53: MRI Utilization Trends In a Large Tertiary Care Pediatric Emergency Department

Ramirez, José; Thundiyil, Josef G.; Cramm-Morgan, Kelly; Papa, Linda; Dobleman, C.; Giordano, Paola

doi:10.1016/j.annemergmed.2010.06.085

Cited by 6 publications

(7 citation statements)

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“…Ramirez et al reported on MRI usage rates of 0.96% of visits in paediatric EDs. 33 Their work suggests that there is an increasing trend in MRI utilization in the paediatric ED setting. In a report for a mixed adult and paediatric ED, MRI was performed during 0.51% of ED visits.…”

Section: Mri Utilization In the Paediatric Emergency Departmentmentioning

confidence: 99%

“…29 Although, Feed and swaddle MRI is feasible without sedation up to 6 months of age. 30 Anecdotally, MRI usage has increased in the emergency setting in recent years, perhaps due to radiation concerns raised in campaigns such as "Image Gently" 31 and "As Low As Reasonably Achievable (ALARA)", 32 and perhaps with increase in the availability of the modality, but to date, only three single centre studies describing MRI utilization in paediatric EDs [33][34][35] have been published, and further evidence-based research is needed.…”

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confidence: 99%

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Overuse of CT and MRI in paediatric emergency departments

Ohana

Soffer

Zimlichman

et al. 2018

The British Journal of Radiology

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The aim of this review is to survey CT and MRI overuse in the paediatric emergency department (ED) population. CT is one of the most important modalities employed in the ED. Not surprisingly, its high accuracy, rapid acquisition and availability have resulted in overuse. An obvious limitation of CT is ionizing radiation; in addition there are economic implications to overuse. Studies from the last two decades have shown increase in paediatric ED CT utilization in the first decade, reaching a plateau forming around 2008, followed by a decrease in the last decade. This decrease occurred in conjunction with campaigns raising awareness to the risks of radiation exposure. Although a trend of decrease in overuse have been observed, great variability has been shown across different facilities, as well as among physicians, with more pronounced overuse in non-teaching and non-children dedicated EDs. The leading types of paediatric ED CTs are head and abdominal scans. Decision rules, such as PECARN for head injury and the Alvarado score for abdominal pain, as well as using alternative imaging modalities, have been shown to reduce CT overuse in these two categories. MRI has the obvious benefit of avoiding radiation exposure, but the disadvantages of higher costs, less availability and less tolerability in younger children. Although anecdotally paediatric ED MRI usage has increased in recent years, only scarce reports have been published. In our opinion, there is need to conduct up-to-date studies covering paediatric CT and MRI overuse trends, usage variability and adherence to clinical protocols.

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Section: Mri Utilization In the Paediatric Emergency Departmentmentioning

confidence: 99%

mentioning

confidence: 99%

Overuse of CT and MRI in paediatric emergency departments

Ohana

Soffer

Zimlichman

et al. 2018

The British Journal of Radiology

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“…No other studies have employed the technique we chose of identifying the time between MRI and therapeutic intervention. 6 Many possible reasons exist that may explain the increasing use of MRI emergently. 4 Our study corroborates this trend in that the rise in MRI utilization markedly outpaced the simultaneous rise in overall ED volumes, but our patient cohort came from a combination of ED and inpatient settings.…”

Section: Discussionmentioning

confidence: 99%

“…5 No other adult studies have sought to document the rise in emergent, after hours spine MRI use in a tertiary care setting, but Ramirez et al identified disproportionately increased MRI utilization from the emergency department relative to the rest of the hospital in a pediatric ED. 6 Many possible reasons exist that may explain the increasing use of MRI emergently. MRI can be employed as an alternate triage tool in an ever busier ED.…”

Section: Discussionmentioning

confidence: 99%

Emergent, After Hours Magnetic Resonance Imaging of the Spine

Black

Wood

Wells

et al. 2014

Journal of Neuroimaging

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“…This was consistent with aprevious study performed in Saudi Arabia, where only 1.2% of all MRI exams for both adults and children were referred from the emergency department. Moreover, in another study, just 0.96% of all pediatric emergency patients had an MRI scan [18] and 0.51% in a further study of mixed adult and pediatric visits to the emergency department had an MRI scan [16].…”

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confidence: 89%

Analysis of Mri Utilization in Pediatric Patients in Saudi Arabia

Alghamdi¹,

Alahmari²

2020

IJAR

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The aim of this study was to evaluate the Utilization of pediatric Magnetic Resonance Imaging (MRI) at a single public hospital. Method: Ethical approval was obtained for data records of pediatric MRI scans from 1 st January to 31 st December 2018 to be extracted from the Radiology Information System (RIS) at the King Fahad Specialist Hospital (KFSH) in Tabuk City, Saudi Arabia. Usage rates were classified and analysed according to the major influencing factors, namely age, gender, admission type, exam type, indication and the use of contrast agents.The frequency variations of genders were evaluated, and the chi-square test was used to analyse whether there was an association between age and other categories such as admission and exam types. Results: Overall, the study shows a pediatric MRI usage rate per MRI unit visit of 5.1%. Headache, back pain, pain and undescended testes were the most common indications in neuroradiology, spine, musculoskeletal and abdomen and pelvis exams, respectively. Among outpatients, more males had an MRI scan than females (49/77= 63.6 %, p= 0.169) while among inpatients, more females had an MRI scan than males (47/75= 62.7 % p= 0.728). Inpatients who had an MRI scan were significantly younger (mean age = 2.40, std = ± 4.1) than the outpatients (mean age = 6.6, std = ± 4.6) p = 0.000. There was a significant difference between the mean age of patients undergone brain MRI and different exam types as the mean age of brain was 3.3 ± 4.6, 7.4 ± 4.9 (p= 0.02) for spinal scans, 7.1 ± 3.9(p= 0.000) for musculoskeletal exams and 6.3 ± 5.2(p = 0.018) for abdomen and pelvis exams. Conclusion: Pediatric MRI usage was significantly influenced by age, most notably between outpatients and inpatients and between exam types.

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53: MRI Utilization Trends In a Large Tertiary Care Pediatric Emergency Department

Cited by 6 publications

References 0 publications

Overuse of CT and MRI in paediatric emergency departments

Overuse of CT and MRI in paediatric emergency departments

Emergent, After Hours Magnetic Resonance Imaging of the Spine

Analysis of Mri Utilization in Pediatric Patients in Saudi Arabia

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