MRI usage in a pediatric emergency department: an analysis of usage and usage trends over 5 years.

Abstract:

BACKGROUND:Magnetic resonance imaging (MRI) usage has anecdotally increased due to the principles of ALARA and the desire to Image Gently. Aside from a single abstract in the emergency medicine literature, pediatric emergency department MRI usage has not been described. OBJECIVE:Our objective was to determine whether MRI use is indeed increasing at a high-volume urban pediatric emergency department with 24/7 MRI availability. Also, we sought to determine which exams, time periods and demographics influenced the trend. MATERIALS AND METHODS:Institutional Review Board exemption was obtained. Emergency department patient visit and exam data were obtained from the hospital database for the 2011-2015 time period. MRI usage data were normalized using emergency department patient visit data to determine usage rates. The z-test was used to compare MRI use by gender. The chi-square test was used to test for trends in MRI usage during the study period and in patient age. MRI usage for each hour and each weekday were tabulated to determine peak and trough usage times. RESULTS:MRI usage rate per emergency department patient visit was 0.36%. Headache, pain and rule-out appendicitis were the most common indications for neuroradiology, musculoskeletal and trunk exams, respectively. Usage in female patients was significantly greater than in males (0.42% vs. 0.29%, respectively, P<0.001). Usage significantly increased during the 5-year period (P<0.001). Use significantly increased from age 3 to 17 (0.011% to 1.1%, respectively, P<0.001). Sixty percent of exams were performed after-hours, the highest volume during the 10 p.m. hour and lowest between 4 a.m. and 9 a.m. MRI use was highest on Thursdays and lowest on Sundays (MRI on 0.45% and 0.22% of patients, respectively). CONCLUSION:MRI use in children increased during the study period, most notably in females, on weekdays and after-hours.

journal_name

Pediatr Radiol

journal_title

Pediatric radiology

authors

Scheinfeld MH,Moon JY,Fagan MJ,Davoudzadeh R,Wang D,Taragin BH

doi

10.1007/s00247-016-3764-y

subject

Has Abstract

pub_date

2017-03-01 00:00:00

pages

327-332

issue

3

eissn

0301-0449

issn

1432-1998

pii

10.1007/s00247-016-3764-y

journal_volume

47

pub_type

杂志文章
  • Digital atlas of fetal brain MRI.

    abstract:BACKGROUND:Fetal MRI can be performed in the second and third trimesters. During this time, the fetal brain undergoes profound structural changes. Interpretation of appropriate development might require comparison with normal age-based models. Consultation of a hard-copy atlas is limited by the inability to compare mul...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-009-1411-6

    authors: Chapman T,Matesan M,Weinberger E,Bulas DI

    更新日期:2010-02-01 00:00:00

  • Epidural dumbbell-shaped chordoma mimicking a neurinoma.

    abstract::The authors present a case of cervical chordoma which manifested in a 5-year-old boy as a dumbbell-shaped epidural tumor without bone destruction. Both CT and MRI demonstrated tumor features suggesting this diagnosis, which was confirmed by histology. ...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/BF01403709

    authors: Karakida O,Aoki J,Seo GS,Ishii K,Sone S,Nakakouji T,Otsuka K

    更新日期:1996-01-01 00:00:00

  • Correlation of ductus arteriosus length and morphology between computed tomographic angiography and catheter angiography and their relation to ductal stent length.

    abstract:BACKGROUND:Patent ductus arteriosus (PDA) stent placement in infants with ductal-dependent pulmonary blood flow is being increasingly used in clinical practice. OBJECTIVE:To correlate computed tomographic (CT) angiography morphology and length of the PDA with catheter angiography and its relation to eventual PDA stent...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-020-04624-1

    authors: Jadhav SP,Aggarwal V,Masand PM,Diaz E,Zhang W,Qureshi AM

    更新日期:2020-05-01 00:00:00

  • Neurofibromatosis involving the lower urinary tract in children. A report of three cases and a review of the literature.

    abstract::Three children with neurofibromatosis involving the lower urinary tract are reported and their clinical, radiological and pathological findings are described. Lower urinary tract involvement in neurofibromatosis has previously been reported in 17 children, 12 of whom had other stigmata of von Recklinghausens disease. ...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/BF00975350

    authors: Daneman A,Grattan-Smith P

    更新日期:1976-04-14 00:00:00

  • Developmental stenosis of the cervical spine in children.

    abstract::Developmental stenosis of the cervical spine results in a reduction of the caliber of the cervical spinal canal that is greatest in the anteroposterior dimensions. This usually becomes symptomatic in adults when a myelopathy may result from compression of the cervical cord by small osteophytes or by hyperextension inj...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/BF02388241

    authors: Starshak RJ,Kass GA,Samaraweera RN

    更新日期:1987-01-01 00:00:00

  • A case of Sertoli-Leydig cell tumour of the ovary with a multilocular cystic appearance on CT and MR imaging.

