MRI Indications (Paediatric)

Population Covered By The Guidance

This pathway provides guidance on general Magnetic Resonance Imaging in children.

Lead Researcher: Dr Arjun Shivananda

Experts & Contributors: Dr Ravinder Dhillon, Prof Michael Ditchfield, Dr Peter Shipman

Editorial Panel: Core Membership

Date reviewed: June 2017

Date Published: December 2017

No available images

Magnetic Resonance Imaging (MRI)

  • MRI scans are time consuming and often take 30mins and require the patient to remain still for up to 5 mins at a time during the scan
  • Sedation or anaesthesia is required in many infants and younger children less than 6 years old
  • Feed and wrap techniques can be used to alleviate the need for sedation or anaesthesia in children up to 3 months of age
  • MRI is contraindicated in children with some implanted devices including certain cochlear implants, brain or spinal stimulators or pacemakers

Date of literature search: May 2017

References are graded from Level I to V according to the Oxford Centre for Evidence-Based Medicine, Levels of Evidence. Download the document

  1. Noonan S, Spuur K, Nielsen S. Immobilisation in Australian paediatric medical imaging: A pilot study. Radiography (Lond). 2017;23(2):e34-e40. (Level IV evidence). View the reference
  2. Hallowell LM, Stewart SE, de Amorim ESCT, Ditchfield MR. Reviewing the process of preparing children for MRI. Pediatr Radiol. 2008;38(3):271-9. (Level III evidence). View the reference
  3. Chou IJ, Tench CR, Gowland P, Jaspan T, Dineen RA, Evangelou N, et al. Subjective discomfort in children receiving 3 T MRI and experienced adults’ perspective on children’s tolerability of 7 T: a cross-sectional questionnaire survey. BMJ Open. 2014;4(10):e006094. (Level III evidence). View the reference
  4. Edwards AD, Arthurs OJ. Paediatric MRI under sedation: is it necessary? What is the evidence for the alternatives? Pediatr Radiol. 2011;41(11):1353-64. (Review article). View the reference
  5. Barton K, Nickerson JP, Higgins T, Williams RK. Pediatric anesthesia and neurotoxicity: what the radiologist needs to know. Pediatric Radiology. 2017:1-6. (Review article). View the reference
  6. Carter AJ, Greer ML, Gray SE, Ware RS. Mock MRI: reducing the need for anaesthesia in children. Pediatr Radiol. 2010;40(8):1368-74. (Level IV evidence). View the reference
  7. Antonov NK, Ruzal-Shapiro CB, Morel KD, Millar WS, Kashyap S, Lauren CT, et al. Feed and Wrap MRI Technique in Infants. Clin Pediatr (Phila). 2016:e20. (Level III evidence). View the reference
  8. Crownover BK, Bepko JL. Appropriate and safe use of diagnostic imaging. Am Fam Physician. 2013;87(7):494-501. (Review article). View the reference
  9. Cogbill TH, Ziegelbein KJ. Computed tomography, magnetic resonance, and ultrasound imaging: basic principles, glossary of terms, and patient safety. Surg Clin North Am. 2011;91(1):1-14. (Review article). View the reference
  10. Abujudeh HH, Kaewlai R, Kagan A, Chibnik LB, Nazarian RM, High WA, et al. Nephrogenic systemic fibrosis after gadopentetate dimeglumine exposure: case series of 36 patients. Radiology. 2009;253(1):81-9. (Level IV evidence). View the reference

Pathway User Guide

Yellow Boxes Denotes extra information. Some contain single or multiple white sub-boxes, click a white box to reveal detailed information in a pop-up.

White Boxes: Denotes standard pathway steps. (If inside a yellow box, they open a specific pop-up).

Zoom & Pan Controls: Use + / − or the slider to zoom. Reset returns to default. Tick Panning to drag the diagram when zoomed.

Blue “View Full Screen” Button: Opens the whole diagram in a large, full-screen pop-up window. Use Close to exit.

The relative radiation level (RRL) of each imaging investigation is displayed in the pop up box.

SYMBOL RRL EFFECTIVE DOSE RANGE
No radiation None 0
Minimal radiation Minimal < 1 millisieverts
Low radiation Low 1-5 mSv
Medium radiation Medium 5-10 mSv
High radiation High >10 mSv

Disclaimer

Status Of Recommendations Each pathway is designed to assist clinicians in situations when faced with a large array of possible diagnostic tests and examinations. However, it is recognised that diagnostic practice may differ from a particular pathway depending on local availability of equipment and expertise, as well as the experience of individual clinicians. Therefore each pathway is neither a rigid set of rules, nor a substitute for clinical assessment, and individual patient circumstances should always be considered.

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Paediatric