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Whole-Body Fast Inversion Recovery MR Imaging of Small Cell Neoplasms in Pediatric Patients: A Pilot Study

Avi Mazumdar1, Marilyn J. Siegel1, Vamsidhar Narra1 and Lori Luchtman-Jones2

1 Department of Radiology, Washington University School of Medicine, Mallinckrodt Institute of Radiology, 510 S. Kingshighway Blvd., St. Louis, MO 63110.
2 Department of Pediatrics, Washington University School of Medicine, 1 Children's Pl., 2 S. 58, St. Louis, MO 63110.



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  		Fig. 1A. —14-year-old girl with Ewing's sarcoma of left ischium. Whole-body turbo short tau inversion recovery (STIR) imaging showed widespread metastatic disease. Turbo STIR MR image shows metastases (arrows) in proximal right femur and mid and distal left femur.

 


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  		Fig. 1B. —14-year-old girl with Ewing's sarcoma of left ischium. Whole-body turbo short tau inversion recovery (STIR) imaging showed widespread metastatic disease. Turbo STIR MR image shows metastases (arrowheads) in both proximal tibias and mid left tibia.

 


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  		Fig. 1C. —14-year-old girl with Ewing's sarcoma of left ischium. Whole-body turbo short tau inversion recovery (STIR) imaging showed widespread metastatic disease. T1-weighted MR image obtained through tibias shows lesions in proximal tibias (arrowheads), but misses the lesions in mid left tibia shown in B.

 


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  		Fig. 1D. —14-year-old girl with Ewing's sarcoma of left ischium. Whole-body turbo short tau inversion recovery (STIR) imaging showed widespread metastatic disease. Skeletal scintigram reveals lesions in left acetabulum, proximal right femur, mid and distal left femur, and both proximal tibias, but misses lesions in the mid left tibia. Lesions measuring more than 1 cm in diameter on MR imaging were detected on scintigraphy. Subcentimeter lesions were not recognized.

 


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  		Fig. 2A. —16-month-old boy with neuroblastoma. Turbo short tau inversion recovery (STIR) MR image shows focal lesions in both distal femurs (arrows) and proximal right tibia (arrowhead).

 


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  		Fig. 2B. —16-month-old boy with neuroblastoma. T1-weighted MR image shows focal lesions in both distal femurs (arrows) and proximal right tibia (arrowhead). Lesions are more obvious on turbo STIR image (A).

 


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  		Fig. 3A. —Pararenal metastasis in 17-year-old girl with extremity rhabdomyosarcoma. Turbo short tau inversion recovery MR image shows metastasis (M) measuring 6 cm in longest diameter in right posterior pararenal space.

 


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  		Fig. 3B. —Pararenal metastasis in 17-year-old girl with extremity rhabdomyosarcoma. T1-weighted MR image shows findings similar to those seen on A.

 


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  		Fig. 3C. —Pararenal metastasis in 17-year-old girl with extremity rhabdomyosarcoma. Contrast-enhanced axial CT scan shows soft-tissue mass (M) in the pararenal space.

 


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  		Fig. 4. —Benign pleural effusion in 15-year-old boy with pelvic Ewing's sarcoma that was diagnosed 2 years previously. Single pulmonary nodule had been resected 2 weeks before whole-body MR imaging study. Histology confirmed metastasis to lung, which was sign of recurrent disease. Turbo short tau inversion recovery MR image shows small apical pleural effusion. No other lung nodules were seen on MR imaging or on follow-up CT.

 

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