Purpose or Case Report: After reviewing this educational exhibit, radiologists and trainees will have up-to-date knowledge about magnetic resonance imaging (MRI) safety in children with implanted medical devices. The following will be presented: 1) Basic MRI physics relating to safety risks in the presence of implanted (passive and active) medical devices, 2) MR Safety screening challenges specific to children, and 3) Review of newly developed or updated medical devices that present challenging pediatric MRI safety scenarios.

MRI is the imaging modality of choice for assessing many pediatric conditions, providing excellent anatomic and pathologic detail without the use of ionizing radiation. However, there are significant potential hazards in the MR environment related to the static magnetic field and the spatial and time varying gradient fields, as well as the impact of radiofrequency pulses. These concerns may be further complicated/exacerbated by the presence of implanted medical devices.

This educational exhibit will focus on reducing risk for children with implanted medical devices in the MR environment. Such devices may be subject to projectile/torsion forces, induced currents, and heating risks. Barriers to effective screening include limited MRI safety information for new passive and active implanted medical devices, incomplete documentation and patient/family education, and limited referring clinician awareness of potential safety risks. The use of sedation/anesthesia in pediatric patients reduces the ability to detect discomfort during MR imaging.
Methods & Materials: This exhibit will present scenarios and strategies for assessment and management of several commonly encountered implanted devices, including programmable ventriculoperitoneal shunts, cochlear implants, vagal nerve stimulators, intracranial neurostimulators, MAGnetic Expansion Control (MAGEC) spinal growing rods, implantable continuous Doppler monitoring devices, Inspire upper airway stimulation (UAS) systems, biliary stents, endoscopic clips, neurally-adjusted ventilator assist (NAVA) catheters, temporary epicardial pacing leads, and MR-conditional pacemakers.
Results:
Conclusions: Implant-related adverse events can result in potentially devastating outcomes. Awareness of the potential safety concerns and application of appropriate safety screening can minimize the risk of pediatric MR imaging.