844 The Neuroradiology Journal 21: 844-847, 2008 www. centauro. it SUMMARY – The aim of this study was to analyze the added utility of contrast administration for spine MRI in children with scoliosis. A retrospective review of 663 consecutive contrast-enhanced spine MRI performed in 319 patients as part of the work up of scoliosis in children 2-18 years with clinically suspected or known scoliosis over a seven year period. Those patients with known tumors (13 patients) being evaluated for scoliosis were excluded from the study. In 306 patients with scolio- sis and no history of tumor pathologic contrast enhancement was seen in seven (2%) patients. Lack of enhancement helped to characterize benign lesions in 31 (10%) of the patients. Although MRI is often recommended to exclude intraspinal pathology in pediatric patients with scoliosis, the need for contrast enhanced imaging is very limited and contrast medium should not be administered unless questionable pathology is detected on noncontrast MR spine imaging. The Value of Contrast Administration in the MRI Evaluation of Scoliosis in the Pediatric Population K. ABUL-KASIM**, D. GOMEZ HASSAN*, L. MCCORMICK*, P. MALY**, P.C. SUNDGREN* * Departments of Radiology, University of Michigan Health Systems; Ann Arbor, MI, USA ** Malmö University Hospital, University of Lund; Malmö, Sweden Key words: MRI, scoliosis, children, contrast enhancement, added utility Introduction The value of MRI in the management of sco- liosis has been extensively reviewed 1-4 . While plain radiography remains the initial examina- tion of choice in evaluating patients with sus- pected or known scoliosis, MRI can be helpful in excluding intraspinal pathology especially in those who may undergo corrective surgery. MRI has also the advantage of not exposing young patients for ionizing radiation. However, the need for contrast administration in the ini- tial evaluation of scoliosis by MRI has not been evaluated. In all pediatric patients with newly diagnosed scoliosis, the presence of pathologic contrast en- hancement might be helpful in identifying the underlying causes of scoliosis, especially tu- mors. However, this benefit may not outweigh the risks associated with the administration of intravenous contrast material for MR imag- ing. Adverse effects such as allergic reactions and nephrogenic fibrosing dermopathy (NFD) among patients with renal insufficiency 5-6 may compromise patients at this level of screening. Furthermore the administration of contrast media lengthens the examination time includ- ing the risk and time of general anesthesia or sedation required in this young patient popu- lation. In addition, increasing the number of images also increases the time required for in- terpretation. Lastly, the administration of con- trast media means also a considerable increase of the cost of the examination. The aim of this study was to analyze the added utility of contrast administration for spine MRI in children with idiopathic scolio- sis. Method and Materials After obtaining the institutional Review Board approval, all contrast enhanced MRIs of the spine performed in pediatric patients dur- ing a 7.5-year period (1995-2002) were retro- spectively reviewed. A computerized search of the radiology information system identified 2069 contrast-enhanced MRI examinations of the spine performed in children during that pe-