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The prevalence of incidental findings on pelvis MRI of 8–13-year-old children

Abstract

Background

The prevalence and clinical relevance of incidental findings (IF(s)) on imaging assessing the pelvis in children has not been well documented.

Methods

Three-thousand two-hundred thirty-one children (mean age 10.2 (range 8.6–12.9) years) were evaluated with MRI of the hips, pelvis, and lumbar spine, as part of a prospective population-based pediatric cohort study. Scans were reviewed by trained medical staff for abnormalities. IFs were categorized by clinical relevance and need for further clinical evaluation.

Results

8.3% (n = 267) of children featured at least one IF. One or more musculoskeletal IFs were found in 7.9% (n = 254) of children, however, only 0.8% (n = 2) of musculoskeletal IFs required clinical evaluation. Most frequent abnormalities were simple bone cysts 6.0% (n = 195), chondroid lesions 0.6% (n = 20), and perineural cysts 0.5% (n = 15). Intra-abdominal IFs were detected in 0.5% (n = 17) of children, with over half (n = 9) of these requiring evaluation. The three most common intra-abdominal IFs were a duplex collecting system 0.09% (n = 3), significant ascites 0.06% (n = 2), and hydroureteronephrosis 0.06% (n = 2).

Conclusions

IFs on MRI of the lower abdominal and hip region are relatively common in children aged 8–13 years, most of these can be confidently categorized as clinically irrelevant without the need for additional clinical or radiologic follow up.

Impact

  • Our research contributes greatly to the knowledge of the prevalence of (asymptomatic) pathology in children. We evaluated MR images of 3231 children, covering hip joints, pelvic skeleton, lower and mid-abdomen, and lumbar and lower thoracic spine as part of a population study.

  • One or more musculoskeletal incidental finding were found in 7.9% of children. Most of these can be confidently categorized as clinically irrelevant without the need for additional follow up. However 0.8% of musculoskeletal findings required further evaluation.

  • Intra-abdominal incidental findings were detected in 0.5% of children, with over half of the abdominal and urogenital findings requiring further evaluation.

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Fig. 1: Figure 1 shows examples of bone lesions on coronal T2 FS Cube images.
Fig. 2: Figure 2 shows examples of renal abnormalities found on coronal T2 FS Cube images.
Fig. 3: Figure 3 shows images of a 10-year-old girl with a teratoma.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

No financial assistance was received in support of the study.

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Authors

Contributions

D.K.d.V., J.H.J.M.B., M.H.G.D., A.v.d.L., E.H.G.O.: substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of the version to be published. M.W.V.: drafting the article or revising it critically for important intellectual content; and final approval of the version to be published.

Corresponding author

Correspondence to Desirée K. de Vreede.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The Erasmus University Medical Center review board approved of the study and parents or legal guardians of the children provided written informed consent. In accordance with Dutch Law, children aged 12 years and older provided written informed consent themselves as well.

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de Vreede, D.K., Bessems, J.H.J.M., Dremmen, M.H.G. et al. The prevalence of incidental findings on pelvis MRI of 8–13-year-old children. Pediatr Res (2022). https://doi.org/10.1038/s41390-022-02259-6

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