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Calls for enhanced MRI scans of infants in Care cases

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The case of the London Borough of Ealing v AR & Ors [2014] EWHC 2172 (Fam) (1 July 2014) concerned care proceedings in respect of an 18 month old baby who had suffered an unexplained head trauma.

In her Judgment, Mrs Justice Russell emphasised the importance of ensuring Magnetic Resonance Imaging (MRI) scans, of infants who present with possible brain injury, being carried out with contrast, and the very dangerous consequences that can flow from failure to carry out an enhanced MRI scan. Mrs Justice Russell stated: “the failure to identify the possibility of the injuries being inflicted at the outset of this case was what led to any delay for A being treated for such injuries and to her parents being informed of such a possibility. The failure was caused by MRI scans being carried out without contrast. It is highly desirable, if not essential, for scans with contrast to be taken of children and infants who present with possible brain injury as A did”

MRI scans carried out with contrast involve the use of a tracing agent, which is essentially a dye, to enhance results and offer a better imaging ability. This makes certain tissues and blood vessels show up more clearly and in greater detail. Some kinds of tissue or lesions are difficult to see with a routine MRI and therefore there can be misdiagnosis. The MRI with tracer is therefore essential in care cases where there are unexplained injuries in children.