and follow-up of urethral anomalies in children. Read More

Authors:  Baijal Neha,  Gupta Amit,  D S Dheeksha,  Singh Shivani,  Jana Manisha

Keywords:  retrograde urethrogram ,  voiding cystourethrogram ,  conventional urethrography

Henry M Katherine,  White Ammie,  Servaes Sabah,  Wood Joanne

Final Pr. ID: Poster #: EDU-031

Infants are at risk for fatal physical abuse yet may present to care multiple times with inflicted trauma before abuse is diagnosed and the infant is protected. Prompt identification of at-risk infants is essential to protection from ongoing abuse. Sentinel injuries are unexplained minor injuries in young infants that are appreciable on physical exam. Examples of sentinel injuries include bruising, subconjunctival hemorrhages, and intra-oral trauma. These injuries can be a subtle external sign of concurrent clinically occult internal injuries (e.g., skeletal, abdominal, intracranial injuries) in a well-appearing infant or may be an early warning that foretells more significant trauma in the future. Identification and evaluation of these infants with appropriate imaging has been highlighted as one approach to ensure that abuse is promptly detected, injuries are addressed, and the infant is protected.

In this multidisciplinary educational presentation made in collaboration with child abuse pediatricians and pediatric radiologists, we will: (1) review different types of sentinel injuries; (2) discuss current evidence and guidance for performance of imaging (skeletal survey, abdominal CT, neuroimaging with MRI or CT) when a sentinel injury is identified; (3) discuss the interpretation and significance of imaging findings; (4) provide imaging examples of these injuries; and (5) discuss gaps in the literature while highlighting opportunities for collaboration between child abuse pediatricians and pediatric radiologists to improve the care of these infants.

Following completion of this educational module, our goals are that the participant will better understand the clinical context of sentinel injuries and have a baseline knowledge to make an appropriate imaging plan for these infants. Read More

Authors:  Henry M Katherine,  White Ammie,  Servaes Sabah,  Wood Joanne

Keywords:  Child Abuse ,  Sentinel Injuries ,  Skeletal Survey

Malkawi Ibraheem,  Bloom David,  Hryhorczuk Anastasia

Final Pr. ID: Poster #: EDU-036

Describe the normal anatomic appearance and anatomic variants of the pediatric coracoid process with representative images.
Evaluate the radiologic fracture patterns and fracture mimics of the pediatric coracoid process with representative images.
Review additional pathology of the pediatric coracoid process that can present incidentally after trauma

Included topics :
I Coracoid process anatomy
Normal pediatric development/ossification
Developmental variations
Associated anatomic structures

II. Sequelae of coracoid process trauma
Multimodality imaging—radiography, CT, MRI
Pediatric fracture patterns
Mimics of fractures

III. Incidental findings of the coracoid process
Neoplasm
Other Read More

Authors:  Malkawi Ibraheem,  Bloom David,  Hryhorczuk Anastasia

Keywords:  shoulder anatomy ,  coracoid process ,  trauma

Lankester Evelyn,  Graeber Brendon

Final Pr. ID: Poster #: EDU-038

Chronic non-infectious osteomyelitis (CNO) is an autoinflammatory disorder of unknown etiology that is characterized by sterile, painful, and destructive bone lesions and has its peak incidence in childhood. Its presentation can be highly variable, and when children present with solitary lesions having an indolent course, the clinical picture and imaging features at presentation can overlap with those of Ewing sarcoma (EWS), a rare, highly malignant, primary pediatric bone tumor with a poor prognosis. Osteomyelitis is a known imaging mimic of EWS, but CNO poses a particular problem because a lack of clinical markers usually indicative of infection can cause the disease to be mistaken for a malignancy at clinical workup as well as imaging. A misdiagnosis between these two diseases may have serious repercussions for treatment and clinical course with potentially devastating effects on patient outcomes. Read More

Authors:  Lankester Evelyn,  Graeber Brendon

Keywords:  CNO ,  Ewing´s Sarcoma

England Elizabeth,  Snyder Elizabeth,  Pastakia Devang,  Pruthi Sumit,  Sarma Asha

Final Pr. ID: Poster #: EDU-043

The phakomatoses are neurocutaneous disorders arising from the abnormal development of cells of embryonic ectodermal and mesodermal origin. Although commonly involving central nervous system and cutaneous structures, these disorders can also involve the visceral organs, vascular system, and connective tissue. There are over 30 neurocutaneous entities, each with unique genetic and physical manifestations. Clinical diagnosis may be challenging, as the physical and imaging expressions of disease are variable and broad. Importantly, many affected individuals may present with less common manifestations of disease, and furthermore, less common disorders may be difficult to recognize.

