View Presentation Video

Sevgi Gokce Kafali^1,2, Bradley D. Bolster Jr.³, Shu-Fu Shih^1,2, Timoteo I. Delgado^1,4, Xiaodong Zhong⁵, Vibhas Deshpande⁶, Timothy R. Adamos⁷, Shahnaz Ghahremani^1,7, Kara L. Calkins⁷, and Holden H. Wu^1,2,4
1Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States, ²Bioengineering, Henry Samueli School of Engineering, University of California, Los Angeles, Los Angeles, CA, United States, ³US MR R&D Collaborations, Siemens Medical Solutions USA, Inc., Salt Lake City, UT, United States, ⁴Physics and Biology in Medicine Interdepartmental Program, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States, ⁵US MR Collaborations, Siemens Medical Solutions USA, Inc., Los Angeles, CA, United States, ⁶US MR Collaborations, Siemens Medical Solutions USA, Inc., Austin, TX, United States, ⁷Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States

Keywords: Elastography, Liver

Hepatic stiffness measured by MR elastography (MRE) is a biomarker for fibrosis. Standard liver MRE requires breath-holding (BH) to avoid motion artifacts, but BH is challenging for children. Radial free-breathing (FB) MRE can overcome this challenge but requires longer scan times. Radial FB-MRE using rapid wave encoding decreases the scan time and self-navigation supports motion compensation. With the help of fractional encoding to reduce echo times, image quality can be further improved. This work demonstrated that self-navigated rapid and rapid fractional FB-MRE methods measure hepatic stiffness with close agreement and similar repeatability compared to corresponding BH-MRE in children at 3T.

View Presentation Video

Ali B Syed¹ and Praveen Jayapal^2
1Department of Radiology, Stanford University, Redwood City, CA, United States, ²Department of Radiology, Stanford University, Palo Alto, CA, United States

Keywords: Body, Diffusion/other diffusion imaging techniques

Simultaneous Multislice (SMS) techniques can reduce scan time without significant impact on image quality. SMS techniques rely on coil geometry, which can be unfavorable in pediatric patients due to large variations in size. At the same time, pediatric imaging often demands minimizing scan time to increase patient compliance and reduce exposure to sedating medications. We evaluate the use of SMS diffusion weighted imaging applied to pediatric abdominal DWI and show that image quality is similar to standard DWI but with significant reduction in scan time. ADC values are not significantly affected. 

View Presentation Video

Xiamei Zhuang¹, Ke Jin¹, Yan Yin ¹, Junwei Li¹, and Huiting Zhang^2
1Hunan Children's Hospital, Changsha, China, ²MR Scientific Marketing， Siemens Healthineers, Wuhan, China

Keywords: Body, Bone

Cortical bone can be clearly displayed by CT-like MRI using ultrashort TE sequence. This study aimed to investigate the value of CT-like MRI using PETRA (ct-PETRA) sequence in the pediatric musculoskeletal diseases. Our results showed that ct-PETRA had no significant difference in measuring the C-E index and acetabulum index of children's hip joint compared with X-ray, and had no significant difference in visualization of lesions compared with X-ray and CT. Moreover, ct-PETRA has more advantages than X-ray in displaying trabecular fracture of fine bone. CT-like PETRA can be used as conventional complementary sequence for some assessments of pediatric musculoskeletal diseases.

View Presentation Video

Hang Su¹, Gang Zhang¹, Jingjing Wu¹, Wei Xing¹, Yufu Hu¹, Zhiwei Shen², Ke Jiang², Yuying Sun¹, Xia Zhang¹, and Xianqing Ren^1
1The First Affiliated Hospital of Henan University of CM, Zhengzhou, China, ²Philips healthcare, Beijing, China

Keywords: Adolescents, Kidney

Blood oxygen level dependent magnetic resonance imaging (BOLD-MRI) could be used to detect renal tissue oxygen levels noninvasively, and the T2* time induced by the paramagnetic effect of deoxyhemoglobin can be obtained to indirectly assess blood oxygen utilization. Previous research has proven that BOLD-MRI can detect renal oxygenation levels with high sensitivity and the accuracy of the data has been validated by invasive probe measuring techniques. In this work, we investigated the clinical feasibility of T2* mapping for the detection of HSPN and HSP in children, since we predicted that HSPN would also result in aberrant renal blood oxygenation signals.

