Eight-second MRI scan for evaluation of shunted hydrocephalus

Pediatric patients harboring shunts placed early in life are subjected to numerous radiographic studies during development of their central nervous system. Radiation is detrimental to these young patients. MRI avoids the risk of radiation but is thought more difficult due to the increased time a young patient must lie motionless during scan acquisition. Optimal radiographic interrogation would be quick, radiation-free, and allow adequate ventricular evaluation.

We queried the electronic medical records system of the senior author (SE) for the terms "hydrocephalus" and "shunt malfunction." All patients currently younger than 18 years were included. In the last 5 years, pediatric patients have been evaluated in an office setting with a limited MRI sequence (T1 sagittal, T2 axial, T1 axial, and DWI) lasting a total of 178 s. In the event of significant motion artifact, the total sequence is abandoned and an 8-s T2 diffusion-weighted scan is performed.

Forty-four patients were included in the study (20 males, average age 10.4 yrs). Eighty-eight rapid acquisition scans were obtained. Adequate ventricular evaluation was performed without sedation in every case. In each instance where there was motion, the 8-s scan provided adequate ventricular evaluation.

Rapid acquisition MRI scanning avoids the deleterious cumulative effects of radiation in pediatric patients and allows adequate evaluation of the ventricles without the need for sedation.