Non-Catheter Causes of Venous Thromboembolism in Children

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 1.75
Procedures: 1.75
Head, Spine, and Musculoskeletal: 0.50
Neck and Chest: 0.50
Abdomen and Pelvis: 0.75

Magnetic Resonance Imaging: 1.00
Procedures: 1.00
Neurological: 0.25
Body: 0.50
Musculoskeletal: 0.25

Registered Radiologist Assistant: 3.00
Procedures: 3.00
Neurological, Vascular, and Lymphatic Sections: 3.00

Sonography: 1.00
Procedures: 1.00
Abdomen: 0.25
Superficial Structures and Other Sonographic Procedures: 0.75

Vascular Sonography: 0.75
Procedures: 0.75
Abdominal/Pelvic Vasculature: 0.25
Venous Peripheral Vasculature: 0.25
Extracranial Cerebral Vasculature and Other Sonographic Procedures: 0.25

Outline

1. Introduction
2. Head and Neck
   1. Dural Venous Sinus and Cerebral Venous Sinus Thrombosis
   2. Cavernous Sinus and Superior Ophthalmic Venous Thrombophlebitis
   3. Lemierre Syndrome
3. Upper Extremity and Thorax
   1. Paget-Schroetter Syndrome
   2. Superior Vena Cava Syndrome
   3. Pulmonary Embolism
4. Abdomen and Pelvis
   1. Portal Venous Thrombosis
   2. Superior Mesenteric Venous Thrombosis
   3. Budd-Chiari Syndrome
   4. Splenic Venous Thrombosis
   5. Renal Venous Thrombosis
   6. May-Thurner Syndrome
5. Lower Extremity
6. Tumor-related Venous Thrombosis
7. Follow-up Imaging of VTE
8. Conclusion

Objectives

Upon completion of this course, students will:

1. recall the prevalence of venous thrombosis in hospital admissions of children
2. list the non-catheter cause of venous thromboembolism in children
3. list the concerns associated with CT in the diagnosis of venous thromboembolism
4. outline reasons that MR imaging is less commonly used for the routine diagnosis of venous thromboembolism in children
5. recall the prevalence of pediatric stroke
6. state when the presence of cerebral venous sinus thrombosis is highest
7. differentiate between symptoms of cerebral venous sinus thrombosis in older children and neonates
8. list the infectious causes of cerebral venous sinus thrombosis
9. choose the imaging test of choice for suspected cerebral venous sinus thrombosis in children
10. list parenchymal changes secondary to cerebral venous sinus thrombosis
11. state the treatment of choice for cerebral venous sinus thrombosis in children
12. list the imaging interpretation pitfalls associated with cerebral venous sinus thrombosis in children
13. list the clinical presentations for septic thrombophlebitis of the cavernous sinus
14. list the symptoms of Lemierre syndrome
15. state the approximate mortality rate associated with Lemierre syndrome
16. recall the location of the costoclavicular space
17. list the anatomy that borders the costoclavicular space
18. recall the extremity affected by Paget-Schroetter syndrome
19. choose the initial test of choice for pediatric patients suspected of having Paget-Schroetter syndrome
20. recall the most feared complication of venous thoracic outlet syndrome
21. list the causes of superior vena cava syndrome
22. state the mortality rate for pulmonary embolism in children
23. list symptoms of pulmonary embolism
24. recall the imaging test of choice for patients with respiratory symptoms suspected of having pulmonary embolism
25. cite the advantages of CT angiography of the pulmonary arteries in children
26. list the imaging findings of prognostic value in acute pulmonary embolism
27. state the most common period of development when portal venous thrombosis is found
28. list the clinically most common indications for ultrasound performed in neonates with portal venous thrombosis
29. list the most common complications of neonatal portal venous thrombosis
30. recall the imaging modality of choice for the diagnosis of portal venous thrombosis
31. state the imaging modality that is not sensitive for diagnosis of superior mesenteric venous thrombosis
32. name the most feared complication of mesenteric venous thrombosis
33. provide the alternative name for Budd-Chiari syndrome
34. list the symptoms of Budd-Chiari syndrome
35. state the first imaging study usually ordered in patients suspected of having Budd-Chiari syndrome
36. list the most common causes of acute pancreatitis in children
37. recall the patient population in which pediatric renal venous thrombosis in most common
38. identify the patient population where May-Thurner syndrome is most common
39. choose the best initial test for diagnosis of deep venous thrombosis in children
40. list the scenarios that could occur after development of venous thrombosis