Jeannette Mercedes Perez-Rossello MD, Presenter: Nothing to Disclose

Susan Andrea Connolly MD, Abstract Co-Author: Nothing to Disclose

David Zurakowski PhD, Abstract Co-Author: Nothing to Disclose

Paul K. Kleinman MD, Abstract Co-Author: Nothing to Disclose

To assess the potential role of whole body MRI (WB-MRI) in cases of suspected infant abuse.

We reviewed imaging studies of 19 infants (10 boys, 9 girls; age 0-12 months; mean, 5 months) who underwent WB-MRI for suspected abuse. Coronal and sagittal STIR images were obtained from shoulders to heels. Skeletal surveys were done according to ACR guidelines within 5 days of the MRI. Follow up skeletal surveys were available in 15 patients. The IRB approved the study.

Of a total of 102 osseous findings, 26% were seen on both studies; 35% only on MRI and 38% only on plain films. There were 34 classic metaphyseal lesions on skeletal survey; 41% had corresponding signal abnormalities on MRI. Forty rib fractures were seen on skeletal survey; 42% had corresponding findings on MRI. Of 24 other fractures on skeletal survey, 50% were seen on MRI. MRI identified marrow hyperintensity in 36 areas were no radiographic abnormality was seen; 12% were positive on follow up skeletal survey. MRI identified 74 areas of muscle and 31 areas of subcutaneous signal abnormalities and 17 joint effusions.

Whole Body MRI appears insensitive for detection of high specificity fractures of infant abuse.

MRI may provide unique information, particularly with respect to soft tissue injuries, but at present, it cannot replace the skeletal survey.

Perez-Rossello, J, Connolly, S, Zurakowski, D, Kleinman, P, Whole-body MRI in the Evaluation of Suspected Infant Abuse.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4430100.html