Review of Diagnostic Yield of MRI Brain Results in Children Under Age 3 Years

Study Overview
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Brief Summary
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The investigators aim to identify the frequency with which an elective brain MRI yields and etiologic diagnosis to explain its indication. The protocol includes children undergoing elective brain MRI with anesthesia prior to their third birthday.

Detailed Description
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On December 14, 2016 the FDA issued a warning regarding elective anesthetics in children under three years of age. While a single, short exposure to general anesthesia may not have negative effects on behavior or learning, repeated or prolonged anesthetics may affect brain development. To that end, minimizing exposure to elective general anesthetics if procedures are not clearly indicated in young children appeals to reason.

Official Title
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Retrospective Review of Indications and Results of Brain MRI With Anesthesia/Sedation in Children Less Than Three Years of Age

Conditions
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Seizures, Development Delay, Anesthetic Neurotoxicity

Intervention / Treatment
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* Diagnostic Test: Change in plan of care based on MRI results


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male or female aged 0-36 months who received anesthesia (volatile gas anesthesia) or IV sedation (propofol, dexmedetomidine, barbiturates, benzodiazepines, or other agents) for brain MRI Exclusion Criteria: MRI without sedation, brain MRI plus additional MRI imaging, i.e. spine, heart, etc., sedated MRI by a member of other department besides Anesthesiology.

Ages Eligible for Study
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Maximum Age: 1095 Days

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Developmental Delay<br>Children under age 3 who underwent MRI brain with anesthesia for the indication of Developmental Delay (between the dates of Dec 13, 2015 - Dec 13, 2016) at our institution. | Diagnostic Test: Change in plan of care based on MRI results<br>* Study subjects have received the intervention if the results of their MRI either 1. provide an etiology for said MRI's indication or 2. the patient received a change in plan of care based on MRI results.<br>|
| Seizure<br>Children under age 3 who underwent MRI brain with anesthesia for the indication of Seizure (between the dates of Dec 13, 2015 - Dec 13, 2016) at our institution. | Diagnostic Test: Change in plan of care based on MRI results<br>* Study subjects have received the intervention if the results of their MRI either 1. provide an etiology for said MRI's indication or 2. the patient received a change in plan of care based on MRI results.<br>|
| Developmental Delay and Seizure<br>Children under age 3 who underwent MRI brain with anesthesia for the indication of Developmental Delay and Seizure (between the dates of Dec 13, 2015 - Dec 13, 2016) at our institution. | Diagnostic Test: Change in plan of care based on MRI results<br>* Study subjects have received the intervention if the results of their MRI either 1. provide an etiology for said MRI's indication or 2. the patient received a change in plan of care based on MRI results.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Etiologic diagnosis obtained from MRI brain | Determine the incidence of brain MRI abnormality that led to etiological explanation of developmental delay, autism or seizure. | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quantify anesthetic exposure | To determine the doses of all anesthetic and sedative agents administered and the duration of anesthesia | 1 year | 
| Incidence of repeat MRI | To determine the incidence of repeat MRI scan in the study population. anesthesia. To determine the incidence of repeat MRI scan in the study population. | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pediatric, MRI Indications, Anesthesia, Anesthetic Neurotoxicity, MRI Diagnostic Yield