Purpose or Case Report: Whole body MR imaging is now widely utilized in the diagnosis and staging of pediatric patients with systemic disorders and diseases such as Chronic nonbacterial osteomyelitis (CNO), Neuroblastoma, Langerhans cell histocytosis (LCH) and fever of unknown origin (FUO). This technique allows the radiologist to visualize the entire body thereby, providing information regarding the full extent of disease allowing clinicians to direct the patient’s treatment. As an alternative to CT and Nuclear medicine, MR whole body imaging produces superior results without exposing the patient to ionizing radiation. We present an educational guide to practical positioning of the patient, coil positioning and protocol optimization.
Methods & Materials: We discuss our whole body MRI technique and procedure, review the common indications for this examination and highlight representative diagnostic images for this educational exhibit.
Results: The duration of the entire procedure including preparation is typically 1.5-2 hours, depending on the size of the child. We include images acquired based on two protocols: one without contrast, e.g. utilized for CNO and FUO, and one with and without contrast in the cases of suspected occult tumor or genetic tumor predisposing syndromes.
Acquisitions include: Head to foot localizers for scan planning, diagnostic acquisitions with Short Tau Inversion Recovery (STIR) sequences in sagittal and coronal planes utilize a multistation approach to generate a composed whole body sequence. Diffusion weighted images are acquired in the axial plane, composed, and may be post-processed into the coronal plane if requested. When indicated, pre and post contrast radio-frequency-spoiled 3D gradient echo images of the head, neck, chest, abdomen and pelvis are acquired in the axial and coronal plane.
Conclusions: Whole body MRI is a valuable tool in the evaluation of select systemic diseases and disorders. Although, the time spent obtaining these images can be long, the result provides high-resolution imaging that makes precise diagnoses and affects patient management. Technologist awareness of appropriate clinical indications and involvement in protocol optimization and patient scanning is critical to the success of the examination.