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Whole-body MR imaging in suspected physical child abuse: comparison with skeletal survey and bone scintigraphy findings from the PEDIMA prospective multicentre study
- Source :
- European Radiology, European Radiology, 2021, Online ahead of print. ⟨10.1007/s00330-021-07896-9⟩, European Radiology, Springer Verlag, 2021, Online ahead of print. ⟨10.1007/s00330-021-07896-9⟩
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- International audience; Objectives: To assess the contribution of whole-body magnetic resonance imaging (WBMRI) and bone scintigraphy (BS) in addition to skeletal survey (SS) in detecting traumatic bone lesions and soft-tissue injuries in suspected child abuse.Methods: In this prospective, multicentre, diagnostic accuracy study, children less than 3 years of age with suspected physical abuse were recruited. Each child underwent SS, BS and WBMRI. A blinded first review was performed in consensus by five paediatric radiologists and three nuclear medicine physicians. A second review investigated discrepancies reported between the modalities using a consensus result of all modalities as the reference standard. We calculated the sensitivity, specificity and corresponding 95% confidence interval for each imaging modality (SS, WBMRI and BS) and for the combinations [SS + WBMRI] and [SS + BS].Results: One hundred seventy children were included of which sixty-four had at least one lesion. In total, 146 lesions were included. The sensitivity and specificity of each examination were, respectively, as follows: 88.4% [95% CI, 82.0-93.1] and 99.7% [95% CI, 99.5-99.8] for the SS, 69.9% [95% CI, 61.7-77.2] and 99.5% [95% CI, 99.2-99.7] for WBMRI and 54.8% [95% CI, 46.4-63.0] and 99.7% [95% CI, 99.5-99.9] for BS. Sensitivity and specificity were, respectively, 95.9% [95% CI, 91.3-98.5] and 99.2% [95% CI, 98.9-99.4] for the combination SS + WBMRI and 95.2% [95% CI, 90.4-98.1] and 99.4% [95% CI, 99.2-99.6] for the combination SS + BS, with no statistically significant difference between them.Conclusion: SS was the most sensitive independent imaging modality; however, the additional combination of either WBMRI or BS examinations offered an increased accuracy.Key points: • SS in suspected infant abuse was the most sensitive independent imaging modality in this study, especially for detecting metaphyseal and rib lesions, and remains essential for evaluation. • The combination of either SS + BS or SS + WBMRI provides greater accuracy in diagnosing occult and equivocal bone injuries in the difficult setting of child abuse. • WBMRI is a free-radiation technique that allows additional diagnosis of soft-tissue and visceral injuries.
- Subjects :
- Child abuse
medicine.medical_specialty
[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging
Skeletal survey
[SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine
Sensitivity and Specificity
[SDV.IB.MN] Life Sciences [q-bio]/Bioengineering/Nuclear medicine
030218 nuclear medicine & medical imaging
03 medical and health sciences
[SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics
0302 clinical medicine
parasitic diseases
medicine
Humans
Whole Body Imaging
Radiology, Nuclear Medicine and imaging
Child Abuse
Prospective Studies
Child
Radionuclide Imaging
Neuroradiology
[SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics
medicine.diagnostic_test
business.industry
Infant
Interventional radiology
Magnetic resonance imaging
General Medicine
Magnetic Resonance Imaging
Occult
Confidence interval
3. Good health
[SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging
Physical Abuse
Bone scintigraphy
030220 oncology & carcinogenesis
Radiology
Tomography, X-Ray Computed
business
Subjects
Details
- ISSN :
- 14321084 and 09387994
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- European Radiology
- Accession number :
- edsair.doi.dedup.....ec30cfbd8a7767cc6655bb0cf2f012e7