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SHR Neuro Cancer Cardio Lipid Metab Microb
Beer, M; Stenzel, M; Girschick, H; Schlegel, PG; Dargel, K.
Whole-body MR imaging in children with suspected osteonecrosis after intensive chemotherapy: Preliminary results
Rofo. 2008; 180(3):238-245
Doi: 10.1055/s-2008-1027185
Web of Science
PubMed
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- Leading authors Med Uni Graz
- Beer Meinrad
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- Abstract:
- Purpose: Use of multidrug chemotherapy poses the risk of avascular osseous necroses in children. Depiction of the whole body, including clinically non-apparent sites is mandatory for starting early and proper treatment, including surgical approaches in lesions near the joints. We analyzed the value of whole-body MRI in the detection of osteonecrosis, (1) in relation to conventional Xray imaging and clinical symptoms, (2) using different MRI sequences, (3) with follow-up examinations. Materials and Methods: 5 patients suffering from an oncological disease, 13 to 16 years old (3 x ALL, 1 x medulloblastoma, 1 x CML), and recently developing bone pain were examined with X-ray imaging of the particular region and a whole-body MRI (T2w TIRM, T1w TSE sequences, pre- and post-contrast GD-DTPA, including fat suppression techniques). Neck/thorax/abdomen/pelvis, and upper and lower extremities were acquired in the coronal plane, and the feet in sagittal orientation. 4 of 5 patients had at least one follow-up examination (in the mean after 10 +/- 4 months). Results: None of the initial X-ray images revealed an abnormal finding. The whole-body MRI showed in 4 of 5 children bone marrow lesions compatible with osteonecrosis. The locations were around the knee joints (n = 3) and the tibiae/ankle joints (n=4). In addition to the symptomatic sites, MRI revealed additional lesions at the following sites: humerus (n = 5), hip joints (n=4), knee joints (n=6), ankle joints (n = 4). The size varied from small focal lesions to lesions measuring 90% of the whole transverse diameter of the bone. The lesions were able to be detected most easily with heavily T2-weighted (TIRM) sequences, and the diagnosis was most easily established using the non-enhanced TSE T1-weighted sequences. As a consequence of the results of the whole-body MRI, all patients with lesions compatible with osteonecrosis received symptomatic (n=2) or specific (n = 2) therapy. In the follow-up examinations, a higher number of patients showed no changes in the lesions as to size and distribution. 2 patients showed partial resolution of the osteonecroses. Conclusion: Whole-body MR imaging allows early diagnosis of symptomatic as well as clinically non-apparent osteonecroses. It can be used in planning and monitoring surgical and pharmacological therapies.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Antineoplastic Agents - adverse effects
- Cerebellar Neoplasms - drug therapy
- Contrast Media -
- Female -
- Follow-Up Studies -
- Gadolinium DTPA - diagnostic use
- Humans -
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy
- Magnetic Resonance Imaging - methods
- Male -
- Medulloblastoma - drug therapy
- Osteonecrosis - chemically induced Osteonecrosis - diagnosis Osteonecrosis - drug therapy Osteonecrosis - radiography
- Pain - etiology
- Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy
- Randomized Controlled Trials as Topic -
- Whole Body Imaging -
- Find related publications in this database (Keywords)
- bones
- neoplasms
- MR imaging
- treatment effects
- osteonecrosis
- children