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Non-sedated fast spine magnetic resonance imaging in pediatric patients

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Abstract

Background

Traditional spine magnetic resonance imaging (MRI) protocols require sedation in young children and uncooperative patients. There is an increased interest in non-sedated pediatric MRI protocols to reduce risks associated with anesthetic agents and improve MRI access.

Objective

To evaluate the image quality of pediatric non-sedated fast spine MRI.

Materials and methods

We retrospectively reviewed 69 pediatric non-sedated fast spine MRI exams performed in 57 patients. Two blinded readers provided image quality ratings for the evaluation of bones, cranio-cervical junction, cerebrospinal fluid (CSF) spaces, spinal cord, soft tissues, ligaments, and overall diagnostic quality on a 1–5 scale, and determined whether there was evidence of syringomyelia, abnormal conus medullaris position, or filum terminale abnormality.

Results

Mean patient age was 7.2 years (age range ≤ 1–17). Indications included syringomyelia (n=25), spinal dysraphism (n=4), combination of both syringomyelia and spinal dysraphism (n=8), and other miscellaneous indications (n=32). The inter-observer agreement ranged between moderate and very good for each variable (Cohen’s weighted kappa] range=0.45–0.69). The highest image quality ratings were given to CSF spaces (mean image quality=3.5/5 ± 0.8) and cranio-cervical junction evaluations (3.5/5 ± 0.9). Overall diagnostic quality was worst in the  <5 years group (P=0.006). Readers independently identified a cervical spinal cord syrinx in 6 cases, and 1 mm spinal cord central canal dilation in one case. Readers agreed on the position of the conus medullaris in 92% of cases (23/25 cases).

Conclusion

Non-sedated pediatric spine MRI can be an effective diagnostic test to evaluate for spine pathology, especially syringomyelia, Chiari malformation, and conus medullaris anatomy.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas Street, MSC 323, Charleston, SC, 29425, USA

    Maria Vittoria Spampinato, Justin A. Chetta, Claire Adcock, Madison Kocher & Milad Yazdani

  2. College of Medicine, Medical University of South Carolina, Charleston, SC, USA

    Abigail Truitt & Georgia Lydon

  3. Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA

    Ramin Eskandari

Authors
  1. Maria Vittoria Spampinato
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  2. Justin A. Chetta
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Contributions

M. V. S., M. Y., and R. E. conceived the study. M. V. S. and M. Y. supervised and supported the study. M. V. S. analyzed the data, performed the statistical analysis, and drafted the initial manuscript. C. A., M. K., A. T, and G. L. collected and organized the data. M. Y. and J. C. interpreted the images. All authors reviewed and approved the final manuscript.

Corresponding author

Correspondence to Maria Vittoria Spampinato.

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Conflict of interest

Maria V. Spampinato: Siemens, Research grant not related to the subject of the paper; Bayer, Research grant, not related to the subject of the paper. No other financial relationships with commercial interests to disclose. Justin Chetta. Claire Adcock, Madison Kocher, Abigail Truitt, Georgia Lydon, Ramin Eskandari, Milad Yazdani: None

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Spampinato, M.V., Chetta, J.A., Adcock, C. et al. Non-sedated fast spine magnetic resonance imaging in pediatric patients. Pediatr Radiol 53, 2478–2489 (2023). https://doi.org/10.1007/s00247-023-05760-0

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  • DOI: https://doi.org/10.1007/s00247-023-05760-0

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