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Nonanesthesia magnetic resonance enterography in young children: feasibility, technique, and performance
Jesse Courtier1, Agustin Cardenas, Cynthia Tan
1*Department of Radiology and Biomedical Imaging †Department of Child Life Services ‡Department of Pediatrics, Division of Pediatric Gastroenterology, UCSF Benioff Children's Hospital, San Francisco, CA.
Insights
Nonanesthesia magnetic resonance enterography (MRE) is effective for diagnosing early-onset inflammatory bowel disease in young children (ages 4-7). This approach reduces risks and costs associated with anesthesia.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
- Medical Economics
Background:
- Early-onset inflammatory bowel disease (IBD) diagnosis in young children (4-7 years) presents challenges.
- Traditional diagnostic methods may require anesthesia, increasing risks and costs.
- Magnetic Resonance Enterography (MRE) offers a non-invasive imaging alternative.
Purpose of the Study:
- To evaluate the effectiveness and cost-efficiency of a nonanesthesia MRE protocol in pediatric patients.
- To assess the feasibility of MRE in young children (4-7 years) with suspected early-onset IBD.
- To compare MRE diagnostic accuracy with colonoscopy and pathology findings.
Main Methods:
- An abbreviated MRE protocol was employed, incorporating video goggles and Child Life Services support.
- MRE was performed on 14 pediatric patients aged 4-7 years with suspected early-onset IBD.
- Results were correlated with colonoscopy and pathology using Pearson correlation; sensitivity, specificity, and predictive values were calculated.
Main Results:
- Successful MRE completion in 13 out of 14 patients (93%).
- MRE findings correlated well with colonoscopy in 12 of 13 patients.
- High specificity (100%) and positive predictive value (100%) for MRE; low sensitivity (43%) and negative predictive value (50%).
Conclusions:
- Nonanesthesia MRE is a feasible and effective diagnostic tool for early-onset IBD in children aged 4-7 years.
- This approach minimizes risks by avoiding anesthesia.
- The nonanesthesia MRE protocol demonstrates potential for significant cost savings.
Objectives:
The aim of the present study was to demonstrate the effectiveness and cost savings of a nonanesthesia approach to magnetic resonance enterography (MRE) in 14 young pediatric patients (age 4-7 years) with clinically suspected early-onset inflammatory bowel disease using an MRE protocol.
Methods:
MRE was performed using a combination of an abbreviated imaging protocol, magnetic resonance imaging video goggles, and Child Life Services support. MRE results were correlated with both colonoscopy and pathology results using Pearson correlation coefficient. Sensitivity, specificity, and positive and negative predictive values were calculated.
Results:
MRE was performed successfully in 13 of 14 patients (age range 4 years 0 months to 7 years 6 months). MRE findings matched with results in 12 of 13 patients in whom colonoscopy was successfully performed. Both MRE and colonoscopy demonstrated a high specificity (100%) and a positive predictive value (100%), but a low sensitivity (43%) and a negative predictive value (50%).
Conclusions:
MRE can be successfully performed in children ages 4 to 7 years using this approach. In addition to decreased risks to the child, the lack of anesthesia also offers a potential overall cost reduction.
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