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. 2023 Jun;53(7):1420-1442. doi: 10.1007/s00247-022-05478-5. Epub 2022 Aug 19.
Whole-body MRI is increasingly used in the evaluation of a range of oncological and non-oncological diseases in infants, children and adolescents. Technical innovation in MRI scanners, coils and sequences have enabled whole-body MRI to be performed more rapidly, offering large field-of-view imaging suitable for multifocal and multisystem disease processes in a clinically useful timeframe. Together with a lack of ionizing radiation, this makes whole-body MRI especially attractive in the pediatric population. Indications include lesion detection in cancer predisposition syndrome surveillance and in the workup of children with known malignancies, and diagnosis and monitoring of a host of infectious and non-infectious inflammatory conditions. Choosing which patients are most likely to benefit from this technology is crucial, but so is adjusting protocols to the patient and disease to optimize lesion detection. The focus of this review is on protocols and the elements impacting image acquisition in pediatric whole-body MRI. We consider the practical aspects, from scanner and coil selection to patient positioning, single-center generic and indication-specific protocols with technical parameters, motion reduction strategies and post-processing. When optimized, collectively these lead to better standardization of whole-body MRI, and when married to systematic analysis and interpretation, they can improve diagnostic accuracy.
全身 MRI 越来越多地用于评估婴儿、儿童和青少年的一系列肿瘤和非肿瘤疾病。MRI 扫描仪、线圈和序列的技术创新使全身 MRI 能够更快地进行，提供大视野成像，适用于临床有用时间内的多发病灶和多系统疾病过程。加上没有电离辐射，这使得全身 MRI 在儿科人群中特别有吸引力。适应证包括在癌症易感性综合征监测中检测病变，以及在已知恶性肿瘤患儿的检查中，以及诊断和监测多种感染和非感染性炎症疾病。选择最有可能从这项技术中受益的患者至关重要，但调整方案以适应患者和疾病以优化病变检测也同样重要。本综述的重点是儿科全身 MRI 的方案和影响图像采集的因素。我们考虑了从扫描仪和线圈选择到患者定位、单中心通用和适应证特异性方案与技术参数、减少运动策略和后处理的实际方面。当优化时，这些方面共同导致全身 MRI 的更好标准化，当与系统分析和解释相结合时，它们可以提高诊断准确性。
