Rapid Sequence Magnetic Resonance Imaging (RS-MRI) is a valuable diagnostic tool for assessing hydrocephalus, trauma, and intracranial tumours in pediatric patients. It minimizes the need for anaesthesia and radiation, streamlining clinic procedures, yet its utilization remains limited. This study aims to enhance the efficacy of RS-MRI.

This retrospective analysis included 131 RS-MRIs in 57 pediatric patients with hydrocephalus and intracranial tumours (March 2013 to June 2023). Descriptive analysis covered age, gender, follow-up duration, etiology, symptoms, clinical/radiological benefits, and surgical/nonsurgical complication rates. MRIs included AAHead-Scout, AAHead-Scout-MPR tra, T2 sequence BLADE tra, and T2 TSE 384 p2 tra 5mm, lasting 195 seconds.

A total of 131 RS-MRIs in 57 pediatric patients were included, with a mean age of 6.94 ± 4.25 years, and 71.8% were males. The most common diagnostic indication was suspected CSF shunt dysfunction (61.1%), followed by symptomatic pediatric patients with known intracranial tumours (19.8%), and hydrocephalic pediatric patients with CSF shunts and intracranial tumours (18.3%). In 32 (24%) RS-MRIs, patients were treated as outpatients, while the rest (76%) were treated as inpatients. Surgery was indicated in 24 (20%) RS-MRIs, and shunt adjustment in 57 (43.5%) RS-MRIs. The median inpatient stay lasted 4 days (range 1-130 days). Only in 7 (5%) RS-MRIs was a normal MRI with intubation and general anaesthesia necessary, with therapy consequences in 6 cases. Patients with intracranial tumours required a significantly longer inpatient stay (33 vs. 9 days on average, p=0.31) compared to patients with CSF shunt systems.

RS-MRI proves to be a safe and efficient diagnostic tool for assessing pediatric patients with hydrocephalus and intracranial tumours, exhibiting high diagnostic yield and a low complication rate. It is strongly recommended to prioritize RS-MRI in children whenever possible.