CT reduction in favor of rapid sequence MRI to decrease pediatric radiation exposure has varied across institutions. We aim to understand national trends in CT and rapid sequence MRI usage, as well as identify variables affecting imaging practices and obstacles to CT reduction.
Retrospective review of deidentified discharge data for children with hydrocephalus and TBI in the Healthcare Cost and Utilization Project’s Kid’s Inpatient Database (KID) in 2000, 2003, 2006, 2009, 2012, and 2016. MRI without contrast and CT use were extracted using ICD9 and ICD10 codes. Hospital region and age cohorts were extracted and used to categorize data. Chi square tests and logistic regression were used for analysis.
Hospitalization utilizing CT use decreased (p<0.05) and those using MRI increased (p<0.05) overall in both diagnosis groups throughout the years analyzed. However, there was significant regional variation in imaging. The Northeast had higher CT rates (p<0.05) and the South had lower CT rates in hydrocephalus and TBI patients (p<0.05). No regional variation was found for TBI patients receiving MRIs.
Nationwide, the average number of discharges after hospitalizations involving CT use in hydrocephalus and TBI patients has decreased, while those involving MRI use as an alternative imaging modality has increased. Despite successful overall CT reduction, significant regional variation exists within this trend showing inconsistent reduction of CT use.

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