Magnetic resonance imaging of the spine in a pediatric population: incidental findings

Abstract

Objective: To determine the prevalence of incidental findings on magnetic resonance imaging (MRI) scans of the cervical, thoracic and lumbar spine in a paediatric population. Materials and Methods: We evaluated 190 spinal MRI examinations of patients aged ≤ 18 years of age. The study included only patients for whom complete medical records were available and who underwent complete MRI examination of the cervical, thoracic or lumbar spine, including whole-spine sagittal T2-weighted sequences. Imaging findings not related to the symptom or indication for MRI were considered incidental findings. Results: Of the 190 MRI examinations evaluated, 110 were in women and 80 were in men. The mean age of the study population was 12.46 ± 3.68 years. The main clinical indications for MRI in the sample were lumbago, scoliosis, dorsalgia and cervicalgia. Incidental findings were detected in the cervical, thoracic and lumbar spine in 40 (21.05%), 26 (13.83%) and 43 (22.63%) of the patients, respectively. The most common were (in the cervical spine) reversal/correction of the normal curvature; (in the thoracic spine) intravertebral disc herniation (Schmorl’s node) and disc dehydration; and (in the lumbar spine) disc protrusion (12 cases), Schmorl’s node (5 cases) and spondylolysis (4 cases). Conclusion: Incidental findings on MRI of the spine are less common in the paediatric population than in the adult population. Nevertheless, careful clinical evaluation of paediatric patients with complaints of axial and radiating pain is necessary in order to determine the correlation between symptoms and imaging findings.

Statement of the German Roentgen Society, German Society of Neuroradiology, and Society of German-speaking Pediatric Radiologists on Requirements for the Performance and Reporting of MR Imaging Examinations Outside of Radiology

“…Incidental findings in all age groups have been described in the literature. A recent review of 190 MRI examinations of pediatric patients found rates of incidental findings of 21.1 % in the cervical spine, 13.8 % in the thoracic spine, and 22.6 % in the lumbar spine [32]. Park et al found incidental findings in 8.4 % of examinations of an older age patient population (95 % of patients over 30 years of age) with 1268 patients who underwent MRI of the lumbar spine for evaluation of disc herniation [33].…”

The anatomy of the thoracic spinal canal investigated with magnetic resonance imaging in children aged 0 to 13 years old

“…4 Another retrospective study of 190 spinal MRIs of patients up to 18 years of age, showed that the frequency of incidental findings on spinal examinations in the pediatric population is lower than in the adult population. 5 In another study on children and adolescents, it is believed that knowing the slopes of the sagittal plane of the development of the spine in childhood and adolescence will contribute to the earlier determination of pathologies. 6 The anatomy of the thoracic spinal canal in different postures was evaluated in 9 volunteers adults showed that the distances between the the dura mater and spinal cord were wider in the mid-thoracic region and with the subject in the sitting position (head-down).…”

Approaches to Incidental Intradural Tumors of the Spine in the Pediatric Population

“…These trends are expected to continue, and advances in MRI technology may further improve clinicians’ ability to detect small lesions. Children are frequently referred for MRIs for an array of indications, including headaches, scoliosis, lumbago, dorsalgia, and trauma workup [14, 15]. Moreover, the upper cervical spine can often be assessed on brain MRIs.…”