Whole-body MR imaging in suspected physical child abuse: comparison with skeletal survey and bone scintigraphy findings from the PEDIMA prospective multicentre study - Archive ouverte HAL Access content directly
Journal Articles European Radiology Year : 2021

Whole-body MR imaging in suspected physical child abuse: comparison with skeletal survey and bone scintigraphy findings from the PEDIMA prospective multicentre study

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Pierre-Hugues Vivier
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Catherine Treguier
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Lydie Abalea
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Séverine Croly-Labourdette
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Phong Dam Hieu
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Murielle Dobrzynski
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Bertrand Fenoll
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Pierre Forlodou
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Christiane Le Bot
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Jérémie Lefranc
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Mélanie Lesoeur
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Philippe Mériot
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Sylviane Peudenier
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Solène Querello
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Pierre Yves Salaun
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Pierre Olivier
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Anne Borsa-Dorion
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Marie-Agnès Galloy
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Laurence Mainard-Simard
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Emmanuel Raffo
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Sylvie Cavare-Vigneron
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Michel Claudon
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Olivier Klein
Emmanuelle Schmitt
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Serge Le Tacon
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Olivier Morel
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Lucie Lapp
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Françoise Bodere-Kraeber
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Caroline Milin
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Juliette Fleury
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Loïc Geffroy
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Sophie Hamel
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Thomas Lefrancois
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Marie-Pierre Longis
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Emmanuelle Mayrargue
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Georges Picherot
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Marie-Pierre Quéré
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Jean-Christophe Rozé
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Nathalie Vabres
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Renaud Bouvet
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Mariannick Le Gueut
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Laurent Riffaud
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Martine Balençon
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Pierre Bétrémieux
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Madeleine Chapuis
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Véronique Chasle
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Alain Dabadie
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Léna Damaj
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Pierre Darnault
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François de La Brière
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Séverine Delahaye
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Regis Duvauferrier
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Céline Farges
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Bernard Fraisse
Théophile Gaillot
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Maryse Gardin
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Cécile Gauvrit
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Marie-Aline Guitteny
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Sylvette Marleix
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Silvia Napuri
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Michel Roussey
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Céline Rozel
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Olivier Tirel
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Catherine Vignaud
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Philippe Violas
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Eric Wodey
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Marion Pierre
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Patrick Pladys
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Saad Abu-Amara
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Bruno Bachy
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Marie Brasseur-Daudruy
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Jean-Nicolas Dacher
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Pascal Delmon
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Joël Lechevallier-Amara
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Bénédicte Lerebours
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Julien Leroux
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Francois Proust
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Sophie Rigal
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Jean-Louis Baulieu
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Yann Venel
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Carpentier Elodie
Alain Chantepie
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Julie Chantreuil
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Mathieu Come
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Benoit de Courtivron
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François Labarthe
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Yves Marot
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Myriam Pepin-Donat
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Dominique Sirinelli
Nadine Travers
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Annie Urvois-Grange
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Patrick O'Byrne
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Antoine Listrat
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Marie-Luce Barge-Galern
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Joseph Le Cloirec
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Pierre Vera
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I. Kone-Paut
Kumaran Deiva
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Philippe Chaumet-Riffaud
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Gilles Grimon
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Frederique Archambaud
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Ferielle Zenkhri
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Caroline Galeotti
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Nancy Sevette-Béchard
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Olivier Prodhomme
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Céline Leconte
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Armelle Haquet
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Mélanie Sainmont
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Loic De-Pontual
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Nicolas Sellier
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Thanh-Van Trieu
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Claire de Labriolle-Vaylet
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Abstract

Objectives: To assess the contribution of whole-body magnetic resonance imaging (WBMRI) and bone scintigraphy (BS) in addition to skeletal survey (SS) in detecting traumatic bone lesions and soft-tissue injuries in suspected child abuse. Methods: In this prospective, multicentre, diagnostic accuracy study, children less than 3 years of age with suspected physical abuse were recruited. Each child underwent SS, BS and WBMRI. A blinded first review was performed in consensus by five paediatric radiologists and three nuclear medicine physicians. A second review investigated discrepancies reported between the modalities using a consensus result of all modalities as the reference standard. We calculated the sensitivity, specificity and corresponding 95% confidence interval for each imaging modality (SS, WBMRI and BS) and for the combinations [SS + WBMRI] and [SS + BS]. Results: One hundred seventy children were included of which sixty-four had at least one lesion. In total, 146 lesions were included. The sensitivity and specificity of each examination were, respectively, as follows: 88.4% [95% CI, 82.0-93.1] and 99.7% [95% CI, 99.5-99.8] for the SS, 69.9% [95% CI, 61.7-77.2] and 99.5% [95% CI, 99.2-99.7] for WBMRI and 54.8% [95% CI, 46.4-63.0] and 99.7% [95% CI, 99.5-99.9] for BS. Sensitivity and specificity were, respectively, 95.9% [95% CI, 91.3-98.5] and 99.2% [95% CI, 98.9-99.4] for the combination SS + WBMRI and 95.2% [95% CI, 90.4-98.1] and 99.4% [95% CI, 99.2-99.6] for the combination SS + BS, with no statistically significant difference between them. Conclusion: SS was the most sensitive independent imaging modality; however, the additional combination of either WBMRI or BS examinations offered an increased accuracy. Key points: • SS in suspected infant abuse was the most sensitive independent imaging modality in this study, especially for detecting metaphyseal and rib lesions, and remains essential for evaluation. • The combination of either SS + BS or SS + WBMRI provides greater accuracy in diagnosing occult and equivocal bone injuries in the difficult setting of child abuse. • WBMRI is a free-radiation technique that allows additional diagnosis of soft-tissue and visceral injuries.
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Dates and versions

inserm-03214574 , version 1 (02-05-2021)

Identifiers

Cite

Maïa Proisy, Pierre-Hugues Vivier, Baptiste Morel, Bertrand Bruneau, Catherine Sembely-Taveau, et al.. Whole-body MR imaging in suspected physical child abuse: comparison with skeletal survey and bone scintigraphy findings from the PEDIMA prospective multicentre study. European Radiology, 2021, Online ahead of print. ⟨10.1007/s00330-021-07896-9⟩. ⟨inserm-03214574⟩
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