Musculoskeletal manifestations of sickle cell disease, diagnosis with whole body MRI

Khedr, Sherif; Hassaan, Mohamed A.; Shabana, Amro A.; Gaballah, Ayman H.; Mokhtar, Doha A.

doi:10.1016/j.ejrnm.2011.12.005

Cited by 7 publications

(11 citation statements)

References 15 publications

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“…Elevated white blood cell count usually found in only 36% of children, but if both the C reactive protein and ESR (erythrocyte sedimentation rate) values are abnormally increased, the sensitivity for infection reaches 98% [17] . The present study included 30 patients known to have sickle cell disease, boys (70%) were affected more than girls (30%), with a mean age of 5 years in agreement with [3,10,15] studies who mentioned similar sex and age group incidence.…”

Section: Discussionsupporting

confidence: 82%

“…Vaso-occlusive crises frequently noticeable in young children as dactylitis which is a painful swelling of the fingers, toes, hands and feet. Other adverse outcomes in SCA include osteomyelitis, osteonecrosis, acute chest syndrome, stroke, papillary necrosis, renal insufficiency splenic infarct and splenic sequestration [3] .…”

Section: Discussionmentioning

confidence: 99%

“…Ischemic complications include painful episodes involving bones and soft tissues, cerebral vascular accidents, acute chest syndrome, priapism, splenic infarction and sequestration and renal dysfunctions. MRI is the superior imaging modality in diagnosing wide range of abnormalities and multisystem affection caused by SCD [5,6] and familiarity of these imaging findings is vital to precisely detect the complications early and initiate proper treatment Bone marrow infarction may have a very similar appearance at MR imaging compared to osteomyelitis as both show areas of high signal on T2weighted and inversion recovery with variable enhancement, so the differentiation of both at MRI is difficult [3] . Soft-tissue abnormalities like edema and abnormal periosteal enhancement, abnormal enhancement of the muscle, fascia, and subcutaneous fat were thought to be a sign of osteomyelitis; but unluckily, the same abnormalities in the soft tissue might also be depicted with infarction [9] .…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of MRI in Early Diagnosis of Musculoskeletal Complications of Sickle Cell Disease in Pediatrics

Hassan

2019

The Medical Journal of Cairo University

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Background: Sickle cell disease (SCD) include a group of genetic abnormalities in which there is inheritance of Hb S (sickle hemoglobin) from both parents, or Hb S from one parent and a gene for beta-thalassemia or an abnormal hemoglobin from the other parent. The most common and the most severe form is sickle cell anemia. Aim of Study:To evaluate the feasibility of MRI in early detection of musculoskeletal complications of pediatric sickle cell disease (SCD) aiming to discriminate osteomyelitis from infarction.Patients and Methods: This prospective study included 30 patients (21 boys, 9 girls) with a mean age of 5 years proved to have SCD and suspected to have osteomyelitis. All patients underwent X-ray and different sequences MRI.Results: Persistence of red marrow and multiple bone infarctions were the most common MRI findings followed by osteomyelitis in 8, chondritis in 7, myositis in 4, septic arthritis in 3, subperiosteal and soft tissue abscess each in 2. There was difficulty in discriminating infarction from osteomyelitis Conclusion: MRI is helpful in early identification of musculoskeletal abnormalities in SCD in pediatrics. Early detection is crucial to initiate treatment to avoid the complication.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Feasibility of MRI in Early Diagnosis of Musculoskeletal Complications of Sickle Cell Disease in Pediatrics

Hassan

2019

The Medical Journal of Cairo University

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“…The typical whole-body MRI protocol included STIR sequences only (20 papers) [ 29 – 32 , 38 , 39 , 41 – 44 , 51 , 56 , 58 , 61 , 63 , 66 – 68 , 74 , 75 ] or STIR and T1-W sequences (17 papers) [ 2 , 3 , 5 , 27 , 28 , 35 , 37 , 40 , 45 , 46 , 49 , 50 , 55 , 57 , 60 , 62 , 71 ]. Five studies used a protocol including STIR, T1-W and DWI [ 36 , 54 , 59 , 64 ], and four studies used only STIR and DWI [ 52 , 53 , 69 , 70 ].…”

