Portable MRI in Pediatrics: Weighing the Costs and Benefits. Revolution or Novelty?

Portable magnetic resonance imaging (pMRI) addresses several limitations of conventional MRI (cMRI): it can be operated at the bedside and is less expensive. However, its lower magnetic field strength produces lower-quality images, limiting the reliable detection of subtle brain injury. This review examines pMRI utility within a pediatric hospital. Current evidence suggests that pMRI offers advantages for hospital care. Bedside imaging eliminates the need to transport critically ill patients to MRI suites, expanding access for children who cannot undergo cMRI. pMRI also reduces equipment costs and energy use per scan. pMRI performs well in identifying large intracranial processes (hydrocephalus, cerebral edema, intraparenchymal hemorrhage, and midline shift). However, it is less reliable for detecting small parenchymal injuries, subtle white-matter changes, infarcts, and small-volume hemorrhages. Motion artifact is a key limitation in pediatrics, where patient stillness is difficult. As an advantage of MRI over computerized tomography (CT) is detecting small-scale pathology, defining the clinical role of pMRI is important. Overall, pMRI is a valuable complement to cMRI and CT in hospitals with bedside monitoring needs, critical-care imaging demands, or limited MRI access. However, due to lower spatial resolution and signal-to-noise ratio, pMRI cannot yet replace cMRI for evaluating subtle pediatric brain injuries.