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[儿童和青少年的全身磁共振成像]

[Whole-body MRI in children and juveniles].

作者信息

Schaefer J F, Kramer U

机构信息

Abt. für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Tübingen.

出版信息

Rofo. 2011 Jan;183(1):24-36. doi: 10.1055/s-0029-1245883. Epub 2010 Dec 15.

Abstract

The imaging of systemic disorders without radiation exposure by whole-body MRI (wb-MRI) represents a paradigm shift for pediatric radiology. The reduction of multiple regional examinations, if necessary under sedation, results in a faster treatment start. Modern scanner techniques using automatic table movement and allowing the combination of multiple coil elements and synchronized signal recording with numerous independent receiving channels are the basic prerequisite for high-resolution wb-MRI. The main indications are the evaluation of multifocal bone involvement in different disorders, rheumatic disorders including fever of unknown origin or metastatic spread in solid tumors. Based on the research, there is currently no absolute indication. However, wb-MRI has been shown to yield a higher diagnostic performance than bone scintigraphy and comparable results to FDG-PET for the detection of bone metastases. Due to the low number of published studies, it is uncertain for which entity of solid tumors wb-MRI is the modality of choice and for which tumors wb-MRI will play only a complementary role in the diagnostic work-up. Methodical strategies, pitfalls in image analysis, indications and diagnostic accuracy will be discussed based on already published results as well as our own experience from over 400 examinations, thus providing an overview of the recent research as well as supplying relevant aspects of the daily routine in pediatric wb-MRI.

摘要

全身磁共振成像(wb-MRI)在不进行辐射暴露的情况下对全身疾病进行成像,代表了儿科放射学的一种范式转变。减少多次局部检查(必要时需在镇静下进行)可使治疗更快开始。采用自动床体移动、允许组合多个线圈元件并通过众多独立接收通道进行同步信号记录的现代扫描技术,是高分辨率wb-MRI的基本前提条件。主要适应证包括评估不同疾病中的多灶性骨受累情况、风湿性疾病(包括不明原因发热)或实体瘤的转移扩散。基于现有研究,目前尚无绝对适应证。然而,对于骨转移的检测,wb-MRI已被证明比骨闪烁显像具有更高的诊断效能,且与氟代脱氧葡萄糖正电子发射断层显像(FDG-PET)结果相当。由于已发表的研究数量较少,目前尚不确定对于哪种实体瘤wb-MRI是首选检查方法,而对于哪些肿瘤wb-MRI在诊断工作中仅起辅助作用。将基于已发表的结果以及我们自身超过400例检查的经验,讨论方法策略、图像分析中的陷阱、适应证及诊断准确性,从而对近期研究进行概述,并提供儿科wb-MRI日常工作中的相关方面。

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