The goals of this educational exhibit are to: 1) Review the pathogenesis, genetic underpinnings, and clinical features of phakomatoses. 2) Emphasize lesser-known imaging manifestations of more commonly encountered phakomatoses (e.g., cortical dysplasia in NF2). 3) Detailed review of imaging manifestations of less common phakomatoses (e.g., Parry-Romberg syndrome).

Covered conditions will include commonly encountered phakomatoses (neurofibromatosis types 1 and 2, tuberous sclerosis, Sturge-Weber syndrome, Von Hippel Lindau disease etc.), and less commonly encountered entities such as basal cell nevus syndrome and other phakomatosis groups such as vascular phakomatoses (e.g, hereditary hemorrhagic telangectasia, PHACE syndrome, meningioangiomatosis, diffuse neonatal hemangiomatosis); melanophakomatoses (e.g., neurocutaneous melanosis, incontinentia pigmenti); and overgrowth syndromes (PTEN hamartoma tumor syndromes). Read More

Authors:  England Elizabeth,  Snyder Elizabeth,  Pastakia Devang,  Pruthi Sumit,  Sarma Asha

Keywords:  Phakomatosis ,  Neurocutaneous disorder

Trofimova Anna,  Reddy Kartik,  Bajaj Manish,  Goldman-yassen Adam

Final Pr. ID: Poster #: EDU-046

A broad spectrum of intracranial cysts and cystic-appearing lesions exist with unique imaging and pathologic characteristics. Some cysts have a predilection for certain intracranial locations, which, in combination with specific imaging features, can help point towards a particular pathology and, in some cases, associated syndromes. Herein, we describe a pattern-based approach for evaluation of intracranial cysts and cystic lesions in order to narrow the differential diagnosis and assist in diagnosing an associated syndrome. Cyst pathologies to be discussed include: Arachnoid cysts, dermoid/epidermoid cysts, subependymal cysts, connatal cysts, cystic encephalomalacia, neuroglial cyst, perivascular spaces, choroid plexus cysts, and choroidal fissure cysts. Syndromes and conditions to be discussed include: Aicardi Syndrome (interhemispheric cysts), congenital muscular dystrophy (cerebellar cysts), congenital CMV (anterior temporal cysts), Zellweger syndrome (caudothalamic groove cysts), Glutaric Aciduria type 1 (middle cranial fossa cysts), and trisomy 18 (choroid plexus cysts). By being familiar with the pattern-based approach to characterization of the intracranial cystic lesions, radiologists can hone their differential diagnoses and differentiate benign/incidental lesions from ones that signify a broader pathology. Read More

Authors:  Trofimova Anna,  Reddy Kartik,  Bajaj Manish,  Goldman-yassen Adam

Keywords:  Cyst ,  Brain ,  Neuroradiology

Defendi Larissa De Andrade,  Sbardelotto Monique,  Rodriguez Larry Marden Rabindranath Alpaca,  Tostes Rodrigo De Oliveira,  Camargo Marcos,  Monteiro Soraya,  Regacini Rodrigo

Final Pr. ID: Poster #: EDU-047

Computed Tomography (CT) is still recommended as the first-line imaging method for the evaluation of premature closure of cranial sutures.
The aims of this exhibit are:
1. To present the anatomy and physiology of cranial sutures;
2. To discuss technical aspects of CT imaging and structured report in craniosynostosis;
3. To present the main imaging findings of isolated and syndromic craniosynostosis.
Teaching cases from our institution will be employed to illustrate the following topics:
1. Cranial sutures: anatomy and time of closure;
2. Imaging evaluation of cranial sutures: sonography (US), radiograph (XR) and CT - technique and protocols;
3. Recognizing a patent suture and distinguishing a normally closed suture from synostosis;
4. Craniosynostosis: pathophysiology, clinical features and associated genetic conditions;
5. Multi-modality imaging appearance of:
- Dolichocephaly;
- Brachycephaly;
- Trigonocephaly;
- Posterior plagiocephaly.
6. The role of imaging in evaluating positional plagiocephaly
7. Syndromic craniosynostosis - main CT imaging features of:
- Crouzon syndrome
- Apert syndrome
- Pfeiffer syndrome
- Saethre-Chotzen Syndrome
8. What matters for surgery planning? Tips on how to organize your report. Read More

