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Imaging of Multisystem Inflammatory Disease in Children (MIS-C) Associated With COVID-19
Figen Palabiyik1, Nihal Akcay2, Esra Sevketoglu2
1University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Pediatric Radiology, Istanbul, Turkey.
Insights
Imaging in pediatric multisystem inflammatory disease (MIS-C) associated with COVID-19 shows varied findings across systems. While not diagnostic, these radiological signs aid in evaluating affected organs and guiding treatment for MIS-C.
Area of Science:
- Pediatric Radiology
- Infectious Diseases
- Inflammatory Diseases
Background:
- Multisystem inflammatory disease in children (MIS-C) is a serious condition linked to COVID-19.
- Understanding the spectrum of imaging findings in MIS-C is crucial for diagnosis and management.
Purpose of the Study:
- To retrospectively evaluate and characterize the imaging findings in pediatric patients diagnosed with MIS-C.
- To correlate radiological findings with affected organ systems in MIS-C.
Main Methods:
- Retrospective analysis of imaging studies in 45 pediatric patients diagnosed with MIS-C.
- Evaluated chest X-ray, echocardiography, abdominal radiographs, CT, MRI, and MRCP.
- Findings were categorized by affected organ system.
Main Results:
- Common chest X-ray findings included perihilar opacity and peribronchial thickening; pleural effusion was frequent on thorax CT.
- Echocardiography revealed myocarditis in 31% of cases.
- Abdominal findings included hepatosplenomegaly, gallbladder wall and periportal edema, mesenteric lymphadenopathy, and bowel wall thickening. Neurological findings included reversible splenial lesion syndrome (RESLES) and ADEM-like lesions.
Conclusions:
- Radiological findings in pediatric MIS-C are diverse and system-dependent.
- No single imaging finding is specific for MIS-C.
- Imaging plays a supportive role in assessing organ involvement and guiding treatment strategies.
Rationale And Objectives:
To retrospectively evaluate imaging findings in multisystem inflammatory disease in children associated with COVID-19 (MIS-C).
Materials And Methods:
The radiological imaging findings of 45 pediatric patients aged between 52 days and 16 years, who were diagnosed with MIS-C according to the World Health Organization (WHO) criteria, were evaluated. All the patients underwent chest X-ray and echocardiography. The findings obtained from 25 abdominal radiographs, 24 abdominal US, 7 abdominal CT, 16 thorax CT, 21 cranial MRI and one spinal MRI, MR cholangiography (MRCP) and cardiac MRI examinations were categorized and evaluated according to the affected systems.
Results:
While the most common findings in chest X-ray were perihilar opacity and peribronchial thickening, pleural effusion was the most finding in thorax CT. Echocardiography findings of myocarditis were observed in 31% of the cases. The most common findings in abdominal radiological evaluation were hepatomegaly and splenomegaly, edema in the gallbladder wall and periportal area, mesenteric lymph nodes in the right lower quadrant, thickening of the intestinal walls, and free fluid. Reversible splenial lesion syndrome (RESLES) was the most common neurological finding. Acute disseminated encephalomyelitis (ADEM)-like lesions, acute hemorrhagic necrotizing encephalomyelitis, and radiological findings consistent with Guillain-Barré syndrome were found in one case each.
Conclusion:
Radiological findings seen in MIS-C in pediatric cases are correlated with the affected system. According to the system involved, there is no specific finding for this disease. Radiological findings are not the primary diagnostic tool but can assist in the evaluation of the affected systems and to guide treatment.
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