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Pelvic abnormalities in children: assessment with MR imaging
Insights
Magnetic resonance (MR) imaging effectively visualizes pediatric pelvic lesions, including congenital anomalies, cysts, and neoplasms. Multiplanar imaging and specific sequences enhance lesion characterization and comparison with ultrasonography and computed tomography.
Area of Science:
- Pediatric Radiology
- Medical Imaging
- Oncology
Background:
- Pelvic lesions in children and adolescents require accurate imaging for diagnosis and management.
- Various imaging modalities exist, each with strengths and limitations.
Purpose of the Study:
- To evaluate the efficacy of 0.3-T magnetic resonance (MR) imaging in characterizing pediatric pelvic lesions.
- To compare MR imaging performance with ultrasonography (US) and computed tomography (CT).
Main Methods:
- Multiplanar MR imaging (0.3-T) was performed on 62 pelvic lesions in 58 pediatric patients.
- Lesions were categorized as congenital anomalies, cystic lesions/fluid collections, or neoplasms.
- MR imaging planes (sagittal, axial, coronal) and sequences (T1- and T2-weighted) were assessed.
- Comparison with US (45 cases) and CT (13 cases) was conducted.
Main Results:
- MR imaging demonstrated lesions well across all categories.
- Specific planes optimized imaging for midline (sagittal), paired structures (axial), and extent (coronal).
- T1-weighted sequences were adequate for congenital/cystic lesions; T2-weighted sequences aided neoplasm and ectopic gonad visualization.
- MR was superior or equal to US in 97.9% of comparisons and superior or equal to CT in 92.3%.
Conclusions:
- 0.3-T MR imaging is a valuable tool for evaluating pediatric pelvic lesions.
- Multiplanar imaging and tailored sequences improve diagnostic accuracy.
- MR imaging demonstrates comparable or superior performance to US and CT in this patient population.
Abstract:
Multiplanar images of 62 pelvic lesions in 58 children and adolescents (aged 7 months to 19 years; mean, 10.6 years) were obtained with 0.3-T magnetic resonance (MR) imaging. Lesions were divided into three categories: congenital anomalies, cystic lesions and fluid collections, and neoplasms. MR demonstrated lesions well in all categories. Midline lesions were best imaged sagittally, and lesions of paired structures, axially. The coronal plane was useful in evaluating the superoinferior extent of lesions and in defining the extent of lymphadenopathy. T1-weighted sequences were sufficient to depict most congenital and cystic lesions. T2-weighted sequences were useful in demonstrating the extent of neoplasms and the position of ectopic gonads. Ultrasonography (US) was also performed in 45 cases. MR and US delineated lesions equally well in 25 cases (55.5%), MR was superior in 19 (42.4%), and US was superior in one (2.2%). Computed tomography (CT) was performed in 13 cases. MR and CT delineated lesions equally well in eight cases (61.5%), MR was superior in four (30.8%), and CT was superior in one (7.7%).