Analysis of MRI Utilization in Pediatric Patients

Although animal studies have consistently demonstrated long-term neurocognitive deficits following early anesthetic exposure under certain conditions, risk in human children remains unknown. Magnetic resonance imaging (MRI) in young patients often requires anesthesia to facilitate image acquisition. We studied MRI utilization in a pediatric population, and associated use of anesthesia for ambulatory MRI.

Data were obtained from the New York State Inpatient Database and State Ambulatory Surgery and Services Database on MRI performed in children under the age of 18 years from 2005 to 2011. Demographic characteristics of children who underwent inpatient or ambulatory MRI were evaluated. A subset of ambulatory MRI patients was assessed to evaluate associated use of anesthesia.

Overall, 2% of pediatric inpatient discharges (55,036/2,779,507), and 0.5% of pediatric ambulatory encounters (4670/943,520), had MRI performed. Inpatient MRI utilization did not change over time. Ambulatory MRI utilization decreased by 55.2%, from 8.07 per 1000 encounters in 2005 to 2006 to 3.62 per 1000 encounters in 2007 to 2011 (P<0.001). Associated use of anesthesia for ambulatory MRI in children aged below 1 year, 1 to below 6 years, 6 to below 12 years, and 12 to below 18 years, was 91.1%, 83.6%, 74.6%, and 47.5%, respectively.

Significant percentages of MRI in children are associated with use of anesthesia, particularly in younger children, a population potentially more vulnerable to anesthetic neurotoxicity. Discussion of risks and benefits of anesthesia for MRI in children among physicians, patients, and families is recommended.