301 Fast-Sequence vs Normal-Sequence MRI for Spinal Pathology in Pediatric Patients: An Institutional Experience and Cost Analysis

INTRODUCTION: Magnetic Resonance Imaging’s (MRI) of the spine in the pediatric population often require extended scan times and anesthesia to maximize compliance. Previous studies have demonstrated that fast-sequence brain MRIs are efficacious, efficient, and present minimal risk to pediatric patients. However, data on their use in the setting of spinal pathology in this population is lacking. METHODS: All spine MRIs administered to pediatric patients in 2023 at our institution were assessed. Indications and length of scan in minutes were retrospectively recorded. To assess the effects of age on scan time, patients were grouped into a younger pediatric cohort (defined as six years of age and younger) and an older cohort (defined as seven years and older). Financial data including hourly personnel rates were acquired for the purposes of the cost analysis. RESULTS: A total of 1,230 spine MRIs were done on pediatric patients in 2023, including 328 fast-sequence and 902 routine scans. Across all patients, the mean time for a fast-sequence MRI was 32.1 minutes (standard deviation (SD)=12.7), compared to 99.7 (SD=49.1) for routine MRIs. In the younger cohort (n=363), the mean fast-sequence MRI time was 33.9 minutes (SD=13.3), compared to 106.3 minutes (SD=51.1) for routine MRIs. Mean fast-sequence MRI time in the older cohort (n=858) was 30.2 minutes (SD=11.7), compared to 97.9 minutes (SD=48.4) for routine MRIs. In a preliminary analysis, it was estimated that the cost of doing a routine MRI with anesthesia was $538.51 greater than the cost of doing a single fast-sequence MRI. CONCLUSIONS: Fast-sequence MRIs reduced the time needed to acquire imaging for pediatric patients presenting with spinal pathology. The potential cost benefits of using this methodology are significant, given the lack of anesthesia and significantly reduced scan time.