Whole-Body MRI Helps Identify Suspected Child Abuse

Whole-body magnetic resonance imaging (MRI), which is very accurate at detecting soft-tissue abnormalities, may provide a means to detect suspected child abuse in infants, according to recent findings.

Whole-body MRI does not use ionizing radiation, but utilizes a magnetic field, radio frequency pulses, and a computer to generate precise images of organs, soft tissues, bone, and virtually all other internal body structures. The diagnosis of abuse relies greatly on the presence of skeletal injuries, and high-quality skeletal surveys (a series of X-rays of all the bones in the body) are recommended to visualize the frequently subtle high-specificity fractures seen in infant abuse. Bruises are the most typical sign of physical abuse, but subcutaneous tissue and muscle injuries are not currently assessed with a global imaging technique in living children.

The study, performed at Children's Hospital Boston (MA, USA) and Harvard Medical School (Boston, MA, USA), included 21 infants who underwent whole-body MRI for the evaluation of suspected child abuse. Summary skeletal survey and whole-body MRI identified 167 fractures or areas of skeletal signal abnormality.

"Although our study results revealed that whole-body MRI is insensitive in the detection of classic metaphyseal lesions and rib fractures, we found it did identify soft-tissue injuries such as muscle edema and joint effusions that, in some cases, led to identifying additional fractures,” said Jeannette M. Perez-Rossello, M.D., lead author of the study, which was published in the September 2010 issue of the American Journal of Roentgenology (AJR). "Although our study indicates that whole-body MRI is currently unsuitable as a primary global skeletal imaging tool for suspected abuse, it may be useful as a supplement to the skeletal survey in selected cases, particularly with regard to soft tissue injuries.”

Related Links:
Children's Hospital Boston
Harvard Medical School