Development and validation of a Fast Spine Protocol for Use in Paediatric Patients

Abstract

Abstract ObjectiveConventional 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. MethodsAfter REB approval, records of pediatric patients under 4 years of age who underwent a spine MRI at CHEO between 2017 and 2020 were reviewed. Two neuroradiologists blindly and retrospectively reviewed the T2 sagittal sequences from the craniocervical junction to sacrum and T1 axial sequence of the lumbar spine, to answer specific questions regarding cerebellar ectopia, syrinx, level of conus, filum <2mm, fatty filum, and spinal dysraphism. The results were independently compared to previously reported findings from the complete imaging series. Results105 studies were evaluated in 54 male and 51 female patients (mean age of 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. ConclusionThis study demonstrates that selected spinal imaging sequences allows for consistent and accurate diagnosis of specific clinical conditions. A limited spine protocol reduces acquisition time, potentially avoiding sedation. Further work is needed to determine the utility of selected imaging for other clinical indications.