Can a screening tool ID kids who can have an MRI without anesthesia?

In pediatric diagnostic imaging, MRI exams are often accompanied by anesthesia so the child can comfortably complete the screening. A study published in the Journal of the American College of Radiology showed that the modified Yale Preoperative Anxiety Scale (mYPAS) may be able to successfully identify pediatric patients from simulation trainings who can undergo an MRI exam without the use of anesthesia.  

"In children, general anesthesia is often required to complete MRI examinations," wrote lead author Arlyne Thung, MD, an anesthesiologist at Nationwide Children's Hospital in Columbus, Ohio, and colleagues. "Simulation training can reduce the need for anesthesia in some children; reliable screening tools to select who could benefit from practice MRI sessions are lacking."  

Eighty children (43 boys and 37 girls) aged 5 or older were recruited for stimulation-based training research. All participants were originally scheduled for MRI with anesthesia from 2015 to 2016. According to study methods, specialists used the MYPAS assessment before and after simulation MRI sessions to find whether each participant could complete an MRI without anesthesia. 

Researchers found 14 percent of participants required general anesthesia to complete an MRI exam despite participating in the simulation. Additionally, mYPAS scores improved from 31 to 27 after stimulation, according to study results.  

"Receiver operating characteristic curve analysis found that pre-simulation mYPAS had good utility for predicting anesthesia requirement for MRI completion (area under the curve = 0.81)," according to the researchers. "A pre-simulation mYPAS score less than 33 predicted need for anesthesia with 82 percent sensitivity and 78 percent specificity."