View Presentation Video

Suraj D Serai^1,2, Hansel J Otero^1,2, Tatiana Morales-Tisnes¹, Mohamed M Elsingergy¹, Tricia Bhatti¹, and Bernarda Viteri^1
1Children's Hospital of Philadelphia, Philadelphia, PA, United States, ²Radiology, University of Pennsylvania, Philadelphia, PA, United States

Keywords: Kidney, Elastography, transplant

MRE can propagate shear waves which can provide better estimates of stiffness of smaller and deeper structures. Here, we found a positive correlation between kidney elasticity and the presence of histological fibrosis where stiffness values tended to be higher in fibrosed allografts than stable or native kidneys. If clinically approved, elastography would  not only be useful for early detection of interstitial fibrosis and tubular atrophy in renal transplants, which would individualize the need for immunosuppression therapy, but could also be used as a screening tool to evaluate fibrosis in potential donors to identify best candidates prior to the transplantation procedure.

View Presentation Video

Victor Murray¹, Syed Siddiq¹, Gerald Behr², and Ricardo Otazo^1,2
1Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States, ²Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States

Keywords: Body, Machine Learning/Artificial Intelligence

Motion remains a significant challenge in pediatric MRI. Motion-resolved 4D MRI, such as XD-GRASP, is a promising alternative to motion correction. However, long scan times and particularly reconstruction times restricted routine clinical use. This work presents a deep learning approach called MRI-movienet for 4D reconstruction of radial data, which enables acceleration of both acquisition and reconstruction for free-breathing pediatric MRI with only 1 minute scan time and less than 2 seconds reconstruction time. The deep learning approach is demonstrated for free-breathing abdominal pediatric MRI without anesthesia using XD-GRASP as a reference for comparison.

View Presentation Video

Yang Cao¹, Dingyi Lin¹, Yufan Zhou¹, Yi-Cheng Hsu², Gaoyang Mi³, Hongxi Zhang³, and Min Wang^1
1College of Biomedical Engneering & Instrument Science, Zhejiang University, Hangzhou, China, ²MR Collaboration, Siemens healthineers Itd, Shanghai, China, ³Department of Radiology, Zhejiang University School of Medicine Children's Hospital Binjiang Campus Pediatrics, Hangzhou, China

Keywords: Data Analysis, Fat

The ectopic fat is not evenly distributed in organs and can be a time dependent process that starts at early age. In this work, we focused on obese or overweight children and adolescents and calculated the voxel-wised liver and pancreas fat fraction. With our recently proposed deep learning method, we separately quantified the fat depositions in different compartments of liver and pancreas with high precisions. Our analysis revealed an unevenly distributed ectopic fat in both liver and pancreas at young age and suggested that hepatic and pancreatic fat depositions are weakly coupled but have different underlying mechanisms.

View Presentation Video

Reyhaneh Nosrati¹, Onur Afacan¹, Kristina Pelkola¹, Sarah Bixby¹, and Simon K. Warfield^1
1Boston Children's Hospital, Harvard Medical School, Boston, MA, United States

Keywords: Liver, Pediatric, Abdominal MRI

T1-weighted GRE sequence with Dixon technique for water/fat separation is a routine component of abdominal MRI to detect lesions and characterize hemorrhage/fat content. The limitations of the routine free-breathing T1-weighted pediatric abdominal MRI and water/fat separation includes low-resolution to achieve high pixel-bandwidth and minimize chemical shift, respiratory motion blurring (despite radial acquisition) that degrades image sharpness, water/fat swapping, and off-resonance fat blurring due to multi-peak nature of fat spectrum. We have assessed a novel image acquisition and reconstruction pipeline based on 3-point Dixon method, multi-peak fat model, and residual motion correction to address all the limitations of the current practice.

View Presentation Video

Tong Wu¹, Junwen Yang-Huang², Meike Vernooij¹, María Rodriguez‑Ayllon³, Vincent Jaddoe⁴, Hein Raat², Stefan Klein¹, and Edwin Oei^1
1Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, Netherlands, ²Department of Public Health, Erasmus MC, Rotterdam, Netherlands, ³Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands, ⁴Department of Pediatrics, Erasmus MC, Rotterdam, Netherlands

Keywords: Adolescents, Body, Body composition

This study is embedded in the Generation R Study, a population-based prospective cohort study in the Netherlands. At 13 years, whole-body Dixon MRI was performed. A previously presented Competitive Dense Fully Convolutional Network (CDFNet) was retrained and used to quantify the abdominal subcutaneous and visceral fat. We found a higher physical activity and lower screen time are associated with lower levels of MRI-based abdominal visceral obesity in adolescents. Therefore, promoting physical activity and reducing screen time should be one of the goals of lifestyle intervention programs for tackling the childhood obesity.

