Erin Simon Schwartz

Erin Simon Schwartz
The Children's Hospital of Philadelphia | CHOP · Department of Radiology

MD, FACR

About

105
Publications
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2,654
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Publications

Publications (105)
Article
Full-text available
Purpose: The aim of the study was to assess the prevalence and characteristics of spinal cord cavernous malformations (SCCM) and intraosseous spinal vascular malformations (ISVM) in a pediatric familial cerebral cavernous malformation (FCCM) cohort and evaluate clinico-radiological differences between children with (SCCM +) and without (SCCM-) SCC...
Article
Increased performance demands have interacted with suboptimal use of technology and contributed to burnout among radiologists. Although the problem of radiologist burnout has been well documented, there is a gap in the literature in terms of how technology can be better utilized to lessen the problem. Informatics-based modifications to existing tec...
Article
Meningioangiomatosis (MA) is a rare intracranial hamartomatous lesion. We retrospectively reviewed the MRIs in 6 pediatric patients with a histopathologic diagnosis of MA. Patients with MA demonstrated a solitary lesion in the frontotemporal regions, with FLAIR hyperintensity and leptomeningeal enhancement. A solitary brain lesion in the frontotemp...
Article
Objective: Resective surgery is the most effective treatment option for patients with refractory epilepsy; however identification of patients who will benefit from epilepsy surgery remains challenging. Synthetic aperture magnetometry and excess kurtosis mapping (SAM(g2)) of magnetoencephalography (MEG) is a non-invasive tool that warrants further...
Article
Purpose: To determine the trajectory of age-dependent cerebral blood flow (CBF) change in infants and young children by fitting mathematical models to the imaging data. Methods: In this retrospective study, we reviewed the arterial spin-labeling imaging studies of 49 typically developing infants and young children at postmenstrual age (PMA) rang...
Article
Full-text available
In utero MR imaging is used increasingly often to assist with the diagnosis of fetal brain abnormalities, and this increased use is supported by proved improvements in diagnostic accuracy compared with sonography. Fetal brain pathology may be considered developmental or acquired, though these definitions are simplistic, and there may be overlap bet...
Article
Background General anesthesia and sedation are used routinely for magnetic resonance imaging (MRI) studies in children to optimize image quality. Airway devices such as supraglottic airways (SGAs) can alter the appearance of cervical soft tissue regions on an MRI and increase the risk of misdiagnosis. This phenomenon has not been well described in...
Article
Full-text available
In this repeated measures case study, we show that sensory deafferentation after limb amputation leads to changes in cortical somatotopic maps which are reversible after restoration of sensory input. Using magnetoencephalography (MEG), we observed in a child with bilateral hand transplants large-scale shifts in somatosensory lip cortical representa...
Article
Purpose The relationship between syringomyelia and presyrinx, characterized by edema in the spinal cord, has not been firmly established. Patients with syringomyelia have abnormal spinal canal tapering that alters cerebrospinal fluid flow dynamics, but taper ratios in presyrinx have never been reported. We tested the hypothesis that presyrinx patie...
Article
Epilepsy affects up to 1 in 1,000 children annually. While it is increasingly recognized that forms of epilepsy may have genetic origins, congenital and acquired structural abnormalities of the brain parenchyma are common causes of seizures. Among the most difficult etiologies to diagnose are focal cortical dysplasias, which will be discussed along...
Article
Background: Although heterologous vascular composite allotransplantation has become a burgeoning treatment option for adult amputees, there have been no successful cases previously reported in children. Here, we describe the surgical, immunological, and neurorehabilitation details with functional outcomes 18 months after heterologous bilateral han...
Article
Full-text available
The purpose of the present study was to compare somatosensory responses from a group of children with epilepsy and a group of children with ASD, with age matched TD controls. We hypothesized that the magnitude of the tactile “P50m” somatosensory response would be reduced in both patient groups, possibly due to reduced GABAergic signaling as has bee...
Article
Background: Ventricular shunt complications in children can be severe and life-threatening if not identified and treated in a timely manner. Evaluation for shunt obstruction is not without risk, including lifetime cumulative radiation as patients routinely receive computed tomography (CT) scans of the brain and shunt series (multiple radiographs o...
Article
Brain tumors can develop in the prenatal and neonatal time periods. Neuroimaging studies are crucial for the early detection of prenatal and neonatal brain tumors. Imaging allows for characterization of morphology, as well as the detection of hydrocephalus, local invasion, and distant spread. The imaging features of the more common neonatal brain t...
Article
The term congenital spinal anomalies encompasses a wide variety of dysmorphology that occurs during early development. Familiarity with current terminology and a practical, clinico-radiologic classification system allows the radiologist to have a more complete understanding of malformations of the spine and improves accuracy of diagnosis when these...
