title: Whole-body MRI in neurofibromatosis: incidental findings and prevalence of scoliosis.
abstract: OBJECTIVE
  To demonstrate incidental findings and scoliosis on whole-body MRI (WBMRI) in patients with neurofibromatosis type 1 and 2 (NF1 & NF2, respectively), and schwannomatosis.
  
  
  METHODS
  Institutional review board approval and written informed consent were obtained for this prospective HIPAA-compliant study. A total of 247 subjects (141 with NF1, 55 with NF2, 51 with schwannomatosis; 132 women (53.5%); mean age, 41 years, range, 18-97 years) underwent WBMRI using coronal STIR (TR/TE: 4190/111 ms, TI: 150 ms) and T1-weighted images (TR/TE: 454/10 ms), 10-mm slice thickness, imaging time ~40 min. Images were reviewed for the presence of incidental findings, outside of nerve sheath tumors. The presence of scoliosis was recorded and curve morphology was assessed and quantified.
  
  
  RESULTS
  Incidental findings other than scoliosis were recorded in 104/247 (42%) patients, most often affecting the musculoskeletal system (65/247 patients, 26%). We found 16/247 (6.5%) significant incidental findings likely to affect clinical management, including avascular necrosis of bone in eight patients (five with NF2), eight insufficiency fractures, and four non-neurogenic neoplasms (Hodgkin's lymphoma, liposarcoma, dermoid cyst, large uterine myoma requiring excision). Scoliosis was seen in 50/247 patients (20%), including 8/55 with NF2 (15%) and 11/51 with schwannomatosis (22%).
  
  
  CONCLUSIONS
  Incidental findings in the neurofibromatoses frequently involve the skeleton. Given the relatively high incidence of unsuspected osteonecrosis and stress fractures, close attention to the skeleton on WBMRI is advised. In addition, knowledge of common incidental findings can help clinicians prepare patients who undergo WBMRI for potential unexpected findings.
authors.affiliation: Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
authors.forename: Jacob L
authors.initials: JL
authors.lastname: Jaremko
authors.forename: Peter J
authors.initials: PJ
authors.lastname: MacMahon
authors.forename: Martin
authors.initials: M
authors.lastname: Torriani
authors.forename: Vanessa L
authors.initials: VL
authors.lastname: Merker
authors.forename: Victor F
authors.initials: VF
authors.lastname: Mautner
authors.forename: Scott R
authors.initials: SR
authors.lastname: Plotkin
authors.forename: Miriam A
authors.initials: MA
authors.lastname: Bredella
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001900:Boston / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D033162:Incidental Findings; D007592:Joint Diseases / Q000453:epidemiology* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017253:Neurofibromatoses / Q000453:epidemiology* / Q000473:pathology*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012600:Scoliosis / Q000453:epidemiology* / Q000473:pathology*; D051598:Whole Body Imaging / Q000706:statistics & numerical data; D055815:Young Adult