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

Simpao, Allan F.; Pollock, Avrum N.; McGinnis, Stephanie E.; Gálvez, Jorge A.

doi:10.1111/pan.12949

Cited by 1 publication

(1 citation statement)

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“…Serial MRIs are performed yearly in children with neurofibromatosis type 1 and other conditions, and airway management strategies such as natural airway, SGA, or ETT can vary from one MRI to the next . We reported a case in which an airway device change from an ETT in a 2012 MRI to an SGA during a 2015 MRI produced the artifactual appearance of interval improvement of the prevertebral neurofibromas with the potential for misdiagnosis . This case prompted us to conduct a retrospective observational study to determine how often at our institution the use of an SGA affected the appearance of neck masses in children who underwent general anesthesia for serial MRIs.…”

Section: Introductionmentioning

confidence: 99%

A retrospective study of the impact of supraglottic airway devices on the appearance of neck masses in children undergoing serial magnetic resonance imaging

Simpao

Obsekov

Gálvez

et al. 2018

Pediatric Anesthesia

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Summary Background General anesthesia and sedation are used routinely for magnetic resonance imaging (MRI) studies in children to optimize image quality. Airway devices such as supraglottic airways (SGAs) can alter the appearance of cervical soft tissue regions on an MRI and increase the risk of misdiagnosis. This phenomenon has not been well described in vivo. Aims We conducted this retrospective study to determine how often SGAs affected the appearance of neck masses in children who received multiple anesthetics for MRIs with and without an SGA. Methods We retrieved data on children 17 years old and younger who had multiple MRIs between January 2005 and January 2015. Inclusion criteria were patients with neck masses who had a SGA for at least one MRI and either a natural airway or endotracheal tube (ETT) for another MRI. We reviewed MRI images and imaging reports to determine if SGAs affected the appearance of neck masses. Results Twelve of the 921 patients who received anesthesia for neck MRIs during the study period met the inclusion criteria. SGAs affected the appearance of the neck mass in 11 of the 12 patients. Conclusions Supraglottic airways can significantly alter the appearance of neck masses in children undergoing MRIs and affect radiologists’ ability to assess those masses. Communication with the radiologist prior to the induction of anesthesia is crucial when using supraglottic devices in this patient population. It may be more prudent to use a different airway device and/or anesthetic technique when MRIs of these neck masses are undertaken.

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Section: Introductionmentioning

confidence: 99%