    abstract::We present a case of Sertoli-Leydig cell tumour of the ovary in a 14-year-old girl who presented with abdominal distension. Ultrasonography showed a multilocular cystic lesion filled with finely echogenic fluid. Contrast-enhanced CT demonstrated a huge multilocular cystic mass with thickened septa. At MR imaging, the ...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-008-0868-z

    authors: Azuma A,Koyama T,Mikami Y,Tamai K,Fujimoto K,Morisawa N,Nagano F,Yoshioka S,Togashi K

    更新日期:2008-08-01 00:00:00

  • Fatal cerebral edema and intracranial hemorrhage associated with hypernatremic dehydration.

    abstract::We report neuroimaging findings of intracranial hemorrhage and cerebral edema in an infant with obtundation and seizures, initially suspected to be secondary to non-accidental trauma but finally attributed to hypernatremic dehydration. Neuroimaging findings due to hypernatremic dehydration have not been previously des...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s002470050232

    authors: Mocharla R,Schexnayder SM,Glasier CM

    更新日期:1997-10-01 00:00:00

  • MR enterography-histology comparison in resected pediatric small bowel Crohn disease strictures: can imaging predict fibrosis?

    abstract:BACKGROUND:Crohn disease is a chronic inflammatory condition that can lead to intestinal strictures. The presence of fibrosis within strictures alters optimal management but is not reliably detected by current imaging methods. OBJECTIVE:To correlate the MRI features of surgically resected small-bowel strictures in ped...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-015-3506-6

    authors: Barkmeier DT,Dillman JR,Al-Hawary M,Heider A,Davenport MS,Smith EA,Adler J

    更新日期:2016-04-01 00:00:00

  • The barium enema in constipation: comparison with rectal manometry and biopsy to exclude Hirschsprung's disease after the neonatal period.

    abstract:BACKGROUND:The diagnosis of Hirschsprung's disease is usually made in neonates but often considered in older infants and children with constipation: these children may be referred for barium enema. Since it is widely accepted that a normal barium enema does not exclude Hirschsprung's disease, some children, after a nor...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s002470000298

    authors: Reid JR,Buonomo C,Moreira C,Kozakevich H,Nurko SJ

    更新日期:2000-10-01 00:00:00

  • Multimodality imaging of vascular anomalies.

    abstract::Vascular malformations and hemangiomas are common in children but remain a source of confusion during diagnosis, in part because of the lack of a uniform terminology. With the existing treatments for hemangiomas and vascular malformations, it is important to make the correct diagnosis initially to prevent adverse phys...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-012-2584-y

    authors: Restrepo R

    更新日期:2013-03-01 00:00:00

  • Fast fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging of the brain: a comparison of multi-shot echo-planar and fast spin-echo techniques.

    abstract:PURPOSE:To evaluate fast spin-echo and multi-shot echo-planar fluid-attenuated inversion recovery (FLAIR) sequences in paediatric brain imaging. MATERIALS AND METHODS:Matched images from 32 patients with suspected tumour or white matter disease were independently evaluated by two paediatric neuroradiologists. The obse...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s002470050177

    authors: Sargent MA,Poskitt KJ

    更新日期:1997-06-01 00:00:00

  • Liver and spleen MRI findings in virus-associated hemophagocytic syndrome in a patient with acute lymphocytic leukemia.

    abstract::Virus-associated hemophagocytic syndrome is characterized by the phagocytosis of erthythrocytes and other blood elements in multiple organ systems, especially the liver and spleen. Magnetic resonance imaging (MRI) can suggest this diagnosis in the proper clinical setting by demonstrating multiple, rounded signal voids...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s002470050498

    authors: Zilkha A,Madan V,Leonidas JC,Valderrama E

    更新日期:1998-12-01 00:00:00

  • Ultrasound of a torsed ovary: characteristic gray-scale appearance despite normal arterial and venous flow on Doppler.

    abstract:BACKGROUND:We present the case of an 8-year-old girl with acute onset of intermittent lower abdominal pain. The gray-scale US examination showed an enlarged right ovary with peripheral cysts, reflecting ovarian congestion and strongly suggesting the diagnosis of torsion. Normal arterial and venous flow, however, was fo...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-002-0739-y

    authors: Hurh PJ,Meyer JS,Shaaban A

    更新日期:2002-08-01 00:00:00

  • Malignant intraperitoneal neoplasms of childhood.

