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

  • Clinical Investigation
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Abstract

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.

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Conflict of interest

J. A. Carrino holds research grants from Siemens AG and Carestream Health, Inc., and is a research consultant for General Electric Company. However, he has no commercial interest in these companies.

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Authors and Affiliations

  1. Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA

    Jan Fritz & John A. Carrino

  2. Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tübingen, 72076, Tübingen, Germany

    Jan Fritz, Christoph Thomas, Marius S. Horger, Claudius W. König & Philippe L. Pereira

  3. Division of Pediatric Rheumatology, University Children’s Hospital, Eberhard-Karls-University Tübingen, 72076, Tübingen, Germany

    Nikolay Tzaribachev

  4. Department of Pediatric Rheumatology, Klinikum Bad Bramstedt, 24576, Bad Bramstedt, Germany

    Nikolay Tzaribachev

  5. Department of Pathology, Eberhard-Karls-University Tübingen, 72076, Tübingen, Germany

    Manfred Wehrmann

  6. Department of Radiology, Minimally Invasive Therapies and Nuclearmedicine, SLK-Kliniken Heilbronn, 4078, Heilbronn, Germany

    Philippe L. Pereira

Authors
  1. Jan Fritz
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  2. Nikolay Tzaribachev
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  3. Christoph Thomas
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  4. Manfred Wehrmann
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  5. Marius S. Horger
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  6. John A. Carrino
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  7. Claudius W. König
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  8. Philippe L. Pereira
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Correspondence to Jan Fritz.

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Fritz, J., Tzaribachev, N., Thomas, C. et al. Magnetic Resonance Imaging-Guided Osseous Biopsy in Children With Chronic Recurrent Multifocal Osteomyelitis. Cardiovasc Intervent Radiol 35, 146–153 (2012). https://doi.org/10.1007/s00270-011-0119-9

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  • DOI: https://doi.org/10.1007/s00270-011-0119-9

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