The effectiveness of neuroradiological magnetic resonance imaging. Focus on children with pineal cysts, intellectual disability, Chiari 1 malformation, and late vertebral changes after brain tumor treatment

Magnetic resonance imaging (MRI) is a common diagnostic technique in medicine and is an important tool in the evaluation of the central nervous system. Due to limited resources, it is important to target imaging to those who need it most. Resources are limited especially in small children who require sedation for imaging. With the growing demand for MRI, it is important to reduce unnecessary imaging. The potential benefits from imaging must always outweigh the potential disadvantages. Increased imaging also leads to increased incidental findings. A limited understanding of incidental findings may lead to unnecessary follow-up imaging.

The purpose of the study was to evaluate the need for MRI in four different patient groups. The importance of follow-up MRI in pineal cysts was evaluated. The role of MRI in the diagnosis of mild intellectual disability (ID) in children, and in the treatment of Chiari 1 malformation (CM1) was examined. The need for follow-up imaging of the late vertebral side effects of pediatric brain tumor treatments was also assessed.

Based on the results of this study, the follow-up imaging of typical pineal cysts is unnecessary. The routine brain MRI is not recommended in mild ID without other symptoms. The symptoms of CM1 does not significantly correlate to the MRI findings and the routine follow-up imaging after good surgical outcome seems to be unnecessary. Childhood brain tumor survivors may need regular follow-up in adulthood, and imaging of the spine may be useful in many cases.