Greer Mary-Louise C
Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, ON,, M5G 1X8, Canada.
Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
Pediatr Radiol. 2018 Aug;48(9):1348-1363. doi: 10.1007/s00247-018-4141-9. Epub 2018 Aug 4.
Whole-body MRI is increasingly utilized for assessing oncologic and non-oncologic diseases in infants, children and adolescents. Focusing on the non-oncologic indications, this review covers technical elements required to perform whole-body MRI, the advantages and limitations of the technique, and protocol modifications tailored to specific indications. Rheumatologic diseases account for the majority of non-oncologic whole-body MRI performed in pediatric patients at the author's institution. Whole-body MRI helps in establishing the diagnosis, documenting disease extent and severity, and monitoring treatment response in enthesitis-related arthritis (ERA) and chronic recurrent multifocal osteomyelitis (CRMO). Other non-oncologic indications for whole-body MRI include osteomyelitis (usually pyogenic), pyrexia of unknown origin, neuromuscular disorders, inherited and inflammatory myopathies such as juvenile dermatomyositis and polymyositis, avascular necrosis, and fat/storage disorders. Use of whole-body MRI in postmortem imaging is rising, while whole-body MRI in non-accidental injury is considered to be of limited value. Imaging findings for a range of these indications are reviewed with whole-body MRI examples.
全身磁共振成像(MRI)越来越多地用于评估婴儿、儿童和青少年的肿瘤性和非肿瘤性疾病。本文聚焦于非肿瘤性适应症,涵盖了进行全身MRI所需的技术要素、该技术的优缺点以及针对特定适应症的方案调整。在作者所在机构,风湿性疾病占儿科患者非肿瘤性全身MRI检查的大部分。全身MRI有助于诊断、记录疾病范围和严重程度,并监测附着点炎相关关节炎(ERA)和慢性复发性多灶性骨髓炎(CRMO)的治疗反应。全身MRI的其他非肿瘤性适应症包括骨髓炎(通常为化脓性)、不明原因发热、神经肌肉疾病、遗传性和炎性肌病,如青少年皮肌炎和多发性肌炎、缺血性坏死以及脂肪/储存障碍。全身MRI在尸检成像中的应用正在增加,而在非意外伤害中的应用价值有限。本文通过全身MRI实例回顾了一系列这些适应症的影像学表现。