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Whole-body MRI in neurofibromatosis: incidental findings and prevalence of scoliosis

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Abstract

Objective

To demonstrate incidental findings and scoliosis on whole-body MRI (WBMRI) in patients with neurofibromatosis type 1 and 2 (NF1 & NF2, respectively), and schwannomatosis.

Materials and methods

Institutional review board approval and written informed consent were obtained for this prospective HIPAA-compliant study. A total of 247 subjects (141 with NF1, 55 with NF2, 51 with schwannomatosis; 132 women (53.5%); mean age, 41 years, range, 18–97 years) underwent WBMRI using coronal STIR (TR/TE: 4190/111 ms, TI: 150 ms) and T1-weighted images (TR/TE: 454/10 ms), 10-mm slice thickness, imaging time ~40 min. Images were reviewed for the presence of incidental findings, outside of nerve sheath tumors. The presence of scoliosis was recorded and curve morphology was assessed and quantified.

Results

Incidental findings other than scoliosis were recorded in 104/247 (42%) patients, most often affecting the musculoskeletal system (65/247 patients, 26%). We found 16/247 (6.5%) significant incidental findings likely to affect clinical management, including avascular necrosis of bone in eight patients (five with NF2), eight insufficiency fractures, and four non-neurogenic neoplasms (Hodgkin's lymphoma, liposarcoma, dermoid cyst, large uterine myoma requiring excision). Scoliosis was seen in 50/247 patients (20%), including 8/55 with NF2 (15%) and 11/51 with schwannomatosis (22%).

Conclusions

Incidental findings in the neurofibromatoses frequently involve the skeleton. Given the relatively high incidence of unsuspected osteonecrosis and stress fractures, close attention to the skeleton on WBMRI is advised. In addition, knowledge of common incidental findings can help clinicians prepare patients who undergo WBMRI for potential unexpected findings.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Funding support

Department of Defense Neurofibromatosis Research Program (NF0502020) and the NIH/NINDS (P01NS024279).

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Authors and Affiliations

  1. Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA

    Jacob L. Jaremko, Peter J. MacMahon, Martin Torriani & Miriam A. Bredella

  2. Department of Neurology and Cancer Center, Massachusetts General Hospital, Boston, MA, 02114, USA

    Vanessa L. Merker & Scott R. Plotkin

  3. Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Victor F. Mautner

Authors
  1. Jacob L. Jaremko
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  2. Peter J. MacMahon
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  3. Martin Torriani
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  4. Vanessa L. Merker
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  5. Victor F. Mautner
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  6. Scott R. Plotkin
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  7. Miriam A. Bredella
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Corresponding author

Correspondence to Miriam A. Bredella.

Additional information

Scott R. Plotkin and Miriam A. Bredella were equal senior authors.

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Jaremko, J.L., MacMahon, P.J., Torriani, M. et al. Whole-body MRI in neurofibromatosis: incidental findings and prevalence of scoliosis. Skeletal Radiol 41, 917–923 (2012). https://doi.org/10.1007/s00256-011-1333-x

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  • DOI: https://doi.org/10.1007/s00256-011-1333-x

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