Foram Bharat Gala¹, Hirava Manek¹, Indrajit Saha², Narayana Krishna Rolla³, Pradeep Kumar⁴, and Rashmi Rao^3
1Department of Radiology, Bai Jerbai Wadia hospital for children, Mumbai, India, ²Clinical Science, Philips India Limited, Delhi, India, ³Philips India Limited, Bangalore, India, ⁴Philips India Limited, Mumbai, India

Keywords: MSK, Spinal Cord

Congenital spinal anomalies are common in children resulting in spinal deformities and these could be due to isolated vertebral segmentation abnormalities or with added cord abnormalities referred to as spinal dysraphism. Early surgical intervention is necessary in these children which requires both MRI and CT scan evaluation for cord and bone details respectively. We utilized novel technique - Compressed Sense accelerated MRI based - Fast field echo Resembling A CT Using Restricted Echo-spacing (CS-FRACTURE) technique in pediatric patients which provides CT like contrast. We describe our experience in evaluation of congenital spinal anomalies

Li Jingling^1
1Xijing Hospital, Air Force Military Medical University, Xi 'an, China

Keywords: Joints, Pediatric

Polydactyly is very common disease in pediatric orthopeadic. In this study, 18 patients with polydactyly were included. All the 3D-DESS image were evaluated by two senior diagnostic radiologists using a double-blind 3-point scale, the intraoperative results were used as the “gold standard” to analyze the consistency of image results and intraoperative results. The purpose of this study is to assess whether the 3D-DESS sequence can provide the growth and development information of cartilage epiphysis, tendon and bone tissue of polydactyly in children before surgery, which has value for preoperative evaluation and preparation of surgical treatment.

View Presentation Video

Jutta Ellermann¹, Abdul Wahed Kajabi², Marc Tompkins³, Joe Luchsinger¹, Stefan Zbyn⁴, Shelly Marette¹, Bradley Nelson³, and Takashi Takahashi^1
1Radiology, University of Minnesota, Minneapolis, MN, United States, ²CMRR/Radiology, University of Minnesota, Minneapolis, MN, United States, ³Orthopedics, University of Minnesota, Minneapolis, MN, United States, ⁴University of Minnesota, Minneapolis, MN, United States

Keywords: Bone, Adolescents, Epiphyseal Cartilage, Juvenile Osteochondritis Dissecans

Healing of Juvenile Osteochondritis Dissecans requires progressive lesion ossification and osseous bridging with the parent bone.  The ‘Scar Sign’ is an MR imaging finding that documents a healed knee JOCD lesion and is characterized by a distinct hypointense line at the prior lesion – parent bone interface, best identified on PD- or T1-weighted images w/o FS on routine clinical MRI. Knowledge of stages, timeline of healing and expected MR imaging findings of JOCD is important for the reporting Radiologist. It will facilitate prognostication and can serve as a reliable outcome measure for future research on evidence based Juvenile Osteochondritis Dissecans management.

View Presentation Video

Divya Joshi^1,2, Alexandra Hruby^1,2, Julius PA Dewald^1,2,3, and Carson Ingo^2,4
1Department of Biomedical Engineering, Northwestern University, Evanston, IL, United States, ²Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States, ³Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, United States, ⁴Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States

Keywords: Muscle, Diffusion Tensor Imaging, Cerebral Palsy

Individuals with cerebral palsy (CP) exhibit musculoskeletal maladaptations that have a profound impact on wrist and hand function, yet there is little understanding regarding underlying arm muscle structural changes. We implemented DTI to estimate in vivo muscle architecture of a forearm flexor muscle in both paretic and non-paretic arms of children with hemiparetic CP (n=5). Bone length, muscle size, fascicle lengths, and MD decreased while fascicle curvature increased in the paretic limb. Interlimb differences in fascicle length and curvature were correlated with interlimb differences in MD. We show that DTI is effective at capturing forearm muscle architecture changes in CP.

