Changing the paradigm for diagnostic MRI in pediatrics: Don't hold your breath

• Published in: Pediatric anesthesia Vol. 27; no. 9; pp. 880 - 884
• Main Authors: Masaracchia, Melissa M., Tsapakos, Michael J., McNulty, Nancy J., Beach, Michael L., Cravero, Joseph
• Format: Journal Article
• Language: English
• Published: France Wiley Subscription Services, Inc 01-09-2017
• Subjects: adverse events; Breath Holding; Child; computerized tomography; education; Humans; infant; magnetic resonance imaging; Magnetic Resonance Imaging - methods; Medical imaging; NMR; Nuclear magnetic resonance; Patient Safety; Pediatrics - methods; quality improvement; Radiation Exposure; Tomography; Tomography, X-Ray Computed - methods; X‐ray; magnetic resonance imaging; education; quality improvement; X-ray; adverse events; computerized tomography; infant
• ISSN: 1155-5645; 1460-9592
• DOI: 10.1111/pan.13165

Summary
Increasingly complex pediatric patients and improvements in technology warrant reevaluation of the risk associated with anesthesia for diagnostic imaging. Although magnetic resonance imaging is the imaging modality of choice for children given the potentially harmful effects of computerized tomography‐associated ionizing radiation, we dare to suggest that certain patients would benefit from the liberalization of our current standard. Incorporating the use of newer computerized tomography technology may improve safety for those that are already at higher risk for adverse events. Furthermore, magnetic resonance imaging is not risk‐free—what is often overlooked is the need for controlled ventilation and breath‐holding to minimize motion artifact. As physicians at the forefront of the development and sustainability of the perioperative surgical home, anesthesiologists must work to not only optimize patients preoperatively but should also act as gatekeepers for procedural safety.