    abstract:OBJECTIVE:The purpose of this paper is to review and categorize the CT appearances of primary and secondary intraperitoneal neoplasms in children. MATERIALS AND METHODS:We retrospectively reviewed the CT images of 14 cases of intraperitoneal neoplasms. They were reviewed for bowel wall thickening, mesenteric nodules, ...

    journal_title:Pediatric radiology

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s002470050363

    authors: Chung CJ,Bui V,Fordham LA,Hill J,Bulas D

    更新日期:1998-05-01 00:00:00

  • Cricopharyngeal ring. A case report.

    abstract::We report a 6-month-old infant with a fibroblastic ring obstructing her hypopharynx. Surgical myotomy gave relief of symptoms. ...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/BF02386642

    authors: Cumming WA,Akhtar M,Ferentzi C,Feteih W

    更新日期:1986-01-01 00:00:00

  • Minimizing radiation injury and neoplastic effects during pediatric fluoroscopy: what should we know?

    abstract::Radiation-induced injuries from fluoroscopic procedures in pediatric patients have occurred, and young patients are at greatest risk of many radiation-induced neoplasms. Some fluoroscopists have been injured from their use of fluoroscopy, and they are known to be at risk of radiation-induced neoplasm when radiation is...

    journal_title:Pediatric radiology

    pub_type: 杂志文章,评审

    doi:10.1007/s00247-006-0187-1

    authors: Wagner LK

    更新日期:2006-09-01 00:00:00

  • US in the diagnosis of gastroesophageal reflux in children.

    abstract::Several techniques have been used to diagnose gastroesophageal reflux (GER) in children, but no single test is sufficiently accurate to completely investigate the problem. Gastroesophageal US has been described as a widely available, noninvasive and sensitive method. It provides morphological and functional informatio...

    journal_title:Pediatric radiology

    pub_type: 杂志文章,评审

    doi:10.1007/s00247-012-2344-z

    authors: Savino A,Cecamore C,Matronola MF,Verrotti A,Mohn A,Chiarelli F,Pelliccia P

    更新日期:2012-05-01 00:00:00

  • Diagnosis of vertebral fractures in children: is a simplified algorithm-based qualitative technique reliable?

    abstract:BACKGROUND:Identification of osteoporotic vertebral fractures allows treatment opportunity reducing future risk. There is no agreed standardised method for diagnosing paediatric vertebral fractures. OBJECTIVE:To evaluate the precision of a modified adult algorithm-based qualitative (ABQ) technique, applicable to child...

    journal_title:Pediatric radiology

    pub_type: 评论,杂志文章

    doi:10.1007/s00247-015-3537-z

    authors: Adiotomre E,Summers L,Allison A,Walters SJ,Digby M,Broadley P,Lang I,Offiah AC

    更新日期:2016-05-01 00:00:00

  • Reinsertion of accidentally removed tunneled central venous catheter via the existing subcutaneous tract.

    abstract:BACKGROUND:A technique for reinsertion of an inadvertently removed tunneled central venous catheter is presented. A 6-year-old boy with short-gut syndrome caused by necrotizing enterocolitis accidentally removed his tunneled central venous catheter. MATERIALS AND METHODS:The existing subcutaneous catheter tract was re...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s002470050724

    authors: Funaki B,Lorenz J,Zaleski GX

    更新日期:1999-12-01 00:00:00

  • Multimodality imaging findings of massive ovarian edema in children.

    abstract:BACKGROUND:Massive ovarian edema is a rare benign condition that predominantly affects childbearing women as well as preadolescent girls. It is thought to result from intermittent or partial torsion of the ovary compromising the venous and lymphatic drainage but with preserved arterial supply. The clinical features of ...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-017-3782-4

    authors: Dahmoush H,Anupindi SA,Pawel BR,Chauvin NA

    更新日期:2017-05-01 00:00:00

  • Evolution of intramural duodenal hematomas on magnetic resonance imaging.

    abstract:BACKGROUND:The magnetic resonance imaging (MRI) characteristics of evolving duodenal hematomas in children are unknown. OBJECTIVE:To describe the MRI changes exhibited by evolving duodenal hematomas and the likely mechanisms behind these changes. MATERIALS AND METHODS:We retrospectively reviewed the MR features of in...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-018-4178-9

    authors: Zhou H,Ma X,Sheng M,Lai C,Fu J

    更新日期:2018-10-01 00:00:00

  • Partial liquid ventilation.

    abstract::We describe the technique of partial liquid ventilation and outline its indications. We present our imaging experience with this infrequently used therapy using a wide variety of radiographs from neonatal and adult patients. The radiographic appearance of white lungs, due to the perfluorocarbons used in partial liquid...

