title: Retrospective review of rapid pediatric brain MR imaging at an academic institution including practice trends and factors affecting scan times.
abstract: OBJECTIVE
  In an effort to reduce radiation exposure in children requiring regular follow up for shunted hydrocephalus, our institution implemented a rapid brain MR imaging protocol. The purpose of this study was to review an academic practice experience with pediatric rapid brain MR imaging without patient sedation in the evaluation of hydrocephalus and a limited group of other conditions.
  
  
  METHODS
  We retrospectively analyzed limited-sequence, rapid brain MR imaging scans performed in nonsedated patients younger than 14 years between April 2009 and December 2011. So-called failed examinations were determined by consensus of 2 authors as insufficiently diagnostic for evaluation of ventricular size. CT and MR imaging quarterly volumes for hydrocephalus-related indications were determined from 2005-2012. Multivariable logistic regression analysis was performed to elucidate factors potentially affecting scan durations including examination indication and patient age, sex, inpatient status, and clinical conditions.
  
  
  RESULTS
  A total of 398 examinations were performed on 168 patients (103 boys, 65 girls; median age, 13 months). None were deemed to be failed examinations. Median scan duration was 4.43 minutes (interquartile range, 4.42 minutes-5.88 minutes; SD, 2.42 minutes). Examination indication of altered mental status was the only factor associated with increased scan duration (+1.77 minutes; P = .0021). Hydrocephalus-related imaging volumes approximately doubled in the 7 years reviewed, but rapid MR imaging introduced in 2009 is quickly replacing CT scanning for these indications, accounting for nearly 7 of every 8 examinations at the end of the study period.
  
  
  CONCLUSIONS
  In every case of initial work-up and follow-up, rapid brain MR imaging effectively evaluated ventricular size and/or intracranial fluid and represents a viable alternative to CT scanning, irrespective of a child's age or clinical condition. For this indication and patient group, MR imaging is now the predominant imaging method in our practice.
authors.affiliation: Department of Radiology.
authors.forename: B D
authors.initials: BD
authors.lastname: Niederhauser
authors.forename: R J
authors.initials: RJ
authors.lastname: McDonald
authors.forename: L J
authors.initials: LJ
authors.lastname: Eckel
authors.forename: G F
authors.initials: GF
authors.lastname: Keating
authors.forename: E M
authors.initials: EM
authors.lastname: Broomall
authors.forename: N M
authors.initials: NM
authors.lastname: Wetjen
authors.forename: F E
authors.initials: FE
authors.lastname: Diehn
authors.forename: K M
authors.initials: KM
authors.lastname: Schwartz
authors.forename: C H
authors.initials: CH
authors.lastname: Hunt
authors.forename: K M
authors.initials: KM
authors.lastname: Welker
authors.forename: D F
authors.initials: DF
authors.lastname: Kallmes
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D001921:Brain; D006801:Humans; D006849:Hydrocephalus / Q000453:epidemiology* / Q000473:pathology*; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008910:Minnesota / Q000453:epidemiology; D010372:Pediatrics / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D011829:Radiation Dosage; D011835:Radiation Protection / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013997:Time Factors; D016526:Workload / Q000706:statistics & numerical data
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