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Background <p>In diagnostic imaging as part of pediatric polytrauma management radiation exposure and diagnostic benefit of a whole-body computed tomography must be weighed up against each other. Performing an adapted polytrauma magnetic resonance imaging (MRI) could be a sensible alternative in some cases. The aim of this study was to show what findings are made in the MRI and if this has consequences for further diagnosis and therapy.</p> Methods <p>We performed a retrospective evaluation of the adapted polytrauma MRI examination as part of the primary survey in trauma room care of children and adolescents (indication was made individually) between 05/2016 and 12/2022 in a level 1 trauma center. Demographic data, cause of the accident, findings obtained during the MRI, additive radiological diagnostics performed, time between admission to hospital and MRI and the therapeutic consequence of the MRI findings were evaluated.</p> Results <p>33 children (21 boys, 12 girls) with an average age of 11.3 years (2.9–17.6 years) were evaluated. The majority of accident mechanisms were traffic accidents in 14 (42.4%) cases and a fall from a height of &gt; 3&#xa0;m in 6 cases (18.2%). Additional radiological diagnosis was performed in 20 (60.6%) cases. Time between admission and MRI was in average 47.58&#xa0;min. In 23 (69.7%) patients, 31 injuries were detected on MRI such as spinal injury (9 cases), soft tissue injury (9), skull/brain injury (4), bony lesion of the extremities/shoulder girdle (4), pelvic injury (3), and lung injury (2). The additional injuries identified on MRI did not lead to surgical intervention in any case.</p> Conclusions <p>It seems reasonable to perform an MRI in children admitted to the trauma room, if available and if the children are circulatory stable. In particular, injuries of the spine and pelvis can be detected without additional radiation diagnostics, even if they usually do not require surgical intervention.</p> Trial registration <p>DRKS, DRKS00036020. Registered 28 January 2025—Retrospectively registered, <a href="https://www.drks.de/DRKS00036020">https://www.drks.de/DRKS00036020</a>.</p>

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Results of an adapted whole-body MRI in the primary care of children and adolescents in the trauma room

  • 期刊论文

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  • 发表日期：

    2025年4月19日

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  • Silvia J. Hufnagel,
  • Alexis Brinkemper,
  • Simon Pätzholz,
  • Charlotte Cibura,
  • Volkmar Nicolas,
  • Thomas A. Schildhauer,
  • Christiane Kruppa

摘要

Background

In diagnostic imaging as part of pediatric polytrauma management radiation exposure and diagnostic benefit of a whole-body computed tomography must be weighed up against each other. Performing an adapted polytrauma magnetic resonance imaging (MRI) could be a sensible alternative in some cases. The aim of this study was to show what findings are made in the MRI and if this has consequences for further diagnosis and therapy.

Methods

We performed a retrospective evaluation of the adapted polytrauma MRI examination as part of the primary survey in trauma room care of children and adolescents (indication was made individually) between 05/2016 and 12/2022 in a level 1 trauma center. Demographic data, cause of the accident, findings obtained during the MRI, additive radiological diagnostics performed, time between admission to hospital and MRI and the therapeutic consequence of the MRI findings were evaluated.

Results

33 children (21 boys, 12 girls) with an average age of 11.3 years (2.9–17.6 years) were evaluated. The majority of accident mechanisms were traffic accidents in 14 (42.4%) cases and a fall from a height of > 3 m in 6 cases (18.2%). Additional radiological diagnosis was performed in 20 (60.6%) cases. Time between admission and MRI was in average 47.58 min. In 23 (69.7%) patients, 31 injuries were detected on MRI such as spinal injury (9 cases), soft tissue injury (9), skull/brain injury (4), bony lesion of the extremities/shoulder girdle (4), pelvic injury (3), and lung injury (2). The additional injuries identified on MRI did not lead to surgical intervention in any case.

Conclusions

It seems reasonable to perform an MRI in children admitted to the trauma room, if available and if the children are circulatory stable. In particular, injuries of the spine and pelvis can be detected without additional radiation diagnostics, even if they usually do not require surgical intervention.

Trial registration

DRKS, DRKS00036020. Registered 28 January 2025—Retrospectively registered, https://www.drks.de/DRKS00036020.