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MR enterography under the age of 10 years: a single institutional experience
Brett J Mollard1, Ethan A Smith2, Manda E Lai3
1Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA.
Insights
Magnetic resonance enterography (MRE) is effective for diagnosing pediatric inflammatory bowel disease (IBD) in children under 10. Most exams require general anesthesia (GA), but it is safe and associated with few minor side effects.
Area of Science:
- Pediatric Radiology
- Gastroenterology
- Medical Imaging
Background:
- MR enterography (MRE) is crucial for pediatric inflammatory bowel disease (IBD) imaging.
- Performing MRE in young children presents unique challenges.
Purpose of the Study:
- To evaluate the institutional experience of MRE in children under 10 years old.
- To assess the role and safety of general anesthesia (GA) during MRE in this age group.
Main Methods:
- Retrospective review of MRE exams in children younger than 10 years (June 2009 - May 2013).
- Data collected included demographics, indications, GA use, diagnoses, and GA-related adverse events.
- Imaging quality and oral contrast progression were assessed.
Main Results:
- 119 MRE exams were performed in 106 children under 10 years old.
- 92% of exams utilized general anesthesia (GA).
- GA-related side effects were infrequent and minor (nausea, emesis).
Conclusions:
- Diagnostic-quality MRE is feasible in young children.
- General anesthesia (GA) is frequently used and safe for pediatric MRE.
- MRE is a valuable tool for evaluating IBD in pediatric patients.
Background:
MR enterography (MRE) plays a major role in the imaging of pediatric patients with inflammatory bowel disease (IBD) but can be challenging to perform in young children.
Objective:
To review our institutional experience regarding the performance of MRE in children younger than 10 years of age, including the use of general anesthesia (GA).
Materials And Methods:
Institutional review board approval was obtained. Radiology and anesthesia records were searched to identify MRE exams in children younger than 10 years old between June 2009 and May 2013. The following information was documented: demographics, indications for MRE, use of GA, imaging diagnoses, and documented GA-related side effects or adverse events. Imaging was reviewed to document study length, quality and progression of oral contrast material.
Results:
One hundred six children (59 boys [56%]) younger than 10 years old underwent 119 MRE examinations (age range: 1 month to 9 years, 11 months). Common indications for MRE included known IBD (42%) and suspected IBD (38%). One hundred ten (92%) examinations were performed under GA. Mean exam length was 52 ± 13 min for GA patients with a range of 31--113 min. Median time under GA was 155 min. Oral contrast material reached the terminal ileum in 31%. Side effects/adverse events associated with GA were uncommon and minor, including transient nausea in 13 children (11%) and emesis in 9 (8%).
Conclusion:
Diagnostic-quality MRE can be performed successfully in young children. The majority of MRE exams were performed under GA, with only occasional minor side effects/adverse events.
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