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Rapid MRI for acute pediatric MSK infections: survey of current utilization and procedural practices
M Alejandra Bedoya1, Jade Iwasaka-Neder2, Nancy A Chauvin3
1The Hospital for Sick Children, Toronto, M5G 1E8, Canada. bedoya3@yahoo.com.
Background:
Some institutions have implemented rapid MRI protocols for acute musculoskeletal (MSK) infections as an attempt to improve early diagnosis.
Objective:
To assess current utilization of pediatric rapid MSK MRI protocols (abbreviated protocol, no IV (intravenous) contrast, and no sedation) using a survey.
Materials And Methods:
A 10-question survey was sent to members of the Society for Pediatric Radiology (SPR) and the Society of Skeletal Radiology, which differed depending on whether a rapid protocol was used or not. The survey was conducted by the SPR MSK and MRI committees.
Results:
A total of 134 surveys (representing 99 institutions) were completed. Twenty-two percent (22/99) of institutions used a rapid protocol. Pediatric institutions were more likely to perform it when compared to adult institutions (P-value<0.01, 37% (14/38) vs. 13% (8/61)). Comparing institutions that use rapid protocol with institutions that do not, the availability of on-call MRI technologists did not differ (P-value=0.33), and pediatric radiologists were more likely to interpret these studies (73% (16/22) vs. 36% (28/77), P-value=0.02). Reported rapid MRI completion times took less than 15 min in 64% (14/22) of the institutions. Seventy-three percent (16/22) of institutions performing rapid protocols have radiologists check images to evaluate the need for additional sequences or contrast. Sixty-eight percent (25/37) reported being very satisfied with rapid protocols. Seventy-seven of 99 institutions do not use a rapid protocol due to a lack of a consensus protocol and concerns about missing findings. Of these institutions, 62% (48/77) administer IV contrast routinely.
Conclusion:
There is limited and variable utilization of rapid MRI protocols for acute pediatric MSK infection. Lack of accepted consensus protocol is the most common reason for non-implementation, highlighting the need for consensus-driven rapid protocols.
Insights
Rapid MRI protocols for pediatric musculoskeletal infections are underutilized due to a lack of consensus. Developing standardized rapid MRI protocols is crucial for improving early diagnosis and patient care.
Area of Science:
- Radiology
- Pediatric Imaging
- Musculoskeletal Imaging
Background:
- Some institutions use rapid MRI protocols for acute musculoskeletal infections to improve early diagnosis.
- These protocols often involve abbreviated sequences, no intravenous contrast, and no sedation.
Purpose of the Study:
- To assess the current utilization of pediatric rapid musculoskeletal MRI protocols.
- The study surveyed members of the Society for Pediatric Radiology and the Society of Skeletal Radiology.
Main Methods:
- A 10-question survey was distributed to radiologists.
- The survey collected data on the use of rapid protocols, technologist availability, radiologist interpretation, and satisfaction levels.
Main Results:
- Only 22% of surveyed institutions use rapid MRI protocols for pediatric musculoskeletal infections.
- Pediatric institutions were more likely to use these protocols than adult institutions.
- Lack of a consensus protocol and concerns about missing findings were primary reasons for non-implementation.
Conclusions:
- Utilization of rapid MRI protocols for pediatric musculoskeletal infections is limited and inconsistent.
- A need exists for consensus-driven rapid protocols to facilitate wider adoption and improve diagnostic efficiency.
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