Authors:  Defendi Larissa De Andrade,  Sbardelotto Monique,  Rodriguez Larry Marden Rabindranath Alpaca,  Tostes Rodrigo De Oliveira,  Camargo Marcos,  Monteiro Soraya,  Regacini Rodrigo

Keywords:  Craniosynostosis

Du Tianyi,  O'brien William

Final Pr. ID: Poster #: EDU-048

This educational exhibit will provide an illustrative review of the following orbital and intracranial complications of sinusitis in children:
Post-septal orbital cellulitis
Ophthalmic vein thrombosis
Cavernous sinus thrombosis
Epidural abscess
Subdural empyema
Meningitis
Cerebritis
Brain abscess
Pott Puffy Tumor Read More

Authors:  Du Tianyi,  O'brien William

Keywords:  CT ,  MR ,  MRI

Bajaj Manish,  Reddy Kartik,  Goldman-yassen Adam,  Trofimova Anna

Final Pr. ID: Poster #: EDU-049

Hypertrophy of inferior olivary nucleus may result from a varied spectrum of pathologies affecting the neuronal connections of the dentato-rubro-olivary pathway. This has been previously extensively described in adult patients as a result of various etiologies. We intend to elaborate on pediatric causes of hypertrophic olivary degeneration including infarction, neoplastic, demyelinating and infective pathologies as the underlying disorder with a few representative cases where available. A detailed explanation of underlying neuronal disruption responsible for this unique imaging finding will also be presented including diagrammatic illustration. Read More

Authors:  Bajaj Manish,  Reddy Kartik,  Goldman-yassen Adam,  Trofimova Anna

Keywords:  Hypertrophic ,  olivary ,  Mollaret

Gagnon Marie-helene,  Parikh Ashish,  Taylor Susan,  Derenoncourt Paul-robert,  Ponisio Maria,  Khanna Geetika

Final Pr. ID: Poster #: EDU-050

Germ cell tumors of childhood are most often gonadal in origin. Extragonadal germ cell tumors are located characteristically in the midline arising intracranially, in the mediastinum, pelvis or retroperitoneum. These tumors are generally easily diagnosed due to typical sites of origin and characteristic imaging findings.

However, germ cell tumors can be associated with unusual clinical syndromes or imaging features that can perplex the clinician/radiologist.

We will review and illustrate atypical imaging/clinical manifestations and complications of germ cell tumors in childhood, based on our experience at two large children’s hospitals.

These atypical findings include:
Atypical metastatic disease: a) Burned out tumor – Testicular primary not typically evident with viable metastatic disease in retroperitoneal lymph nodes distant viscera, b) Growing teratoma syndrome (increasing size of tumor/pseudoprogression despite appropriate therapy), c) gliomatosis peritonei (maturation into glial tissue during therapy with pseudoprogression on FDG-PET), d) ossified pulmonary metastasis mimicking granulomas

Antibody mediated paraneoplastic syndromes: a) anti–N-methyl-D-aspartate (NMDA)– receptor antibody–mediated encephalitis associated with ovarian teratomas, b) anti-Ma2 antibody-mediated encephalitis associated with testicular germ cell tumors
Endocrine manifestations: a) Precocious puberty/gynecomastia due to hormonal (hCG) production, b) hyperthyroidism (TSH stimulation and struma ovarii)

Local complications: a) ovarian torsion (common), b) ruptured teratoma or dermoid cyst (uncommon)

Unusual primary tumors: a) Multifocal primary (e.g. pineal and suprasellar germinoma), b) Currarino triad, c) fetus-in-fetu, d) malignant transformation Read More

Authors:  Gagnon Marie-helene,  Parikh Ashish,  Taylor Susan,  Derenoncourt Paul-robert,  Ponisio Maria,  Khanna Geetika

Keywords:  growing teratoma ,  gliomatosis peritonei ,  NMDA encephalitis

Siu Navarro Youck Jen,  Poletto Erica,  Malik Archana,  Koenigsberg Robert

Final Pr. ID: Poster #: EDU-053

Congenital tumors represent only 1.5–2% of all pediatric tumors, with a prevalence of 1:12,500 to 1:27,500 live births. Tumors are considered congenital when detected during pregnancy or in the first 3 months of life (1). Nowadays, with more accessible prenatal care and fetal imaging, these tumors can be detected very early during fetal period. Some lesions are benign, while others carry high risk of morbidity and mortality postnatally. As a radiologist, it is important to be familiar with these tumors by recognizing their imaging features, imaging modality work up and differential diagnosis. Doing so, we contribute to a proper imaging evaluation, early diagnosis and management.

