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075. Development of a Fast SPINE Protocol for Use in Paediatric Patients

Authors: Winnie Wu

Introduction:
Current SPINE MRI protocols have multiple sequences resulting in long acquisition times. General anesthetic is consequently required in pediatric populations. This study evaluates the diagnostic capability of a limited SPINE MRI protocol for a selection of common pediatric indications.Methods: After REB approval, records of patients from 0 to 48 months of age who underwent a SPINE MRI between 2017 and 2020 were reviewed. A blinded review by 2 experienced neuroradiologists was carried out. A T2 sagittal view from the craniocervical junction to sacrum and T1 axial view of the lumbar SPINE from each series was provided to reviewers. The results were independently compared to previously reported findings. Specific features of interest were the presence of cerebellar ectopia, syrinx, level of conus, filum < 2mm, fatty filum, and spinal dysraphism.
Results:
110 studies were evaluated in 59 male and 51 female patients (mean age=19.2 months). 74 studies were carried out under sedation (mean age=27.8 months) and 36 were without (mean age=1.44 months). The combined average scan time of the limited sequences was 11.28 minutes compared to 56.53 minutes for conventional protocols (difference=45.3 minutes, p < 0.05). The average agreement between conventional and limited imaging was >87% in all but identifying a filum < 2mm (75%). Using limited imaging had high sensitivity (>0.90) and specificity (>0.88) for the detection of cerebellar ectopia, fatty filum, and spinal dysraphism.
Conclusion:
This study demonstrates that the use of selected SPINE imaging sequences provides consistent and accurate diagnosis of specific clinical conditions. The time required to obtain limited imaging is substantially less than traditional protocols and potentially avoids the need for sedation. Further study is required to determine the utility of selected imaging for other potential clinical indications.