Abstract:
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Purpose: To examine the contribution of intravenous gadolinium contrast material administration in the MRI work-up of suspected spine abnormalities in children under two years of age.
Methods and Materials: During a 7.5-year period (1995-2002) 405 MRI examinations of the spine have been performed in children under two years of age (204 girls and 201 boys). We reviewed both the clinical records and the MR reports of all patients, noting both the clinical problem as given in the records as well as on the radiology requisition. Both the radiological diagnoses and the final clinical diagnoses were compared, and the impact of the MR examination on the work-up and care of the patient was evaluated. MR studies of patients with enhancing lesions were reviewed, and the contribution of post-contrast images to the diagnoses was evaluated.
Results: Of the 405 examinations, 357 (88%) included intravenous gadolinium contrast material. The majority of the children were older than three months: 0-30 days, 32 patients; 1-3 months, 25 patients; 3-12 months, 145 patients; and 1-2 years, 155 patients. All children underwent MRI under sedation or general anesthesia. MRI of the spine in children was typically done in the work-up of congenital malformations. Other clinical concerns were trauma, neoplasm, or infection. Approximately 70% of the studies were abnormal, most commonly demonstrating various types of dysraphism or tethered cord, less frequently lipoma and other congenital abnormalities. Primary and secondary neoplasm and infection were uncommon. Pathological contrast enhancement was rare, and its presence or the lack of it helped the neuroradiologist in the differential diagnosis in only a limited number of cases.
Conclusion: The value of gadolinium contrast material-enhanced MRI of the spine in children under two years of age will be illustrated. Suggestions and recommendations for when to use intravenous contrast will be proposed, especially with respect to the clinical question, patient symptoms, and pretest probability of finding an abnormality.
Jennings MD, J,
The Value of Contrast Administration in MRI of the Spine in Children Under Two Years of Age. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3105244.html
