Developing spinal column: gadolinium-enhanced MR imaging

Area of Science:

• Pediatric Radiology
• Neuroimaging
• Skeletal Development

Background:

• The developing pediatric spine exhibits unique enhancement patterns on magnetic resonance (MR) imaging.
• Understanding these normal enhancement characteristics is crucial for accurate interpretation of pediatric spinal MR studies.

Purpose of the Study:

• To characterize the enhancement patterns of the normally developing pediatric spinal column using MR imaging.
• To differentiate normal enhancement from potential pathological findings in children.

Main Methods:

• Retrospective analysis of MR images from 58 children (7 days to 9 years old).
• Utilized a 1.5-T imager with short-repetition-time spin-echo sequences.
• Images acquired before and after gadolinium-based contrast agent administration (0.1 mmol/kg gadopentetate dimeglumine).

Main Results:

• Normal bone marrow enhancement was observed in all children under 7 years, most pronounced in those under 2 years.
• Cartilage enhancement was noted in all children under 1.5 years, representing a key finding in infant spine MR.
• Enhancement is attributed to prominent vasculature, capillary permeability, and extravascular space in pediatric bone marrow and cartilage.

Conclusions:

• Vertebral body and cartilage enhancement are normal findings in the pediatric spine, particularly in younger children.
• Radiologists must exercise caution when interpreting diffuse vertebral body enhancement in children, as it differs from adult pathological criteria.
• These findings aid in the accurate diagnosis of spinal conditions in pediatric patients.