Close
Enter your
text here

Fast Brain MRI Demonstrates High Diagnostic Value for Pediatric Neurologic Emergencies

Fast Brain MRI Demonstrates High Diagnostic Value for Pediatric Neurologic Emergencies 1024 683 JoAnna Pendergrass, DVM

Fast brain MRI is a radiation-sparing technique that has demonstrated value as a screening tool for generalized emergent neurologic conditions in the pediatric emergency setting.

 

A recent retrospective study led by Nathaniel Forman, MD, a former pediatric emergency medicine fellow at Nationwide Children’s and current pediatrician at Joe DiMaggio Children’s Hospital, reported that fast brain MRI missed fewer pathologies and had higher sensitivity than head CT for children presenting to the emergency department (ED) with generalized, neurologic conditions.

Research has identified several advantages of fast brain MRI, including its ability to be performed in less than 10 minutes and to detect acute brain pathologies. However, its use in the pediatric ED setting is relatively limited.

“Very little research, if any, has been performed to evaluate the use of fast brain MRI as a primary screening tool for generalized pediatric neurologic emergencies,” says Julie Leonard, MD, MPH, associate division chief for research in emergency medicine at Nationwide Children’s and part of the study’s research team.

Diagnosing neurologic emergencies is often time-sensitive, underscoring the need for rapid diagnostic imaging in the ED.

The current study, published in Pediatrics, was part of a quality improvement (QI) project focused on reducing time to diagnosis in pediatric neurologic emergencies.

Children aged 2 to 24 months with emergent neurologic conditions who received either fast brain MRI (n=159) or head CT (n=636) from July 2016 to June 2021 were included in the study. The children receiving head CT were divided into 3 comparison groups to minimize potential biases in imaging modality selection:

  • Group 1: Randomly selected
  • Group 2: Age-matched within 2 years to children receiving fast brain MRI
  • Group 3: Matched based on diagnosis categories

The researchers evaluated missed diagnoses, ED length of stay (LOS) and hospital LOS.

Fast brain MRI missed fewer pathologies than head CT. Additionally, sensitivity was markedly higher for fast brain MRI than for head CT (95.8% vs 63%), as was negative predictive value (98.2% vs 91.5%).

Hospital LOS was similar between patients receiving fast brain MRI (142 minutes) and those receiving head CT (139 minutes). Imaging time was also similar: 15 minutes for fast brain MRI and 11 minutes for head CT.

“Study results demonstrate that fast brain MRI is feasible for broad use in the ED,” says Dr. Forman, emphasizing that fast brain MRI is a radiation-sparing technique.

The risk of radiation exposure in children is especially pertinent because children’s bodies are small and rapidly growing, Drs. Forman and Leonard explain. The dosing effect of radiation could be particularly dangerous in children.

Moving forward, Drs. Forman and Leonard highlight the need to make fast brain MRI more widely and readily available to children in resource-limited settings who may need diagnostic brain imaging.

Dr. Leonard notes that a clinical algorithm developed for the QI project to determine who needs imaging for nontraumatic neurologic emergencies will need further refinement before it can be used more widely in the ED.

Dr. Forman is excited about additional research that could pave the way for improving diagnostic imaging for children in the ED.

“The best research is always driven by a clinician’s understanding of clinical practice and a strong desire to make a change for the better,” Dr. Forman concludes.

 

Reference

Forman NH, Spencer SP, Nash M, Helwig S, Drapeau A, Jones J, Chung MG, Lovett M, Leonard JC. Fast MRI Compared With Head CT in Evaluating Pediatric Neurologic Emergencies. Pediatrics. 2026;157(5):e2024068363.

 

Image credit: Adobe Stock

 

About the author

JoAnna Pendergrass

JoAnna Pendergrass, DVM, is a veterinarian and freelance medical writer in Atlanta, GA. She received her veterinary degree from the Virginia-Maryland College of Veterinary Medicine and completed a 2-year postdoctoral research fellowship at Emory University’s Yerkes Primate Research Center before beginning her career as a medical writer.

As a freelance medical writer, Dr. Pendergrass focuses on pet owner education and health journalism. She is a member of the American Medical Writers Association and has served as secretary and president of AMWA’s Southeast chapter.

In her spare time, Dr. Pendergrass enjoys baking, running, and playing the viola in a local community orchestra.

You might also like