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João Jacinto, Carla Conceição, Isabel Fragata, João Reis

1 - Serviço de Neurorradiologia; Hospital Dona Estefânia e Hospital de São José, CHLC

- XI Congresso Nacional de Neurorradiologia, 23-25 de Outubro 2015, Aveiro - Prémio de melhor poster

Volumetric Proton Density (vPD) is often used on musculoskeletal joint imaging, as it better depicts ligamentous structures containing bound protons, namely ligaments, cortical bone and also cartilage being especially useful on meniscal tears diagnosis. By consequence, and besides not routinely used on spine imaging, PD has a recognized role on ruptures of spine ligamentous structures, such as annulus fibrosus tears, which are clearly seen. Moreover, there are several studies that show wider utility on spine diseases assessment. The purpose of this work is to show the value of vPD on specific clinical conditions.
Case Reports
The authors present pediatric cases with single or multiple vertebral malformations including body and posterior elements fusions, hemivertebras and duplications, with abnormal curvatures associated (scoliosis). None of them had performed a CT exam before, due to radiation risks in children. The MRI protocol included routine sagittal planes T1WI, T2WI and T2 STIR, and axial planes T1WI and T2WI. Additionally, sagittal vPD was acquired with coronal and sagittal reconstructions. The images obtained from vPD acquisition seems to help in assessment of vertebral malformations and abnormal curvatures.
vPD may be helpful on MRI spine imaging, particularly to evaluate vertebral morphologic changes, in which it appears to be superior to the routine spine protocol. Nevertheless, the aim of this work was not to study the possible replacement of T1WI or T2WI of the routine protocol, but to demonstrate the complementary role of vDP on the evaluation of certain morphological abnormalities of the spine, particularly in the absence of previous CT scans, common in the pediatric population.