    journal_title:Pediatric radiology

    pub_type: 杂志文章,评审

    doi:10.1007/s00247-005-1548-x

    authors: Hamilton MC,Peek GJ,Dux AE

    更新日期:2005-11-01 00:00:00

  • Radiation doses from small-bowel follow-through and abdomen/pelvis MDCT in pediatric Crohn disease.

    abstract:BACKGROUND:The onset of Crohn disease (CD) can occur in childhood. Imaging, which often involves radiation, is frequent in CD both for disease diagnosis and follow-up. However, information regarding radiation dose for contemporary CT and fluoroscopy is not available for determining the cost/benefit ratio for imaging st...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-007-0702-z

    authors: Gaca AM,Jaffe TA,Delaney S,Yoshizumi T,Toncheva G,Nguyen G,Frush DP

    更新日期:2008-03-01 00:00:00

  • Pros and cons of organ shielding for CT imaging.

    abstract::With the increased importance of CT radiation dose to health care providers, patients and the general public, there is an increased responsibility to minimize patient dose effectively. Bismuth shields offer a simple strategy to reduce dose to certain anterior radiosensitive organs such as breasts and eyes. However, in...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-014-3084-z

    authors: Samei E

    更新日期:2014-10-01 00:00:00

  • Severe mid-cervical kyphosis with cord compression in Larsen's syndrome and diastrophic dysplasia: unrelated syndromes with similar radiologic findings and neurosurgical implications.

    abstract::Mid-cervical kyphosis in diastrophic dysplasia (DD) with cord compression and weakness has been recognized for the last three decades. A strikingly similar situation exists in Larsen's syndrome (LS), an otherwise unrelated problem of weakness with lay joints and dislocations with typical facies. Forty patients with DD...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/BF02010328

    authors: Forese LL,Berdon WE,Harcke HT,Wagner ML,Lachman R,Chorney GS,Roye DP

    更新日期:1995-01-01 00:00:00

  • Clinical safety of 3-T brain magnetic resonance imaging in newborns.

    abstract:BACKGROUND:The effects and potential hazards of brain magnetic resonance imaging (MRI) at 3 T in newborns are debated. OBJECTIVE:Assess the impact of 3-T MRI in newborns on body temperature and physiological parameters. MATERIAL AND METHODS:Forty-nine newborns, born preterm and at term, underwent 3-T brain MRI at ter...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-018-4105-0

    authors: Fumagalli M,Cinnante CM,Calloni SF,Sorrentino G,Gorla I,Plevani L,Pesenti N,Sirgiovanni I,Mosca F,Triulzi F

    更新日期:2018-07-01 00:00:00

  • Inferior right hepatic veins: MR assessment of prevalence and potential clinical significance in children.

    abstract::The prevalence of Inferior Right Hepatic Veins (IRHVs) in 82 children who had magnetic resonance imaging (MRI) of the abdomen was assessed. IRHVs larger than or equal in size to the Superior Right Hepatic Vein were found in 23% (19/82). In two patients with radiological evidence of Superior Hepatic Venous occlusion an...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/BF02129069

    authors: Ng YY,Finn JP,Hall-Craggs MA

    更新日期:1990-01-01 00:00:00

  • Subcutaneous fat necrosis of the newborn.

    abstract::We present the MRI findings in a case of subcutaneous fat necrosis of the newborn. To our knowledge, the MRI findings of this entity have not been reported. Subcutaneous fat necrosis of the newborn is an uncommon, benign process in full-term infants. Hypercalcemia may be a potentially life-threatening complication of ...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s002470050696

    authors: Anderson DR,Narla LD,Dunn NL

    更新日期:1999-10-01 00:00:00

  • Lung ultrasound for the diagnosis of community-acquired pneumonia in children.

    abstract::Ultrasound (US) has been proposed as an alternative first-line imaging modality to diagnose community-acquired pneumonia in children. Lung US has the potential benefits over chest radiography of being radiation free, subject to fewer regulatory requirements, relatively lower cost and with immediate bedside availabilit...

    journal_title:Pediatric radiology

    pub_type: 杂志文章,评审

    doi:10.1007/s00247-017-3910-1

    authors: Stadler JAM,Andronikou S,Zar HJ

    更新日期:2017-10-01 00:00:00

  • Congenital orbital sudoriferous cyst: radiological findings.

    abstract::We report an extremely unusual case of a 4-month-old boy who presented with a sudoriferous gland cyst of the orbit. Congenital sudoriferous cyst is extremely rare in both the adult and pediatric populations. The CT and MRI findings are presented and the pertinent literature reviewed. ...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-005-1523-6

    authors: Haider E,Saigal G,Gill D,Brown E,Daniel S

    更新日期:2005-11-01 00:00:00