View Presentation Video

Ola Kvist¹, Peter Damberg¹, Zelong Dou¹, Johan Sanmartin Berglund², Carl-erik Flodmark³, Ola Nilsson^1,4, and Sandra Diaz Ruiz^1,3
1Karolinska Institute, Stockholm, Sweden, ²Blekinge Institute of Technology, Stockholm, Sweden, ³Lunds University, Malmö, Sweden, ⁴Örebro University, Örebro, Sweden

Keywords: Cartilage, Diffusion Tensor Imaging

The hindlimbs of female rabbits aged 16, 20, and 24 weeks were studied in a 9.4T MRI scanner to assess the ability of MRI-DTI to evaluate growth plate morphology and activity compared with that of histomorphometry and micro-computed tomography (μCT) in rabbits. The MRI sequences included a multi-gradient echo 3D sequence and DTI in 14 directions (b-value= 984 s/mm²). The growth plate height and volume were similar for all modalities at each time point and age. Tract number and volume declined with age; however, tract length did not show any changes. MRI-DTI may be useful for evaluating the growth plates. 

Elena Voronkova^1,2, Petr Menshchikov^3,4, Ilya Melnikov¹, Olga Bozhko¹, Andrei Manzhurtsev^1,3,5, Maxim Ublinskiy^1,3, Denis Vorobyev¹, Dmitriy Kupriyanov⁴, and Tolib Akhadov^1
1Radiodiagnosis, Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russian Federation, ²Institute of Biochemical Physics, Russian Academy of Sciences, Moscow, Russian Federation, ³Institute of Biochemical Physics, Russian Academy of Sciences, Moscow, Moscow, Russian Federation, ⁴LLC Philips, Moscow, Russian Federation, ⁵Moscow State University, Moscow, Russian Federation

Keywords: MSK, Cartilage

The purpose of the study was to examine short-term consequences of the single and first-time lateral patellar displacement on patellar cartilage quality in teenagers using T2 mapping. The research showed a principal difference in T2 changes between medial and lateral cartilage facet. The medial part usually suffering first after LPD, the absence of T2 changes for the mild group may indicate completed reparative processes, while the decrease in T2 denotes that the reparation is still ongoing. T2 increase in lateral patellar regardless chondromalacia severity indicates secondary damage.

View Presentation Video

Kwan-Jin Jung¹ and Elahe Ganji^2
1Biomedical Imaging Center, Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, IL, United States, ²Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, IL, United States

Keywords: Cartilage, Relaxometry, growth plate, UTE

Growth plates are one of the most common sites of injury in the young skeleton. The growth plate is an interwoven and multi-layered interfacial tissue that transitions from cartilaginous to mineral morphology as it extends into metaphysis of long bones. We used Ultrashort Echo-time (UTE) MR imaging as a promising sensitive technique to detect the growth plate transition that has short T2. The UTE sequence was extended to measure T2* and T1 using multi-echoes and variable flip angles. The contrast of the transitional zone was further enhanced by a ratio of T1 over T2*.

yan sun¹, yujie chen¹, xuesheng li¹, yi liao¹, xijian chen¹, yu song¹, xinyue liang², yongming dai², and gang ning^1
1Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University), Ministry of Education,West China Second university Hospital, Sichuan University, Chengdu, China, ²Central Research Institute, United Imaging Healthcare, shanghai, shanghai, China

Keywords: Lung, Pediatric, pediatric pneumonia

   As a promising MRI technique, ultrashort echo‑time (UTE) sequence has been widely used in the evaluation of pulmonary diseases, allowing for increased contrast-to-noise ratio and the comparable image quality with CT. Literature on the use of the UTE in pneumonia is broadly available in older children and adults, whereas the data in younger children group is limited. This study illustrated the ability of UTE lung imaging for assessing pneumonia patients under 3 years old and has good diagnostic utility in detecting the typical morphological findings of pediatric pneumonia.

View Presentation Video

Narayan Iyer^1,2, Matthew Borzage^1,2, and Eamon Doyle^2,3
1Pediatrics, Children's Hospital of Los Angeles, Los Angeles, CA, United States, ²Keck School of Medicine, University of Southern California, Los Angeles, CA, United States, ³Radiology, Children's Hospital of Los Angeles, Los Angeles, CA, United States

Keywords: Lung, Pediatric, BPD, UTE

Bronchopulmonary dysplasia (BPD) is the most common serious complication of prematurity affecting approximately 30,000 infants annually in the USA alone.  Decisions regarding treatment course as well as prognostication require an understanding of regional lung changes. However, chest radiographs poorly distinguish the severity of BPD.  Advances in ultra-short echo time imaging have made lung imaging feasible at clinically relevant field strengths.  We have implemented a UTE-based imaging protocol at our institution and started validation in pre-term infants. Initial results demonstrate that clinically interpretable images can be acquired in an infant with BPD.