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Validation of a shortened MR imaging protocol for pediatric spinal pathology

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Abstract

Objective

Conventional pediatric spine MRI protocols have multiple sequences resulting in long acquisition times. Sedation is consequently required. This study evaluates the diagnostic capability of a limited MRI spine protocol for selected common pediatric indications.

Methods

Spine MRIs at CHEO between 2017 and 2020 were reviewed across pediatric patients younger than four years old. Two blinded neuroradiologists reviewed limited scan sequences, and results were independently compared to previously reported findings from the complete imaging series. T2 sagittal sequences from the craniocervical junction to sacrum and T1 axial sequence of the lumbar spine constitute the short protocol, with the outcomes of interest being cerebellar ectopia, syrinx, level of conus, filum < 2 mm, fatty filum, and spinal dysraphism.

Results

A total of 105 studies were evaluated in 54 male and 51 female patients (mean age 19.2 months). The average combined scan time of the limited sequences was 15 min compared to 35 min for conventional protocols (delta = 20 min). The average percent agreement between full and limited sequences was > 95% in all but identifying a filum < 2 mm, where the percent agreement was 87%. Using limited MR sequences had high sensitivity (> 0.91) and specificity (> 0.99) for the detection of cerebellar ectopia, syrinx, fatty filum, and spinal dysraphism.

Conclusion

This study demonstrates that selected spinal imaging sequences allow for consistent and accurate diagnosis of specific clinical conditions. A limited spine imaging protocol has potential as a screening test to reduce the need for full-sequence MRI scans. Further work is needed to determine utility of selected imaging for other clinical indications.

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Availability of data and material

The data that support the findings of this study are available from the corresponding author (AT) at reasonable request.

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Authors and Affiliations

  1. Faculty of Medicine, University of Ottawa, Ottawa, Canada

    W. Wu

  2. Department of Medical Imaging, University of Ottawa, CHEO, 401 Smyth Ave, Ottawa, ON, K1H8L1, Canada

    E. Miller, J. Hurteau–Miller & C. Kapoor

  3. CHEO Research Institute, 401 Smyth Ave, Ottawa, ON, K1H8L1, Canada

    M. Thipse & R. Webster

  4. Division of Pediatric Neurosurgery, Department of Surgery, Rm 3359, CHEO, 401 Smyth Ave, Ottawa, ON, K1H8L1, Canada

    D. McAuley & A. Tu

Authors
  1. W. Wu
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Contributions

WW—data collection, statistical analysis, manuscript writing, and preparation of tables and figures. MT—data collection and preparation of reference list. EM, JHM, AT, and DM—protocol development. EM and JHM—limited spine image review. CK—data extraction. RW—statistics review. AT and DM—supervision. All authors reviewed and approved the final manuscript.

Corresponding author

Correspondence to A. Tu.

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Ethics approval and consent to participate

This study was performed retrospectively and was approved by the CHEO Research Ethics Board.

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All authors have consented to publication.

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The authors declare no competing interests.

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The authors have no personal financial or institutional interest in any of the drugs, materials, or devices described in this article.

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Wu, W., Miller, E., Hurteau–Miller, J. et al. Validation of a shortened MR imaging protocol for pediatric spinal pathology. Childs Nerv Syst 39, 3163–3168 (2023). https://doi.org/10.1007/s00381-023-05940-1

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  • DOI: https://doi.org/10.1007/s00381-023-05940-1

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