Article
Full-text available
Advancements in magnetoencephalography (MEG) present new opportunities for clinical pediatric centers faced with the challenge of offering a sensitive diagnostic evaluation for epilepsy in infants and young children. A noninvasive brain imaging method, which measures the magnetic fields generated by the electrical activity of the human brain, MEG p...
Article
Background: Electroencephalographic monitoring is being used with increasing frequency in critically ill children who may require frequent and sometimes urgent brain CT scans. Standard metallic disk EEG electrodes commonly produce substantial imaging artifact, and they must be removed and later reapplied when CT scans are indicated. Objective: T...
Article
Fetal magnetic resonance imaging (MRI) is a useful adjunct to ultrasound in the evaluation of neural tube defects. The development of ultrafast imaging techniques has contributed to the increasing clinical use of fetal MRI. This review summarizes the utility, safety and technical aspects of fetal MRI and the role it plays in the evaluation of myelo...
Article
Schizencephaly is a rare malformation of the brain characterized by a gray matter-lined defect extending from the pial surface to the lateral ventricles. The purpose of this study was to correlate imaging findings of schizencephaly and associated anomalies on fetal and postnatal MR imaging and assess possible changes that may occur from the prenata...
Conference Paper
LEARNING OBJECTIVES 1) Identify the key imaging features of various common pediatric spine diseases. 2) Identify the basic anatomic, physiologic and pathologic features of diseases affecting the pediatric spine. 3) Highlight primary imaging techniques used for assessment, clinical practice, problem-solving and patient management.
Conference Paper
LEARNING OBJECTIVES This interactive session will use RSNA Diagnosis Live™. Please bring your charged mobile wireless device (phone, tablet or laptop) to participate. Sub-Events
Conference Paper
PURPOSE There has been emerging interest in the acute phase of mild traumatic brain injury (mTBI), with the possibility of early medical intervention targeting presumed underlying metabolic dysfunction. The purpose of our study is to perform a pilot study of multimodal advanced imaging, including gamma-aminobutyric acid MR spectroscopy (GABA-MRS),...
Article
Background and purpose: The neurologic significance of residual cerebral white matter tracts, identified on diffusion tensor tractography, has not been well studied in tuberous sclerosis complex. We aimed to correlate the quantity of reconstructed white matter tracts with the degree of neurologic impairment of subjects with the use of DTI and dete...
Conference Paper
LEARNING OBJECTIVES View learning objectives under main course title.
Article
A 10-year-old girl presented to an emergency room with acute-onset, brief, repetitive episodes of loss of consciousness. Computed tomography indicated a 0.6 cm colloid cyst of the anterior third ventricle, adjacent to the foramen of Monro. This finding was confirmed by magnetic resonance imaging. The patient underwent transcallosal surgical resecti...
Chapter
Magnetoencephalography (MEG) directly measures the magnetic fields created by neural electrical activity. Unlike functional magnetic resonance imaging (fMRI), which detects a tertiary effect of neural activation (change in local blood oxygenation level due to a change in blood flow), MEG is a more direct measure of brain functional activity. The te...
Article
Full-text available
Magnetoencephalography (MEG) is increasingly implemented as an important part of the pre-operative evaluation in the setting of intractable epilepsy. With MEG, epilepto-genic zones can be non-invasively localized and the relationship to eloquent functional cortex highly accurately determined. These provide the epilepsy team with additional valuable...
Article
Myelomeningocele (MMC) is characterized by a defect in caudal neurulation and appears at birth with a constellation of neuroanatomical abnormalities, including Chiari malformation Type II. The authors investigated the effects of antenatal versus postnatal repair of MMC through a quantitative analysis of morphometric changes in the posterior fossa (...
Article
Full-text available
Vein of Galen aneurysmal malformations (VGAM) are rare but clinically significant intracranial arteriovenous shunt lesions that most often present in neonates and infants. Retrospective clinical data were collected for patients evaluated with a diagnosis of VGAM from 1994 to 2007. Thirteen patients with VGAM were evaluated from 1994 to 2007. Seven...
Article
Congenital tumors of the central nervous system (CNS) are often arbitrarily divided into "definitely congenital" (present or producing symptoms at birth), "probably congenital" (present or producing symptoms within the first week of life), and "possibly congenital" (present or producing symptoms within the first 6 months of life). They represent le...
Article
We explored the relationship between seizure activity (SA) and/or chronic epilepsy (CE) and short-term neurodevelopmental outcomes following fetal myelomeningocele (fMMC) surgery. Retrospective databases and a parental questionnaire focusing on common complications of hindbrain herniation associated with MMC were used to determine the incidence of...
