Erasmus MC, Department of Radiology, Doctor Molewaterplein 40, 3015 GD, Rotterdam, Zuid-Holland, The Netherlands.
Erasmus MC, Department of Orthopedics, Doctor Molewaterplein 40, 3015 GD, Rotterdam, Zuid-Holland, The Netherlands.
Pediatr Res. 2023 Jun;93(7):2045-2050. doi: 10.1038/s41390-022-02259-6. Epub 2022 Oct 7.
The prevalence and clinical relevance of incidental findings (IF(s)) on imaging assessing the pelvis in children has not been well documented.
Three-thousand two-hundred thirty-one children (mean age 10.2 (range 8.6-12.9) years) were evaluated with MRI of the hips, pelvis, and lumbar spine, as part of a prospective population-based pediatric cohort study. Scans were reviewed by trained medical staff for abnormalities. IFs were categorized by clinical relevance and need for further clinical evaluation.
8.3% (n = 267) of children featured at least one IF. One or more musculoskeletal IFs were found in 7.9% (n = 254) of children, however, only 0.8% (n = 2) of musculoskeletal IFs required clinical evaluation. Most frequent abnormalities were simple bone cysts 6.0% (n = 195), chondroid lesions 0.6% (n = 20), and perineural cysts 0.5% (n = 15). Intra-abdominal IFs were detected in 0.5% (n = 17) of children, with over half (n = 9) of these requiring evaluation. The three most common intra-abdominal IFs were a duplex collecting system 0.09% (n = 3), significant ascites 0.06% (n = 2), and hydroureteronephrosis 0.06% (n = 2).
IFs on MRI of the lower abdominal and hip region are relatively common in children aged 8-13 years, most of these can be confidently categorized as clinically irrelevant without the need for additional clinical or radiologic follow up.
Our research contributes greatly to the knowledge of the prevalence of (asymptomatic) pathology in children. We evaluated MR images of 3231 children, covering hip joints, pelvic skeleton, lower and mid-abdomen, and lumbar and lower thoracic spine as part of a population study. One or more musculoskeletal incidental finding were found in 7.9% of children. Most of these can be confidently categorized as clinically irrelevant without the need for additional follow up. However 0.8% of musculoskeletal findings required further evaluation. Intra-abdominal incidental findings were detected in 0.5% of children, with over half of the abdominal and urogenital findings requiring further evaluation.
在评估儿童骨盆的影像学检查中，偶然发现（IF）的发生率和临床意义尚未得到很好的记录。
3231 名儿童（平均年龄 10.2 岁（8.6-12.9 岁））接受了髋关节、骨盆和腰椎的 MRI 检查，作为一项前瞻性基于人群的儿科队列研究的一部分。受过训练的医务人员对扫描进行了异常检查。IF 根据临床相关性和进一步临床评估的需要进行分类。
8.3%（n=267）的儿童至少有一个 IF。7.9%（n=254）的儿童存在一种或多种肌肉骨骼 IF，但只有 0.8%（n=2）的肌肉骨骼 IF 需要临床评估。最常见的异常是单纯性骨囊肿 6.0%（n=195）、软骨样病变 0.6%（n=20）和神经周围囊肿 0.5%（n=15）。17 名儿童（0.5%）发现腹部内 IF，其中一半以上（n=9）需要评估。腹部内 IF 中最常见的三种是双肾盂 0.09%（n=3）、大量腹水 0.06%（n=2）和肾盂积水 0.06%（n=2）。
8-13 岁儿童下腹部和髋关节 MRI 上的 IF 较为常见，其中大多数可被明确归类为无临床意义，无需进一步临床或放射学随访。
我们的研究极大地增加了对儿童无症状性疾病发生率的认识。我们评估了 3231 名儿童的 MRI 图像，涵盖髋关节、骨盆骨骼、下腹部和中腹部以及腰椎和胸腰椎，作为人群研究的一部分。7.9%的儿童发现了一种或多种肌肉骨骼 IF。其中大多数可被明确归类为无临床意义，无需进一步随访。然而，0.8%的肌肉骨骼发现需要进一步评估。0.5%的儿童发现了腹部 IF，其中一半以上的腹部和泌尿生殖系统发现需要进一步评估。
