Magnetic Resonance Imaging-Guided Osseous Biopsy in Children With Chronic Recurrent Multifocal Osteomyelitis

Journal Article · Wed Feb 15 00:00:00 EST 2012 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-011-0119-9· OSTI ID:21608631

Fritz, Jan ^[1]; Tzaribachev, Nikolay ^[2]; Thomas, Christoph ^[3]; Wehrmann, Manfred ^[4]; Horger, Marius S ^[3]; Carrino, John A ^[1]; Koenig, Claudius W; Pereira, Philippe L ^[3]

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1. Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science (United States)
2. University Children's Hospital, Eberhard-Karls-University Tuebingen, Division of Pediatric Rheumatology (Germany)
3. Eberhard-Karls-University Tuebingen, Department of Diagnostic and Interventional Radiology (Germany)
4. Eberhard-Karls-University Tuebingen, Department of Pathology (Germany)

Purpose: To report the safety and diagnostic performance of magnetic resonance (MRI)-guided core biopsy of osseous lesions in children with chronic recurrent multifocal osteomyelitis (CRMO) that were visible on MRI but were occult on radiography and computed tomography (CT). Materials and Methods: A retrospective analysis of MRI-guided osseous biopsy performed in seven children (four girls and three boys; mean age 13 years (range 11 to 14) with CRMO was performed. Indication for using MRI guidance was visibility of lesions by MRI only. MRI-guided procedures were performed with 0.2-Tesla (Magnetom Concerto; Siemens, Erlangen, Germany; n = 5) or 1.5-T (Magnetom Espree; Siemens; n = 2) open MRI systems. Core needle biopsy was obtained using an MRI-compatible 4-mm drill system. Conscious sedation or general anesthesia was used. Parameters evaluated were lesion visibility, technical success, procedure time, complications and microbiology, cytology, and histopathology findings. Results: Seven of seven (100%) targeted lesions were successfully visualized and sampled. All obtained specimens were sufficient for histopathological analysis. Length of time of the procedures was 77 min (range 64 to 107). No complications occurred. Histopathology showed no evidence of malignancy, which was confirmed at mean follow-up of 50 months (range 28 to 78). Chronic nonspecific inflammation characteristic for CRMO was present in four of seven (58%) patients, and edema with no inflammatory cells was found in three of seven (42%) patients. There was no evidence of infection in any patient. Conclusion: MRI-guided osseous biopsy is a safe and accurate technique for the diagnosis of pediatric CRMO lesions that are visible on MRI only.

• OSTI ID: 21608631
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 35, Issue 1; Other Information: DOI: 10.1007/s00270-011-0119-9; Copyright (c) 2012 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
ANESTHESIA
BIOPSY
CHILDREN
COMPUTERIZED TOMOGRAPHY
CYTOLOGY
DIAGNOSIS
EDEMA
INFLAMMATION
MAGNETIC RESONANCE
NEOPLASMS
NMR IMAGING
NUCLEAR INDUSTRY
OSTEOMYELITIS
PATIENTS
PEDIATRICS
SAFETY
AGE GROUPS
ANIMALS
BIOLOGY
DIAGNOSTIC TECHNIQUES
DISEASES
INDUSTRY
MAMMALS
MAN
MEDICINE
PATHOLOGICAL CHANGES
PRIMATES
RESONANCE
SKELETAL DISEASES
SYMPTOMS
TOMOGRAPHY
VERTEBRATES