Aortic Arch Thrombosis Associated with Fetal Cytomegalovirus Viremia

Cytomegalovirus(CMV) associated thrombosis has been reported sporadically in the medical literature; however, its antenatal scenario has not been documented. We herein present the antenatal, Doppler's ultrasound and magnetic resonance angiographic features of thrombosis in the aortic arch showing extension toward the medial lumen of the brachiocephalic trunk with critical occlusion of the left common carotid artery and left subclavian artery in a term fetus to raise obstetricians'/ neonatologists'/pediatric cardiologists' awareness for the association between CMV viremia and intrauterine thrombosis that caused cerebral injury, neurodevelopmental impairment, and permanent sequela.

Adapting CMR sequences for CHD and imaging small patients

In this chapter, the necessary modifications to common cardiovascular magnetic resonance sequences will be discussed. Specific areas that will be covered are: optimization of steady-state free precession cine imaging for the assessment of function, whole heart imaging in infants and children, velocity-encoded phase contrast magnetic resonance for the assessment of flow in paediatrics, and modification of contrast-enhanced magnetic resonance angiographic sequences in childhood. In addition, various methods of dealing with respiratory motion in children will be discussed.

“Twig-like” cerebral vessels are not pathognomonic for ACTA A2 mutations: A case report

ACTA2 mutations are recently described genetically defined abnormalities of blood vessels in various organs of the body with specific abnormalities in cerebral vessels in the form of straightening of all cerebral arteries (“twig-like” pattern), stenosis/occlusions, proximal dilatation, and absent “moyamoya” type of collaterals. We describe a one-and-a half year-old girl child who presented with mild motor developmental delay and on neuroimaging showed septo-preoptic holoprosencephaly, diffuse radial polymicrogyria, and pontine hypoplasia along with magnetic resonance angiographic features suggestive of ACTA2 mutation type of cerebral vessels. However, genetic studies revealed no evidence of ACTA2 mutation, indicating that the “twig-like” pattern may not only be a pathognomonic feature of ACTA2 mutations.