GADOLINIUM-DOTA ENHANCED MRI OF PAINFUL OSSEOUS CRISES IN CHILDREN WITH SICKLE-CELL-ANEMIA

In order to evaluate the role of gadolinium-DOTA enhanced MRI in the m anagement of painful osseous crises in children with sickle cell anemi a (SCA), nine children with SCA underwent MRI, bone scans and ultrason ographic studies during 11 osseous crises. Imaging findings were compa red with the final diagnosis: three acute osteomyelitis (AO) and 16 ac ute infarcts (AI). MRI could not differentiate AO from AI. The appeara nce of severe Al was very misleading and was similar to the usual appe arance of AO, including soft tissue changes, periosteal reaction and p atterns of enhancement. Gadolinium-DOTA enhanced MRI was useful for de termining the anatomic site and extent of AO or Al and for distinguish ing between necrotic material, fluid collection and vascularized infla mmatory tissue. It can also help to guide the aspiration of intraosseo us, subperiosteal and soft tissue fluid collections.