Magnetic Resonance Imaging Process Variation During Musculoskeletal Infection Evaluation at 6 Pediatric Centers.

IF 1.5 3区 医学 Q3 ORTHOPEDICS
Journal of Pediatric Orthopaedics Pub Date : 2025-10-01 Epub Date: 2025-07-16 DOI:10.1097/BPO.0000000000003018
Yida Liu, Naureen G Tareen, Shyam Kishan, Lauren E LaMont, Dustin M Loveland, Scott B Rosenfeld, Christopher D Souder, Matthew R Hammer, Norman A Lapin, Kristy Reyes, Niamh McMahon, Grace S Anand, Justine Kasay, Lawson A Copley
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引用次数: 0

Abstract

Introduction: Magnetic resonance imaging (MRI) is heavily utilized for evaluation of children suspected to have musculoskeletal infection (MSI). This allows early visualization of the anatomic and spatial extent of evolving inflammation to guide treatment decisions. Organized protocols for efficient and effective use of this diagnostic modality have been published but may not be actively followed at most pediatric centers. The purpose of this study is to comparatively evaluate MRI processes and workflows at 6 pediatric centers in the state of Texas.

Methods: Institutional Review Board approval and data use agreements were established at the centers for retrospective study of MRI practices and experience. A survey of pediatric orthopaedic surgeon principal investigators at each center assessed MRI acquisition strategies and satisfaction. Data were collected and analyzed for demographics, diagnoses, MRI indications, processes, and outcomes.

Results: Seventy children who underwent MRI evaluations over a 3-year period were included with a range of 5 to 20 children per center. Two centers had protected MRI scan time, organized MRI protocols, and facilitated immediate transfer to the operating room when surgical indications were present for sedated children. The 2 centers demonstrated significantly shorter MRIs (median 21.0 vs. 52.0 m), fewer sequences (median 3.0 vs. 7.0), less contrast use (4.0% vs. 53.3%), and a shorter delay from MRI to OR for children who underwent surgery (median 26.0 vs. 967.5 m) when compared with the remaining centers ( P <0.0001).

Conclusions: Organized MRI workflows were not followed at most centers studied. While challenging to implement and sustain, a multidisciplinary MRI protocol for MSI evaluation will make this heavily scheduled resource substantially more efficient and improve provider satisfaction.

Level of evidence: Level III-retrospective study of nonconsecutive patients.

6个儿科中心的肌肉骨骼感染评估中的磁共振成像过程变化。
简介:磁共振成像(MRI)被广泛用于评估疑似患有肌肉骨骼感染(MSI)的儿童。这使得早期可视化的解剖和空间范围演变炎症指导治疗决策。高效和有效地使用这种诊断方式的有组织的协议已经发表,但可能不会在大多数儿科中心积极遵循。本研究的目的是比较评估德克萨斯州6个儿科中心的MRI流程和工作流程。方法:在各中心建立机构审查委员会批准和数据使用协议,对MRI实践和经验进行回顾性研究。对每个中心的儿科骨科医生的主要研究人员进行了一项调查,评估了MRI获取策略和满意度。收集和分析人口统计学、诊断、MRI指征、过程和结果的数据。结果:70名儿童在3年内接受了MRI评估,每个中心5至20名儿童。两个中心保护了MRI扫描时间,组织了MRI协议,并在镇静儿童出现手术指征时促进了立即转移到手术室。与其他中心相比,这两个中心的MRI成像时间明显缩短(中位数21.0比52.0 m),序列更少(中位数3.0比7.0),对比剂使用更少(4.0%比53.3%),接受手术的儿童从MRI到OR的延迟时间更短(中位数26.0比967.5 m) (p结论:大多数研究中心没有遵循有组织的MRI工作流程。虽然实施和维持具有挑战性,但用于MSI评估的多学科MRI协议将使这一高度调度的资源大大提高效率,并提高提供者的满意度。证据等级:iii级——非连续患者的回顾性研究。
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来源期刊
CiteScore
3.30
自引率
17.60%
发文量
512
审稿时长
6 months
期刊介绍: ​Journal of Pediatric Orthopaedics is a leading journal that focuses specifically on traumatic injuries to give you hands-on on coverage of a fast-growing field. You''ll get articles that cover everything from the nature of injury to the effects of new drug therapies; everything from recommendations for more effective surgical approaches to the latest laboratory findings.
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