Section: Resultsmentioning

confidence: 99%

“…In 18 of the papers (33.3%), the authors concluded that whole-body MRI is a sensitive tool for detecting clinically silent lesions [ 1 – 3 , 5 , 6 , 28 , 32 , 35 , 37 , 40 , 43 , 46 , 56 , 60 , 62 , 72 , 73 , 75 ], of which only 3 papers discussed the possibility of these findings being due to normal growth related changes [ 35 , 37 , 75 ]. In total, 12 of 54 papers (22.2%) suggested bone bruise and/or highly cellular bone marrow as a cause of high signal on T2-W sequences [ 34 , 35 , 37 , 45 , 50 , 51 , 53 , 57 – 59 , 66 , 75 ].…”

Section: Resultsmentioning

confidence: 99%

Whole-body magnetic resonance imaging in children – how and why? A systematic review

et al. 2020

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Whole-body magnetic resonance imaging (MRI) is increasingly being used for a number of indications. Our aim was to review and describe indications and scan protocols for diagnostic value of whole-body MRI for multifocal disease in children and adolescents, we conducted a systematic search in Medline, Embase and Cochrane for all published papers until November 2018. Relevant subject headings and free text words were used for the following concepts: 1) whole-body, 2) magnetic resonance imaging and 3) child and/or adolescent. Included were papers in English with a relevant study design that reported on the use and/ or findings from whole-body MRI examinations in children and adolescents. This review includes 54 of 1,609 papers identified from literature searches. Chronic nonbacterial osteomyelitis, lymphoma and metastasis were the most frequent indications for performing a whole-body MRI. The typical protocol included a coronal STIR (short tau inversion recovery) sequence with or without a coronal T1-weighted sequence. Numerous studies lacked sufficient data for calculating images resolution and only a few studies reported the acquired voxel volume, making it impossible for others to reproduce the protocol/images. Only a minority of the included papers assessed reliability tests and none of the studies documented whether the use of whole-body MRI affected mortality and/or morbidity. Our systematic review confirms significant variability of technique and the lack of proven validity of MRI findings. The information could potentially be used to boost attempts towards standardization of technique, reporting and guidelines development.

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Whole-body diffusion magnetic resonance imaging with simultaneous multi-slice excitation in children and adolescents

et al. 2023

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Background Whole-body magnetic resonance imaging (WB-MRI) is an increasingly used guideline-based imaging modality for oncological and non-oncological pathologies during childhood and adolescence. While diffusion-weighted imaging (DWI), a part of WB-MRI, enhances image interpretation and improves sensitivity, it also requires the longest acquisition time during a typical WB-MRI scan protocol. Interleaved short tau inversion recovery (STIR) DWI with simultaneous multi-slice (SMS) acquisition is an effective way to speed up examinations. Objective In this study of children and adolescents, we compared the acquisition time, image quality, signal-to-noise ratio (SNR) and apparent diffusion coefficient (ADC) values of an interleaved STIR SMS-DWI sequence with a standard non-accelerated DWI sequence for WB-MRI. Materials and methods Twenty children and adolescents (mean age: 13.9 years) who received two WB-MRI scans at a maximum interval of 18 months, consisting of either standard DWI or SMS-DWI MRI, respectively, were included. For quantitative evaluation, the signal-to-noise ratio (SNR) was determined for b800 images and ADC maps of seven anatomical regions. Image quality evaluation was independently performed by two experienced paediatric radiologists using a 5-point Likert scale. The measurement time per slice stack, pause between measurements including shim and total measurement time of DWI for standard DWI and SMS-DWI were extracted directly from the scan data. Results When including the shim duration, the acquisition time for SMS-DWI was 43% faster than for standard DWI. Qualitatively, the scores of SMS-DWI were higher in six locations in the b800 images and four locations in the ADC maps. There was substantial agreement between both readers, with a Cohen’s kappa of 0.75. Quantitatively, the SNR in the b800 images and the ADC maps did not differ significantly from one another. Conclusion Whole body-MRI with SMS-DWI provided equivalent image quality and reduced the acquisition time almost by half compared to the standard WB-DWI protocol.

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Musculoskeletal manifestations of sickle cell disease, diagnosis with whole body MRI

Cited by 7 publications

References 15 publications

Feasibility of MRI in Early Diagnosis of Musculoskeletal Complications of Sickle Cell Disease in Pediatrics

Feasibility of MRI in Early Diagnosis of Musculoskeletal Complications of Sickle Cell Disease in Pediatrics

Whole-body magnetic resonance imaging in children – how and why? A systematic review

Whole-body diffusion magnetic resonance imaging with simultaneous multi-slice excitation in children and adolescents

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