Added utility of gadolinium in the magnetic resonance imaging (MRI) workup of seizures in children younger than 2 years.

The purpose of this study was to evaluate the added utility of gadolinium administration in the magnetic resonance imaging (MRI) workup of seizures in children younger than 2 years. A computerized retrospective search of the radiology information system identified all brain MRI examinations performed at the authors' institution from 1995 to 2002 for children younger than 2 years. Review of the clinical records revealed that 437 of a total 1466 brain magnetic resonance examinations performed on this subset of the pediatric population were performed as part of an initial seizure workup. Magnetic resonance reports and clinical notes were reviewed. MRI studies with enhancing lesions as well as those with equivocal findings were also reviewed in a consensus fashion by 2 senior neuro-radiologists and 2 radiology residents. Contrast administration was rated as essential, helpful, or not helpful for each study. Administration of contrast medium was felt to be essential in formulating a diagnosis in a total of 8 (1.8%) studies, all of which involved documented or highly suspected cases of infection. In an additional 26 cases (5.9%), which included 4 cases of neoplasm, contrast was felt to be useful but not essential in reaching a diagnosis. Contrast was judged not helpful in making the diagnosis in the other 403 studies (92.3%).