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Analysis of whole-body MRI artifacts in a pediatric population with a special emphasis on the effect of hands position - 21/10/22

Doi : 10.1016/j.diii.2022.10.002 
Solène Le Cam a, b, Paul de Boissieu c, Jean Paul Teglas d, Valérie Merzoug b, Inès Mannes b, Catherine Adamsbaum a, b,
a Faculty of Medicine, Paris Saclay Université, 94270 Le Kremlin, Bicêtre, France 
b AP-HP, Bicêtre Hospital, Pediatric Imaging Department, 94270 Le Kremlin, Bicêtre, France 
c AP-HP, Bicêtre Hospital, Epidemiology and Public Health Department, 94270 Le Kremlin, Bicêtre, France 
d CESP U1018 INSERM, 94270 Le Kremlin, Bicêtre, France 

Corresponding author: catherine.adamsbaum@aphp.frFaculty of MedicineParis Saclay UniversitéLe KremlinBicêtre94270France
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 21 October 2022
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Highlights

Artifacts on whole-body MRI in a pediatric population mainly affect images of the feet, hands, sacrum, and ribs.
In a pediatric population whole-body MRI is affected mainly by partial volume and motion artifacts.
The use of both STIR and T1-weighted sequences helps distinguish between actual lesions and artifacts.
Hands position should be considered with respect to both diagnosis benefit and safety.

Le texte complet de cet article est disponible en PDF.

Abstract

Purpose

The purpose of this retrospective study was to determine the prevalence of artifacts on whole-body (WB) magnetic resonance imaging (MRI) examination in pediatric patients and identify their causes.

Materials and methods

A total of 107 pediatric patients who underwent a total of 107 WB-MRI examinations, including short-tau inversion recovery (STIR) and T1-weighted sequences, were included. There were 62 girls and 45 boys with a mean age of 11 ± 3 (SD) years (age range: 2–16 years). WB-MRI examinations were analyzed for the presence of artifacts on STIR and T1-weighted sequences. Artifacts were further assigned to one of eight categories (motion, partial volume, cross-talk, phase sampling, susceptibility, equipment, noise, and “other”) and 19 anatomical sites by a 4-year resident. Prevalence of artifacts were analyzed especially according to hands position during the examination for the upper limbs and patients’ age. Age was expressed as a binary variable using median age (10 years) as the cut-off value. All qualitative variables were compared using chi-square test.

Results

A total of 3436 artifacts were found. The STIR sequences showed more “noise” artifacts (93/1038; 8.96%) and more “cross-talk” (102/1038; 9.83%) artifacts than T1-weighted sequences (12/1038 [1.16%] and 7/1038 [0.67%], respectively) (P < 0.001 for both). T1-weighted sequences showed more “equipment” (84/1038; 8.09%) and “stair-step” (a subset of “other”) (41/1038; 3.95%) artifacts than the STIR sequences (39/1038 [3.76%] and 21/1038 [2.02%], respectively) (P < 0.001 and P = 0.01, respectively). T1-weighted sequences showed fewer artifacts on the wrists when the hands were under the bottom (P = 0.001). T1-weighted sequences showed less “equipment” artifacts when the hands were alongside the body (22/296; 7%) than on the abdomen (48/432; 11%) or under the bottom (14/128; 11%) (P < 0.001). STIR sequences showed more “motion” artifacts when the hands were on the abdomen (54/432; 13%) than alongside the body (30/296; 10%) or under the bottom (15/128; 12%) (P < 0.001). WB-MRI examinations had more “susceptibility” artifacts (38/960; 4%) and more “equipment” artifacts (81/960; 8.4%) in patients older than 10 years than in those under 10 years (23/752 [3.1%] and 42/752 [5.6%]) (P = 0.01 and P < 0.001, respectively).

Conclusion

Artifacts on WB-MRI do not affect coronal STIR and T1-weighted sequences equally, so the use of both sequence types appears useful. Hands position should be considered with respect to both diagnostic benefit and safety.

Le texte complet de cet article est disponible en PDF.

Keywords : Artifacts, Chronic recurrent multifocal osteomyelitis, Pediatrics, Whole body magnetic resonance imaging

Abbreviations : CRMO, SD, SE, STIR, WB-MRI


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