Laryngeal mask airway (LMA) artefact resulting in MRI misdiagnosis

Abstract

We report a 7-year-old child who underwent brain MRI for a known seizure disorder. The technique used for general anesthesia included inhalation induction followed by placement of a laryngeal mask airway (LMA) for airway maintenance. Because the reviewing radiologist was unfamiliar with the use of an LMA during anesthesia, and because the attending anesthesiologist did not communicate his technique to the radiologist, an MRI misdiagnosis was reported because of artefact created by the in situ LMA. As a result of this misdiagnosis the child was subjected to unnecessary subsequent testing to rule out a reported anatomic abnormality induced by the LMA. Our case illustrates the need for coordination of patient care among hospital services.

A simple novel technique to make any supraglottic airway device magnetic resonance imaging compatible: A fusion of the past with the present

“…Non-MRI compatible SGDs have ferromagnetic material in their spring-loaded valve, which leads to reduced image quality, spurious interpretations of the film, and unnecessary wrong diagnoses. [4] The extent to which the image quality gets compromised depends on the quantity of ferromagnetic material within the field, the pulse sequence used, and the distance between the area of interest and the SGD. [5]…”

The vanishing neck mass: how using a laryngeal mask airway during magnetic resonance imaging of a child can cause misdiagnosis

“…This case and figure illustrate clearly how using laryngeal mask airways during neck imaging in children can create the potential for misdiagnosis. Laryngeal mask airways may affect the appearance of the submandibular, retropharyngeal, and prevertebral cervical regions , while cuffed ETTs can alter subglottic anatomy. Communication between the anesthesiologist and radiologist should strive to optimize the diagnostic capability of the study while maintaining a safe airway.…”

A clinical evaluation of the pediatric i-gel™ for airway management during MRI examination

“…The laryngeal mask airways (LMAs) are well-established in pediatric anesthetic practice and their use in the MRI suite has been described. I-gel™ does not cause artefacts[3] and its successful use in children undergoing MRI has been previously described. [4] The three reported complications were all related to the selection of the correct size.…”