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Use of Magnetic Resonance Imaging in Neuroprognostication After Pediatric Cardiac Arrest: Survey of Current Practices

2022; Elsevier BV; Volume: 134; Linguagem: Inglês

10.1016/j.pediatrneurol.2022.06.011

1873-5150

Juan Piantino, Christopher M. Ruzas, Craig A. Press, Subramanian Subramanian, Binod Balakrishnan, Ashok Panigrahy, David Pettersson, John A. Maloney, Arastoo Vossough, Alexis A. Topjian, Matthew P. Kirschen, Lesley Doughty, Melissa G. Chung, David G. Maloney, Tamara Haller, Anthony Fabio, Ericka L. Fink, Patrick M. Kochanek, Robert M. Clark, Hülya Bayır, Ashok Panigrahy, Rachel P. Berger, Sue R. Beers, Tony Fabio, Karen Walson, Alexis A. Topjian, Christopher J. L. Newth, Elizabeth A. Hunt, Jordan Duval‐Arnould, Binod Balakrishnan, Michael T. Meyer, Melissa G. Chung, Anthony Willyerd, Lincoln Smith, Jesse Wenger, Stuart H. Friess, Jose Pineda, Ashley Siems, Jason Patregnani, J. Wesley Diddle, Aline B. Maddux, Craig A. Press, Lesley Doughty, Juan Piantino, David G. Maloney, Pamela Rubin, Beena Desai, Maureen G. Richardson, Cynthia Bates, Darshana Parikh, Janice Prodell, Maddie Winters, Katherine Smith, Jeni Kwok, A. Cabrales, Ronke Adewale, Pam Melvin, Sadaf Shad, Katherine Siegel, Katherine Murkowski, Mary C. Kasch, Josey Hensley, Lisa Steele, Danielle Brown, Brian Burrows, Lauren Hlivka, Deana Rich, Amila Tutundzic, Tina Day, Lori Barganier, Ashley Wolfe, Mackenzie Little, Elyse Tomanio, Neha Patel, Diane Hession, Yamila Sierra, Rhonda Jones, Laura Benken, Jonathan Elmer, Subramanian Subramanian, Srikala Narayanan, Julia Wallace, Tami Echavarria Robinson, Andrew Frank, Stefan Blüml, Jessica L. Wisnowski, Keri Feldman, Avinash Vemulapalli, Linda Ryan, Scott Szypulski,

Neonatal and fetal brain pathology

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.