Validation of a shortened MR imaging protocol for pediatric spinal pathology
Author:
Wu Winnie Shu Yu1, Miller Elka2, Hurteau-Miller Julie2, Thipse Madhura3, Kapoor Cassandra2, Webster Richard3, McAuley David4, Tu Albert4
Affiliation:
1. Faculty of Medicine, University of Ottawa 2. Department of Medical Imaging, University of Ottawa, CHEO 3. CHEO Research Institute 4. Division of Pediatric Neurosurgery, Department of Surgery, CHEO
Abstract
Abstract
Objective
Conventional pediatric spine MRI protocols have multiple sequences resulting in long acquisition times. Sedation is consequently required. This study evaluates the diagnostic capability of a limited MRI spine protocol for selected common pediatric indications.
Methods
Spine MRIs at CHEO between 2017 and 2020 were reviewed across pediatric patients younger than four years old. Two blinded neuroradiologists reviewed limited scan sequences and results were independently compared to previously reported findings from the complete imaging series. T2 sagittal sequences from the craniocervical junction to sacrum and T1 axial sequence of the lumbar spine constitute the short protocol, with the outcomes of interest being cerebellar ectopia, syrinx, level of conus, filum < 2mm, fatty filum, and spinal dysraphism.
Results
105 studies were evaluated in 54 male and 51 female patients (mean age 19.2 months). The average combined scan time of the limited sequences was 15 minutes compared to 35 minutes for conventional protocols (delta = 20 minutes). The average percent agreement between full and limited sequences was > 95% in all but identifying a filum < 2mm, where the percent agreement was 87%. Using limited MR sequences had high sensitivity (> 0.91) and specificity (> 0.99) for the detection of cerebellar ectopia, syrinx, fatty filum, and spinal dysraphism.
Conclusion
This study demonstrates that selected spinal imaging sequences allow for consistent and accurate diagnosis of specific clinical conditions. A limited spine imaging protocol has potential as a screening test to reduce the need for full sequence MRI scans. Further work is needed to determine utility of selected imaging for other clinical indications.
Publisher
Research Square Platform LLC
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