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Pediatr Radiol. 2012 Jun;42(6):706-13. doi: 10.1007/s00247-011-2327-5. Epub 2011 Dec 27.

Magnetic resonance imaging in children with sickle cell disease--detecting alterations in the apparent diffusion coefficient in hips with avascular necrosis.

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1
Department of Pediatric Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA. john.mackenzie@ucsf.edu

Abstract

BACKGROUND:

Avascular necrosis (AVN) is a common morbidity in children with sickle cell disease (SCD) that leads to pain and joint immobility. However, the diagnosis is often uncertain or delayed.

OBJECTIVE:

To examine the ability of apparent diffusion coefficient (ADC) measurements on diffusion-weighted imaging to detect AVN in children with SCD.

MATERIALS AND METHODS:

ADC values were calculated at the hips of normal children (n = 19) and children with SCD who were either asymptomatic with no known previous hip disease (n = 13) or presented for the first time with clinical symptoms of hip pathology (n = 12). ADC values were compared for differences among groups with and without AVN using non-parametric statistical methods.

RESULTS:

The ADC values were elevated in the hips of children with AVN (median ADC = 1.57 × 10(-3) mm(2)/s [95% confidence interval = 0.86-2.10]) and differed significantly in pairwise comparisons (all P < 0.05) from normal children (0.74 [0.46-0.98]), asymptomatic children with SCD (0.55 [0.25-0.85]), and SCD children who had symptoms referable to their hips but did not show findings of hip AVN on conventional MRI or radiographs (0.46 [0.18-0.72]).

CONCLUSION:

Children with sickle cell disease have elevated apparent diffusion coefficient values in their affected hips on initial diagnosis of avascular necrosis.

PMID:
22200862
DOI:
10.1007/s00247-011-2327-5
[Indexed for MEDLINE]
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