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Use of Magnetic Resonance Imaging in Neuroprognostication After Pediatric Cardiac Arrest: Survey of Current Practices. Pediatr Neurol 2022 Sep;134:45-51

Date

07/15/2022

Pubmed ID

35835025

Pubmed Central ID

PMC9883065

DOI

10.1016/j.pediatrneurol.2022.06.011

Scopus ID

2-s2.0-85133923534   1 Citation

Abstract

BACKGROUND: Use of magnetic resonance imaging (MRI) as a tool to aid in neuroprognostication after cardiac arrest (CA) has been described, yet details of specific indications, timing, and sequences are unknown. We aim to define the current practices in use of brain MRI in prognostication after pediatric CA.

METHODS: A survey was distributed to pediatric institutions participating in three international studies. Survey questions related to center demographics, clinical practice patterns of MRI after CA, neuroimaging resources, and details regarding MRI decision support.

RESULTS: Response rate was 31% (44 of 143). Thirty-four percent (15 of 44) of centers have a clinical pathway informing the use of MRI after CA. Fifty percent (22 of 44) of respondents reported that an MRI is obtained in nearly all patients with CA, and 32% (14 of 44) obtain an MRI in those who do not return to baseline neurological status. Poor neurological examination was reported as the most common factor (91% [40 of 44]) determining the timing of the MRI. Conventional sequences (T1, T2, fluid-attenuated inversion recovery, and diffusion-weighted imaging/apparent diffusion coefficient) are routinely used at greater than 97% of centers. Use of advanced imaging techniques (magnetic resonance spectroscopy, diffusion tensor imaging, and functional MRI) were reported by less than half of centers.

CONCLUSIONS: Conventional brain MRI is a common practice for prognostication after CA. Advanced imaging techniques are used infrequently. The lack of standardized clinical pathways and variability in reported practices support a need for higher-quality evidence regarding the indications, timing, and acquisition protocols of clinical MRI studies.

Author List

Piantino JA, Ruzas CM, Press CA, Subramanian S, Balakrishnan B, Panigrahy A, Pettersson D, Maloney JA, Vossough A, Topjian A, Kirschen MP, Doughty L, Chung MG, Maloney D, Haller T, Fabio A, Fink EL, POCCA Investigators

Authors

Binod Balakrishnan MBBS Associate Professor in the Pediatrics department at Medical College of Wisconsin
Michael T. Meyer MD Chief, Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Brain
Child
Diffusion Magnetic Resonance Imaging
Diffusion Tensor Imaging
Heart Arrest
Humans
Magnetic Resonance Imaging
Surveys and Questionnaires