MRI with Anesthesia Delays and Impacts on Neurosurgical Care – Observations from a Single-Institution

: Objective Although MRI is an indispensable imaging tool, its requirement for prolonged stillness in an enclosed space is challenging for some patients. Gaps exist regarding delays in care for patients requiring MRI with anesthesia (MRIa). We sought to characterize contributors to and effects of MRIa delays in patients undergoing neurosurgical intervention. Methods We conducted a retrospective review of neurosurgical patients undergoing MRIa at a tertiary care center. Of 450 patients (615 MRIa exams), 26 neurosurgical patients (27 preoperative MRIa exams) met inclusion criteria. Regression assessed factors associated with delay from preferred date, order-to-MRIa, MRIa-to-surgery, and order-to-surgery intervals. Results Delays from the preferred MRIa date occurred in 40.7% of cases. Although the likelihood of delay did not differ by MRIa setting (p = 0.701), delay magnitude varied significantly between inpatient (median: 2.5 days) and outpatient settings (median: 60 days). Inpatients spent a median 20% of preoperative hospitalization time awaiting imaging. Regression showed inpatient MRIa was associated with shorter order-to-exam (p = 0.010) and order-to-surgery intervals (p = 0.004) and trended toward shorter delays from the preferred date (p = 0.070). Most delays were attributable to anesthesia staffing availability and clearance. Conclusion Inpatient MRIa facilitates faster imaging but may contribute to prolonged hospitalization, whereas outpatient MRIa is associated with long scheduling and surgical care delays. Early identification of patients requiring anesthesia and use of alternative strategies, including open scanners and pre-MRI anxiolytics, may reduce delays. When unavoidable and in select high-risk patients, considering admission for MRIa may avoid long outpatient delays.