From the Department of Radiology, Massachusetts General Hospital, Boston, Mass (R.V.G., M.S.G., P.J.H.); Department of Diagnostic Imaging, the Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8 (M.L.C.G.); and Department of Medical Imaging, University of Toronto, Toronto, Ont, Canada (M.L.C.G.).
Radiographics. 2019 Mar-Apr;39(2):516-534. doi: 10.1148/rg.2019180130. Epub 2019 Jan 25.
Imaging is fundamental to diagnosis and management of pediatric patients with cancer and cancer predisposition syndromes (CPSs). Whole-body MRI has emerged as a versatile tool for pediatric oncologic imaging, with the potential to spare children from ionizing radiation imparted by conventional modalities such as CT and PET. Whole-body MRI also enables simultaneous high-resolution local-regional staging and wide field-of-view distant staging in the same imaging session, with superior evaluation of the brain, spine, liver, and marrow. Recent technical advances have reduced imaging times and enhanced image quality, with continued advances on the near horizon. Pulse sequences such as whole-body diffusion-weighted imaging have also broadened the range of diagnostic information obtainable. In addition, increasing identification of children with CPSs has compelled efforts to establish surveillance imaging strategies for affected individuals, with whole-body MRI playing a pivotal role in screening algorithms for several CPSs. In light of these emerging trends, a working knowledge of oncologic whole-body MRI applications and evolving CPS surveillance algorithms is vital to providers who participate in the care of pediatric patients affected by or predisposed to cancer. Recognizing both the strengths and limitations of whole-body MRI not only enables more thoughtful implementation but also improves the accuracy of image interpretation. RSNA, 2019 See discussion on this article by Khanna .
成像对于患有癌症和癌症倾向综合征（CPS）的儿科患者的诊断和治疗至关重要。全身 MRI 已成为儿科肿瘤成像的多功能工具，具有使儿童免受 CT 和 PET 等常规方式产生的电离辐射的潜力。全身 MRI 还可以在同一成像过程中同时进行高分辨率局部区域分期和宽视场远处分期，从而更好地评估大脑、脊柱、肝脏和骨髓。最近的技术进步缩短了成像时间并提高了图像质量，并且在不久的将来还会有更多的进步。全身扩散加权成像等脉冲序列也拓宽了可获得的诊断信息量。此外，随着越来越多的儿童被诊断出患有 CPS，人们努力为受影响的个体建立监测成像策略，全身 MRI 在几种 CPS 的筛查算法中发挥着关键作用。鉴于这些新出现的趋势，了解全身肿瘤 MRI 应用和不断发展的 CPS 监测算法对于参与治疗患有癌症或有癌症倾向的儿科患者的医务人员至关重要。认识到全身 MRI 的优缺点不仅可以使实施更加深思熟虑，还可以提高图像解释的准确性。RSNA，2019 请参阅 Khanna 对本文的讨论 。
