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Updated: Mar 15, 2026
Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure
Published on: July 30, 2009
Description and Contribution of Brain Magnetic Resonance Imaging in Nontraumatic Critically Ill Children
Guillaume Mortamet1,2, Manoelle Kossorotoff3, Amandine Baptiste4
1Service de Réanimation et de Surveillance continue médico-chirurgicales Pédiatriques, Hôpital Necker, Assistance Publique-des Hôpitaux de Paris, Paris, France mortam@hotmail.fr.
Insights
Brain MRI in critically ill children offers significant diagnostic value, aiding care decisions in most cases. While not always leading to direct treatment changes, it provides crucial insights for managing complex pediatric intensive care unit cases.
Area of Science:
- Pediatric Neurology
- Pediatric Critical Care
- Diagnostic Imaging
Background:
- Brain magnetic resonance imaging (MRI) is a key tool in assessing critically ill children.
- Understanding the utility of brain MRI in the pediatric intensive care unit (PICU) is essential for optimizing patient care.
Purpose of the Study:
- To describe the findings of brain MRI in critically ill children.
- To evaluate the contribution of brain MRI to patient management within the PICU.
Main Methods:
- A retrospective, single-center study analyzed brain MRIs performed in critically ill children over two years.
- Neurologists and intensivists independently assessed the indication and diagnostic contribution of each MRI exam.
Main Results:
- Brain MRI was performed in 87 children (7.5%), with abnormalities found in 78.2%.
- Experts deemed MRI indicated in most cases and found a diagnostic contribution in 69-87.4% of patients.
- Therapeutic changes occurred in 21.8% of cases, and MRI influenced life-sustaining treatment decisions in 24.1%.
Conclusions:
- Brain MRI serves as a valuable component of neuromonitoring in critically ill children.
- While offering substantial diagnostic insights, the direct therapeutic impact of brain MRI in the PICU is diagnosis-specific.
Background:
The authors aimed to collect all brain magnetic resonance imaging (MRI) performed in critically ill children in the authors' medical pediatric intensive care unit over a 2-year period (2012-2013) to (1) describe the findings and (2) assess its contribution on practical patient care.
Methods:
This is a single-center and retrospective study. All children without traumatic brain injury who underwent a brain MRI during pediatric intensive care unit stays were included. To assess the exam's contribution, the patient's medical condition at the time of the MRI exam was blindly and separately exposed to a pediatric neurologist and a pediatric intensivist.
Results:
During the study period, 87 patients (7.5%) underwent a brain MRI. Median age was 4 months and 13 children (14.9%) died in pediatric intensive care unit. The most common final diagnosis was postanoxic encephalopathy. Brain MRI was abnormal in 68 patients (78.2%). No serious adverse event occurred during the transport. The neurologist and the intensivist considered brain MRI as indicated during pediatric intensive care unit stay in 65 (74.7%) and 68 patients (78.2%). They deemed that brain MRI had a diagnostic contribution in 76 (87.4%) and 60 (69.0%) patients, respectively. A therapeutic change consecutive to MRI findings occurred in 19 patients (21.8%) and MRI results were associated with a decision to withdraw life-sustaining treatment in 21 patients (24.1%).
Conclusion:
Brain MRI is one component of neuromonitoring, and this study suggests a substantial diagnostic contribution, although its therapeutic impact appears limited to specific diagnoses.
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