The objectives of this educational exhibit are:
-To describe the imaging features of some congenital tumors on different image modalities.
-To recognize and emphasize the key radiologic findings of each tumor and their differential diagnoses.
-To briefly review the literature, including etiology, epidemiology, cytopathology characteristics, diagnosis and treatment.

Pictorial cases from our Radiology Department will be used to describe the imaging features of the following entities:

1) Head/Neck:
● Atypical teratoid/rhabdoid tumor (ATRT)
● Cervical teratoma
● Hemangioma

2) Chest:
● Neuroblastoma
● Cardiac rhabdomyoma

3) Abdomen- Pelvis:
● Hepatic hemangioendothelioma
● Hepatic hemangioma
● Neuroblastoma
● Mesoblastic nephroma
● Sacrococcygeal teratoma

4) Soft tissues:
● Infantile fibrosarcoma

5) Systemic:
● Leukemia Read More

Authors:  Siu Navarro Youck Jen,  Poletto Erica,  Malik Archana,  Koenigsberg Robert

Keywords:  congenital tumor ,  neonatal tumors

Khumalo Zonah

Final Pr. ID: Poster #: EDU-061

Disorders of the large airways occur frequently in the pediatric population.
Affected pediatric patients typically present with symptoms related to airway obstruction, including stridor, wheezing and dyspnea.
Infants and children are particularly vulnerable to respiratory compromise because of the smaller size of their airways.
As radiologists, we are pretty good at commenting on the lungs, pleural spaces and cardiomediastinal contours, but we often neglect or forget to take a look at the airways.

By definition, the upper airways are the air passages from the nasal cavity to the cervical trachea above the thoracic inlet. The lower airways begin below the thoracic inlet and include the thoracic trachea and bronchi. The spectrum of airways disorders is vast and includes both upper and lower airways anomalies, which can be congenital or acquired.

This educational exhibit will review the imaging findings of congenital lower airways anomalies, both on conventional radiography and cross-sectional imaging. I will also highlight radiographic features suggesting large airway pathology.

The following congenital lower airways anomalies will be reviewed:

Laryngeal cleft
Tracheal bronchus
Congenital tracheal stenosis
Congenitally short trachea
Congenital bronchial stenosis
Tracheobronchomalacia
Bronchial agenesis/hypoplasia/aplasia Read More

Authors:  Khumalo Zonah

Keywords:  congenital ,  lower ,  airways

Prasad Preeti,  Khan Muhammad,  Maller Vijetha

Final Pr. ID: Poster #: EDU-062

Congenital anomalies of lungs are heterogenous group of developmental disorders which vary widely in their clinical manifestations, imaging appearance and pathology, but with a considerable overlap. There has been substantial improvement in our understanding of these lesions due to advances in prenatal and postnatal imaging. The purpose of this educational exhibit is to describe the radiological appearance of various congenital lung abnormalities and facilitate our fellow radiologists to accurately diagnose these anomalies and contribute to the patient management. Read More

Authors:  Prasad Preeti,  Khan Muhammad,  Maller Vijetha

Keywords:  pulmonary ,  anomalies ,  congenital

Nguyen Derek,  Dunn Emily

Final Pr. ID: Poster #: EDU-063

Children and young adults occasionally present with breast complaints in the emergency setting, typically with palpable abnormalities or pain. Ultrasound is the imaging of modality of choice in this setting due to its wide availability, resolution for superficial soft tissue structures, and lack of ionizing radiation. In this presentation, we review breast lesions seen in children and young adults undergoing sonographic evaluation in the emergency department at a tertiary pediatric hospital with the final diagnosis. The aim of this exhibit is to review pediatric breast anatomy and depict representative ultrasound imaging features of normal variants, benign lesions, and findings which should raise suspicion for malignancy. Cases will include but not limited to: premature glandular tissue, ductal ectasia, breast edema, breast cellulitis, breast abscess, periductal mastitis, complicated cyst, intraductal papilloma, fibroadenoma, phyllodes tumor, and breast cancer. Read More

Authors:  Nguyen Derek,  Dunn Emily

Keywords:  Emergency ,  Breast ,  Ultrasound