Whole-body magnetic resonance imaging for detection of the lymphatic and hematogenous metastasis of soft tissue tumors of the trunk and extremities in children

The aim of the study was to improve the diagnosis of lymphatic and hematogenous metastasis of soft tissue tumors in children with disseminated lesions.
Material and methods. WBMRI was performed on 15 patients with soft tissue tumors: 13 had malignant lesions, 2 had benign lesions. 7 men, 8 women; age from 1.5 to 16 years. MR imaging was performed using a SIeMenS MAgneToМ AVAnTo 1,5T and SKYRA 3T (germany). WBMRI was performed with T1-se and T2 – STIR sequences in coronary projection. We analyzed the sensitivity, specificity, PPV, NPV of WBMRI in detecting metastasis.
Results. 13 patients were determined disseminated forms of soft tissue tumors with presence of the primary tumor, 2 patients had metastases of the primary lesion that was not detected. Skeletal metastases were found in 5 children, of whom 4 in the bone marrow. 7 patients had enlarged lymph nodes, 1 patient in this case had a false positive result on WBMRI. changes in the lung tissue were detected in 3 patients and were confirmed with CT of the chest. In 1 patient with small foci of up to 3 mm, identified in the CT of the chest is given a false negative conclusion on WBMRI. other organs (spleen, peritoneum, pleura, brain), as the metastatic character of malignant forms of soft tissue tumors, and in particular lesion at the neurofibromatosis type 1 is identified at the WBMRI in 3 patients.
Conclusion. WBMRI showed high information content to identify the primary pathological process and metastatic. Sensitivity of WBMRI and SSC for the detection of bone metastases – 98% and 47.1%, specificity – 100% and 100%, respectively.
WBMRI is more informative for the detection metastases of the target organs than abdominal ultrasound: sensitivity – 100% and 66.7%, specificity – 100% and 100%, respectively. WBMRI gives way ultrasound study lymph nodes: sensitivity – 100% and 100%, specificity – 87.5% and 100%, respectively. WBMRI gives way CT of the chest to identify MTS in lung: sensitivity – 75% and 100%, specificity – 100% and 100%, respectively.