ISMRM21 - Antenatal & Pediatric MRI Challenges

Antenatal & Pediatric MRI Challenges

Weekend Course

ORGANIZERS: Dianna Bardo, Mary-Louise Greer

Sunday, 16 May 2021

Concurrent 1

14:30 - 15:15

Moderators:
Antenatal & Pediatric Renal & Abdominal: Claudia Hillenbrand & Minhui Ouyang
Antenatal & Childhood Cardiac & Spinal: Julio Garcia Flores & Elka Miller

Skill Level: Basic to Advanced

Session Number: WE-26

Parent Session: Antenatal & Pediatric MRI Challenges

Session Number: WE-26

Overview
This pediatric-concentration weekend educational course is designed to provide insights for managing the challenges of antenatal and pediatric patients with small anatomic parts who do not often willingly remain motionless for MRI exams.

The first half of the course covers topics in the antenatal and pediatric abdomen and pelvis: 1) Antenatal hydronephrosis and fetal intervention; 2) Neonatal and pediatric MR urography and renal perfusion; 3) Antenatal and neonatal cystic and solid masses; 4) SAM session on neuroblastoma diagnosis and staging.
The second half of the course will cover antenatal and pediatric congenital heart disease and spinal pathology: 5) Techniques in antenatal congenital heart disease imaging; 6) Neonatal and pediatric 4D flow and fractional flow reserve in MRI; 7) Antenatal spine anomalies with indications for fetal intervention; 8) SAM session on neonatal and pediatric spine pathology with CSF flow and spinal cord motion.

Target Audience
The target audience are pediatric radiologists, general radiologists, cardiologists, neurologists, and urologists interested in pediatric and obstetric imaging and MRI physicists caring for children.

Educational Objectives
As a result of attending this course, participants should be able to:
- Recognize a range of congenital and pediatric diseases;
- Explain the challenges of imaging small bodies and methods for improving image quality; and
- Critically analyze antenatal imaging and recognize potential for fetal surgical intervention.

	Antenatal & Pediatric Renal & Abdominal
		Antenatal Hydronephrosis with Fetal Intervention Watch the Video Mark Sugi, Mark Sugi Antenatal urinary tract dilation (UTD) occurs in 1-2% of fetuses and may be caused by multiple genitourinary anomalies, although mild forms are often transient. UTD can be detected as early as the first trimester as megacystis. Differential diagnosis for fetal UTD can be refined via assessment of the kidneys, ureters, bladder, sex, and amniotic fluid volume. Early detection allows for potential interventions aimed at increasing amniotic fluid volume to allow for critical pulmonary development. While UTD is often detected by ultrasound, fetal MRI has a role in further characterizing renal function and delineating the anatomy of complex urinary tract anomalies.
		Neonatal/Pediatric MR Urography with Renal Perfusion Watch the Video Cara Morin MRU provides a thorough anatomic and functional assessment of the urinary tract in children, allowing detailed evaluation of the renal parenchyma, collecting systems and ureters, and the bladder, while also providing both static and dynamic functional information. As such, MRU has the potential to be contributory to the evaluation of a wide variety of pediatric urologic abnormalities. With new motion-robust dynamic post-contrast sequences, quantitative assessment of renal perfusion is becoming increasingly accessible as a clinical technique.
		Antenatal/Neonatal Cystic & Solid Masses Watch the Video Teresa Victoria In this session we will review common and uncommon feral lesions of the chest, with postnatal follow up. Diagnosis pearls will be discussed with an emphasis on MR imaging. Also discussed will be cystic and solid lesions of the fetal abdomen, with postnatal follow up.
		Pediatric Neuroblastoma: Diagnosis & Staging Watch the Video Alexander Towbin Neuroblastoma is the most common extracranial soft tissue malignancy in children. In 2004, the International Neuroblastoma Risk Group (INRG) published a new staging system designed to standardize the presurgical staging of neuroblastoma. The INRG staging system developed a series of 20 different image-defined risk factors (IDRF) that confer additional surgical risk and upstage a patient from L1 to L2 disease. Radiologists should be familiar with the different IDRFs and the standard definitions used assess patients with neuroblastoma.
	Antenatal & Childhood Cardiac & Spinal
		Antenatal MR Techniques: Congenital Heart Disease David Lloyd
		Neonatal/Pediatric Cardiac 4D Flow & Fractional Flow Reserve Joshua Robinson
		Antenatal Spinal Pathology with Fetal Surgical Intervention Video Permission Withheld Usha Nagaraj This talk will review the pathology of open spinal dysraphism and Chiari II malformation, the current surgical techniques for repair and the imaging criteria for fetal surgery. Relevant imaging findings on fetal and postnatal MRI in this population will be reviewed.
		Neonatal/Pediatric Spinal Pathology Helen Branson