Article
The aim of our study was to delineate whether the reversal of hindbrain herniation (HH) following fetal myelomeningocele (fMMC) closure subsequently reduces the incidence and severity of HH-associated brainstem dysfunction (BSD). Prior to the NIH-sponsored Management of Myelomeningocele Study (MOMS) trial, 54 children underwent fMMC closure at our...
Article
Although magnetoencephalography (MEG) may not be familiar to many pediatric radiologists, it is an increasingly available neuroimaging technique both for evaluating normal and abnormal intracranial neural activity and for functional mapping. By providing spatial, temporal, and time-frequency spectral information, MEG affords patients with epilepsy,...
Article
The goal in this study was to evaluate the incidence and clinical implications of the development of cutaneously derived intradural inclusion cysts (ICs) following fetal myelomeningocele (fMMC) closure. Retrospective databases and responses to a parental questionnaire were reviewed to determine the incidence, clinical presentation, and outcomes of...
Conference Paper
LEARNING OBJECTIVES Learning Objectives: Determine the relative indications of ultrasound and MRI in assessing the fetal brain and spine. Develop basic skills and knowledge relevant to assessment of the fetal brain and spine. Apply the latest technological advances to imaging of the fetal brain and spine. Summarize ideas about imaging the fetal bra...
Conference Paper
PURPOSE To evaluate the role of MEG in presurgical evaluation of patients with medically-refractory epilepsy. METHOD AND MATERIALS 112 consecutive patients (75% pediatric) underwent MEG as a part of the pre-surgical assessment. Patients were medically-refractory, suffering ongoing debilitating seizures and had non-localizing other tests (including...
Article
Schizencephaly is a rare congenital cortical brain malformation defined by unilateral or bilateral clefts of the cerebral hemispheres. These malformations are often associated with medically intractable epilepsy. Surgical solutions include lesionectomy, lobectomy, or hemispherectomy. The authors describe the case of an anatomic hemispherectomy for...
Article
We present serial MR findings in a child ultimately diagnosed with the early infantile form of Krabbe disease. MR showed typical features of Krabbe disease including cerebellar and brainstem hyperintensity, periventricular and deep white matter hyperintensity, and cerebral atrophy. In addition, the combination of both enlargement and enhancement of...
Article
Full-text available
Magnetoencephalography (MEG) is increasingly being used in the preoperative evaluation of pediatric patients with epilepsy. The ability to noninvasively localize ictal onset zones (IOZ) and their relationships to eloquent functional cortex allows the pediatric epilepsy team to more accurately assess the likelihood of postoperative seizure freedom,...
Article
The CT, MR, and diffusion-weighted initial and follow-up imaging findings in neonatal herpes simplex virus type 2 (HSV-2) encephalitis were assessed. The clinical, laboratory and imaging findings in 12 patients (eight girls and four boys) with proven neonatal HSV-2 encephalitis with follow-up were retrospectively reviewed. Patterns of brain involve...
Article
The objective of the study was to examine the effect of selective fetoscopic laser photocoagulation (SFLP) vs serial amnioreduction (AR) on perinatal mortality in severe twin-twin transfusion syndrome (TTTS). This was a 5 year multicenter, prospective, randomized controlled trial. The primary outcome variable was 30 day postnatal survival of donors...
Article
We review the physiological basis of diffusion-weighted imaging and discuss the implementation of diffusion-weighted imaging pulse sequences and the subsequent postprocessing to yield quantitative estimations of diffusion parameters. We also introduce the concept of directionality of "apparent" diffusion in vivo and the means of assessing such anis...
Article
To examine the impact of fetal myelomeningocele (MMC) repair on fetal head biometry and cerebrospinal fluid (CSF) spaces assessed by magnetic resonance imaging (MR) studies. Axial measurements of intracranial structures were taken at defined anatomical landmarks. Pre- and postnatal head biometry data and CSF spaces obtained from in utero repaired M...
Conference Paper
LEARNING OBJECTIVES 1. Describe the clinical-radiological classification system of spinal dysraphism. 2. Identify the most common embryologic anomalies associated with the development of spinal dysraphism. ABSTRACT Spinal dysraphism and caudal spinal anomalies are among the most commonly encountered congenital anomalies clinically and radiological...
Article
Full-text available
The clinical outcome of acute necrotizing encephalopathy of childhood (ANEC), an encephalopathy characterized by symmetrical involvement of the thalami, has historically been poor, but recent studies have reported better outcomes. By devising a MR imaging scoring system, we determined the relationship between characteristic MR findings and clinical...
