MRI is our first modality for axial imaging, and has been for some time. Interestingly enough the hardest time to get an MRI typically was the weekday (8-5) time when appy's were competing with sedated patients. At those times, they would try to squeeze them in where they could, or they would have to wait. (Also remember that although the scans are short due to short sequences (around 20 minutes of scanning) getting a younger kid on the table and comfortable can take some time so the process is generally more than 30 minutes minimum.) This would result, often, in either admission or CT scan (less and less frequent). Our institution recently added a third MRI (actually PET/MRI), which frees up scan time and wait times during the day have reduced significantly. But you are correct, having access to the MRI is the biggest problem and even the busiest PEDs ED would have a hard time justifying the cost of their own MRI.
From: Pediatric Emergency Medicine Discussion List [mailto:[log in to unmask]] On Behalf Of jennifer marin
Sent: Monday, August 14, 2017 10:35 AM
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Subject: MRI for appendicitis
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We are working on a protocol for MRI for patients with suspected appendicitis. The rate limiting step appears to be availability of MRI. For those who are routinely using MRI as part of the evaluation for appendicitis, has this been an issue and how did you overcome it? Does anyone have a dedicated ED MRI scanner?
Thank you, Jennifer MarinChildren's Hospital of Pittsburgh
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