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Normal changes in the MR appearance of the spleen during early childhood
L F Donnelly1, K H Emery, K E Bove
1Department of Radiology, Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
Insights
The spleen
Area of Science:
- Pediatric radiology
- Spleen imaging
- Lymphoid system maturation
Background:
- The spleen undergoes significant histologic changes during infancy as the lymphoproliferative system matures.
- Understanding these changes is crucial for accurate interpretation of spleen imaging in young children.
Purpose of the Study:
- To characterize the normal magnetic resonance (MR) appearance of the spleen in infants and young children.
- To correlate MR imaging findings with age-related splenic histologic development.
Main Methods:
- Retrospective analysis of 28 abdominal MR studies in patients up to 23 months of age.
- Comparison of splenic signal intensity (T1 and T2 weighted) relative to the liver.
- Correlation of imaging findings with autopsy specimen histology.
Main Results:
- T2-weighted splenic signal intensity evolved from isointense/hypointense to moderately hyperintense relative to the liver by 8 months.
- T1-weighted splenic signal intensity showed a gradual decrease with age.
- These MR signal changes correlated with increasing white pulp to red pulp ratios in spleen histology.
Conclusions:
- Normal neonatal spleen T2-weighted signal intensity is typically decreased compared to the liver.
- Older children and adults exhibit moderately hyperintense splenic signal on T2-weighted images.
- Recognizing these age-related MR signal variations is essential to avoid misinterpreting normal splenic development as pathology.
Objective:
During the first year of life, the spleen undergoes histologic changes as the lymphoproliferative system matures. The purposes of this study were to describe the normal MR appearance of the spleen during infancy and early childhood and to correlate imaging findings with age-related histologic changes.
Materials And Methods:
The spleen was evaluated on 28 abdominal MR studies obtained during the first 23 months of life. Splenic signal intensity was compared to that of the liver. Selected autopsy specimens were compared with the imaging results.
Results:
The T2-weighted signal intensity of the spleen gradually increased from isointense to hypointense relative to the liver during the first week of life to moderately hyperintense to the liver by 8 months of age. T1-weighted splenic signal intensity gradually decreased. These findings corresponded to histological increases in white-pulp-red-pulp ratios.
Conclusion:
Before the lymphoid system completely matures, the T2-weighted signal intensity of the normal neonatal spleen appears decreased compared with the moderately hyperintense splenic signal seen in older children and adults. This finding should not be mistaken for disease.