General anesthesia / sedation requirement influences the way MRI brain scans are ordered in a tertiary pediatric hospital.

Background: MRI guidelines have been created to help clinicians order scans appropriately. Some scans in children are carried out under general anesthesia (GA) / sedation. Purpose: To evaluate if the requirement for GA/sedation influences the way MRI brain scans are ordered. Study Type: Retrospective. Population: Children with MRI brain scans in 2015 to 2017. Field Strength: 3T, 1.5T. Assessment: Institutional Review Board approval for waiver of consent was obtained. Clinical MRI brain reports for children were classified into whether they conformed to the American College of Radiology (ACR) 2013 guidelines by research assistants under supervision of a pediatric radiologist. Scans were sorted into those with normal brains or abnormality. Statistical Test: The statistical difference between groups was assessed using t‐test for continuous variables and chi‐square test for categorical variables with IBM SPSS 19. Results: Of the total 1893 MRI scans, 431 were performed under GA and six under sedation. Of the 431 cases performed under GA/sedation, 383 (87.6%) were ordered according to guidelines. Of the 1456 cases that did not require GA/sedation, 710 (48.8%) conformed to guidelines. The percentage of scans ordered according to guidelines was 38.8% higher in those who had scans performed under GA/sedation (P < 0.001). MRI scans were normal in 635 (58.0%) out of the 1093 cases ordered according to guidelines and normal in 638 (79.8%) out of the 800 cases that did not follow guidelines. Scans not ordered according to guidelines had higher proportion of normal scans (21.8%) compared with those ordered according to guidelines (P < 0.001). Data Conclusion: Higher adherence to imaging guidelines is seen in younger patients who were exposed to the risks of GA/sedation for the MRI. Scans not adhering to guidelines had a higher percentage of having no brain abnormality detected. Level of Evidence: 3 Technical Efficacy: Stage 6 J. Magn. Reson. Imaging 2019;49:e250–e255. [ABSTRACT FROM AUTHOR]