Category: Pediatrics
Posts related to pediatric neuroradiology.
This playlist is a collection of all the board review style cases on the site. All the board review style cases on the site in one place! These cases are geared towards preparation for the radiology resident ABR core exam, although similar material is used for the ABR certifying exam general and neuroradiology sections as well as neuroradiology CAQ.
The format of this playlist is case-based. Each case consists of a series of images followed by 1 or 2 questions. The first question is usually to name the diagnosis, while the second is a multiple choice question to test deeper understanding of the specific condition. Try to get the diagnosis before you see the second questions.
If you prefer, check out the full “Neuroradiology board review cases – All” playlist on YouTube.
Neuroradiology brain tumor board review. This lecture is geared towards the ABR core exam for residents, but it would be useful for review for the ABR certifying exam or certificate of added qualification (CAQ) exam for neuroradiology.
More description and the answer (spoiler!) are seen below the video.
This case shows you a posterior fossa mass in a child. It his relatively homogeneously T2 hyperintense with relatively avid central enhancement on post-contrast imaging. On ADC, it is relatively dark centrally. A sagittal FLAIR image looks like it confirms that the mass is arising from the cerebellar wall of the ventricle and is displacing the ventricle anteriorly.
Anytime you have a posterior fossa mass in a child, you should be able to list a differential diagnosis, which includes:
These are listed in order of decreasing ADC values, because the tumors at the bottom are more cellular and have more tightly packed cells that will be bright on DWI and dark on ADC.
The diagnosis is: medulloblastoma
Medulloblastomas are aggressive tumors in children most commonly found in the posterior fossa. They can be differentiated from other tumors in these age groups by their aggressive appearance and lower ADC values. They arise from the walls of the 4th ventricle or cerebellar hemispheres. There are 4 types (WNT, SHH, group 3, and group 4), but for most radiologists this is beyond the expected knowledge. Genetic features will ultimately guide the prognosis and treatment.
The main differential diagnosis in a child with a lesion such as this is ATRT. I recommend an age based approach to making your differential diagnosis. Because ATRT patients usually are around 6 months old, if a patient is less than 2 years old, choose ATRT. If older, choose medulloblastoma. This will not always be true but is probably true > 95% of the time.
This playlist is a collection of only the pediatric board review cases on this site. These cases are geared towards preparation for the radiology resident ABR core exam, although similar material is used for the ABR certifying exam general and neuroradiology sections as well as neuroradiology CAQ.
The format of this playlist is case-based. Each case consists of a series of images followed by 1 or 2 questions. The first question is usually to name the diagnosis, while the second is a multiple choice question to test deeper understanding of the specific condition. Try to get the diagnosis before you see the second questions.
If you prefer, check out the full “Neuroradiology board review cases – Pediatrics” playlist on YouTube.
Neuroradiology board review. This lecture is geared towards the ABR core exam for residents, but it would be useful for review for the ABR certifying exam or certificate of added qualification (CAQ) exam for neuroradiology.
More description and the answer (spoiler!) are seen below the video.
This case shows a hyperdense mass in the left posterior nasal passages. There is expansion of the left sphenopalatine foramen. In a relatively young patient, there is really only one diagnostic consideration.
The diagnosis is: Juvenile nasal angiofibroma (JNA)
Juvenile nasal angiofibromas are masses that arise in the sphenopalatine foramen in young boys. They are extremely vascular lesions and are typically treated by embolization of branches of the external carotid artery which supply the mass prior to resection.
Neuroradiology board review. This lecture is geared towards the ABR core exam for residents, but it would be useful for review for the ABR certifying exam or certificate of added qualification (CAQ) exam for neuroradiology.
More description and the answer (spoiler!) are seen below the video.
In this case, there are curvilinear calcifications which follow the cortex in the right cerebral hemisphere on CT. On MRI, there is atrophy of the right cerebral hemisphere with abnormal veins coursing through the deep white matter of the right cerebral hemisphere. On contrast enhanced images, there is avid enhancement of the right hemisphere leptomeninges.
The diagnosis is: Sturge-Weber syndrome
Sturge-Weber syndrome is a variant in which normal cortical vessels fail to form, and the hemisphere is drained by abnormal mesenchymal veins which course through the cerebral hemisphere. Classic imaging findings include cortical calcifications of one hemisphere.