Optimising diagnostics for hard-of-hearing infants: factors associated with successful MRI scanning without general anaesthesia

Purpose: Scanning during infancy is often required in otology, preferably without general anaesthesia. This study aims to determine the success rate of MRI of the head without general anaesthesia for infants, and to identify predictors for a successful scan.

Methods: Data was extracted from the electronic patient file for patients who received MRI of the head without general anaesthesia between 01-01-2019 and 31-12-2022 at an age younger than 6 months. Each MRI-session was dichotomised into success (i.e., of sufficient quality to answer the clinical question) or failure, and success percentages were calculated. A logistic regression analysis was performed to determine the association between success and variables of interest, which were selected based on interviews with medical specialists.

Results: Eighty-seven patients were included, showing an overall success rate of 75.9% for MRI of the head without anaesthesia. Success rates for MRI brain were higher than for MRI cerebellopontine angle (CPA), respectively 91.2% and 66.0% (p = 0.013). For MRI CPA the odds of success decreased for infants aged 3-5 months, compared to infants under 2 months (respectively 84.6% and 48.1%, p = 0.009). For MRI CPA the success percentage was lower for boys (51.9%) than for girls (80.8%, p = 0.039). Time of day and hearing loss showed no significant effect on the success rate.

Conclusion: Obtaining MRI of the head without anaesthesia for infants under six months is feasible. For MRI CPA the success rate is higher for infants scanned at a younger age, as well as for female infants compared to male infants.