Article
This article represents a review of the authors' experience with two 3.0 T Siemens Trio Whole Body MR imaging units, with a cumulative experience of 12 months total imaging time on these scanners, over 1000 cases. The authors were able to identify and review numerous patients who had diagnostic studies both on 1.5 T and 3.0 T.
Article
To retrospectively determine the relationship between posterior fossa volume (PFV) and estimated gestational age (EGA) and/or femur length (FL) during pregnancy for the purpose of developing a normal growth curve. Advance institutional review board approval was obtained for this HIPAA-compliant study, and the need for parent informed consent was wa...
Article
Three Tesla imaging of the pediatric brain is feasible without significant SAR limitations and provides improved diagnostic information relative to 1.5 T for MRA, thin section T1 and T2 images, susceptibility scans, and conspicuity of contrast enhancement.
Conference Paper
LEARNING OBJECTIVES 1. Describe the clinical-radiological classification system of spinal dysraphism. 2. Identify the most common embryologic anomalies associated with the development of spinal dysraphism. ABSTRACT Spinal dysraphism and caudal spinal anomalies are among the most commonly encountered congenital anomalies clinically and radiological...
Article
Full-text available
Methotrexate is a major cause of treatment-related acute neurotoxicity in children with hematologic malignancies. The purpose of this study was to investigate whether diffusion-weighted MR imaging (DWI) detects acute methotrexate white matter neurotoxicity in this patient population. Six children-three female and three male-with hematologic maligna...
Conference Paper
BACKGROUND AND PURPOSE: Methotrexate is a major cause of treatment-related acute neurotoxicity in children with hematologic malignancies. The purpose of this study was to investigate whether diffusion-weighted MR imaging (DWI) detects acute methotrexate white matter neurotoxicity in this patient population. METHODS: Six children-three female and th...
Article
Unlabelled: Biotinidase deficiency is an inherited metabolic disorder characterized by inability to recycle protein-bound biotin. It usually presents with ataxia and seizures, though atypical presentations have also been described. We report a 15-month-old boy with profound biotinidase deficiency who presented with laryngeal stridor and subsequent...
Article
We report an extremely rare case of primary intramedullary germinoma in the cervical spinal cord arising in an 18-year-old man who had not undergone previous surgery or irradiation. The patient had a 2-month history of intermittent neck pain and a 4-week history of bilateral hand paresthesias and weakness. A magnetic resonance imaging scan demonstr...
Article
Magnetic resonance imaging of the fetal spine is a vital complement to fetal sonographic examination. Assessing the wide spectrum of spinal dysraphism, as well as spinal neoplasia, allows for more correct prenatal diagnoses, patient care planning, and patient counselling. Proper appraisal of the value of experimental procedures, such as fetal myelo...
Article
Full-text available
Subdural empyema (SDE), an infection of the subdural space, occurs most often in pediatric patients as a complication of meningitis, sinusitis, or otitis media. Diffusion-weighted imaging (DWI) has been used in the past to investigate intracerebral infections. The purpose of this study was to determine the signal intensity characteristics of SDE on...
Article
We report a case of the middle interhemispheric variant of holoprosencephaly (MIH) with noncleavage of the posterior portion of the frontal lobes and the parietal regions in a fetus at 22 weeks' gestation. To our knowledge, this is the first case of the rare MIH variant to be diagnosed in utero by use of ultrafast MR imaging and one of the few such...
Article
Sphenoid sinusitis is unusual in children, but when it occurs, it can lead to serious intracranial complications. We show the value of MRI in demonstrating intracranial abnormalities due to sphenoid sinus infection, particularly those involving the internal carotid arteries and cavernous sinuses. We reviewed our imaging experience of sphenoid sinus...
Article
Bacterial meningitis is frequently fatal or leads to severe neurological impairment. Complications such as vasculitis, resulting in infarcts, should be anticipated and dealt with promptly. Our aim was to demonstrate the complications of meningitis by diffusion weighted imaging (DWI) in patients who deteriorated despite therapy. We studied 13 infant...
Article
Full-text available
We present a unique finding of an elevated level of pyruvate at 2.37 ppm revealed by in vivo MR spectroscopy of a female neonate. Low fibroblast pyruvate dehydrogenase (PDH) complex activity subsequently confirmed a diagnosis of PDH deficiency. Abnormalities of brain development consistent with PDH deficiency were also evident on fetal and postnata...
Article
Recent developments have made available for ophthalmologic MR imaging a very high-resolution 3D fast spin echo T2 (3D FSE T2) sequence, which runs in a standard head coil. A modification of this technique, 3D FSEz T2, uses a zero-filled slice interpolation method during post-processing to further improve spatial resolution. We describe the techniqu...