Magnetic resonance imaging of the spine in a pediatric population: incidental findings

Objective: To determine the prevalence of incidental findings on magnetic resonance imaging (MRI) scans of the cervical, thoracic and lumbar spine in a paediatric population. Materials and Methods: We evaluated 190 spinal MRI examinations of patients aged ≤ 18 years of age. The study included only patients for whom complete medical records were available and who underwent complete MRI examination of the cervical, thoracic or lumbar spine, including whole-spine sagittal T2-weighted sequences. Imaging findings not related to the symptom or indication for MRI were considered incidental findings. Results: Of the 190 MRI examinations evaluated, 110 were in women and 80 were in men. The mean age of the study population was 12.46 ± 3.68 years. The main clinical indications for MRI in the sample were lumbago, scoliosis, dorsalgia and cervicalgia. Incidental findings were detected in the cervical, thoracic and lumbar spine in 40 (21.05%), 26 (13.83%) and 43 (22.63%) of the patients, respectively. The most common were (in the cervical spine) reversal/correction of the normal curvature; (in the thoracic spine) intravertebral disc herniation (Schmorl’s node) and disc dehydration; and (in the lumbar spine) disc protrusion (12 cases), Schmorl’s node (5 cases) and spondylolysis (4 cases). Conclusion: Incidental findings on MRI of the spine are less common in the paediatric population than in the adult population. Nevertheless, careful clinical evaluation of paediatric patients with complaints of axial and radiating pain is necessary in order to determine the correlation between symptoms and imaging findings.