High signal in bone marrow at diffusion-weighted imaging with body background suppression (DWIBS) in healthy children.

Pediatric Radiology
Lil-Sofie Ording MüllerOystein E Olsen

Abstract

In our experience, diffusion-weighted imaging with body background suppression (DWIBS) is hard to interpret in children who commonly have foci of restricted diffusion in their skeletons unrelated to pathology, sometimes in an asymmetrical pattern. This raises serious concern about the accuracy of DWIBS in cancer staging in children. To describe the signal distribution at DWIBS in the normal developing lumbar spine and pelvic skeleton. Forty-two healthy children underwent an MR DWIBS sequence of the abdomen and pelvis. An axial short-tau inversion-recovery (STIR) echo-planar imaging (EPI) pulse sequence was used. Two radiologists did a primary review of the images and based on these preliminary observations, separate scoring systems for the lumbar spine, pelvis and proximal femoral epiphyses/femoral heads were devised. Visual evaluation of the images was then performed by the two radiologists in consensus. The scoring was repeated separately 2 months later by a third radiologist. Restricted diffusion was defined as areas of high signal compared to the background. Coronal maximum intensity projection (MIP) reformats were used to assess the vertebral bodies. For the pelvis, the extension of high signal for each bone was given a sc...Continue Reading

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Jan 10, 2014·Skeletal Radiology·Hassan Hirji, Asif Saifuddin
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