RESEARCH REPORT A retrospective study of the impact of supraglottic airway devices on the appearance of neck masses in children undergoing serial magnetic resonance imaging Allan F. Simpao 1,2 | Vladislav Obsekov 2 | Jorge A. Gálvez 1,2 | Rebecca S. Isserman 1,2 | Mohamed A. Rehman 3 | Erin S. Schwartz 4 1 Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 2 Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 3 Department of Anesthesiology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida 4 Department of Radiology, University of Pennsylvania Perelman School of Medicine and Children's Hospital Of Philadelphia, Philadelphia, Pennsylvania Correspondence Allan F. Simpao, Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia and The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. Email: simpaoa@email.chop.edu Section Editor: Mark Thomas Summary Background: General anesthesia and sedation are used routinely for magnetic reso- nance imaging (MRI) studies in children to optimize image quality. Airway devices such as supraglottic airways (SGAs) can alter the appearance of cervical soft tissue regions on an MRI and increase the risk of misdiagnosis. This phenomenon has not been well described in vivo. Aims: We conducted this retrospective study to determine how often SGAs affected the appearance of neck masses in children who received multiple anesthet- ics for MRIs with and without an SGA. Methods: We retrieved data on children 17 years old and younger who had multi- ple MRIs between January 2005 and January 2015. Inclusion criteria were patients with neck masses who had a SGA for at least one MRI and either a natural airway or endotracheal tube (ETT) for another MRI. We reviewed MRI images and imaging reports to determine if SGAs affected the appearance of neck masses. Results: Twelve of the 921 patients who received anesthesia for neck MRIs during the study period met the inclusion criteria. SGAs affected the appearance of the neck mass in 11 of the 12 patients. Conclusions: Supraglottic airways can significantly alter the appearance of neck masses in children undergoing MRIs and affect radiologists’ ability to assess those masses. Communication with the radiologist prior to the induction of anesthesia is crucial when using supraglottic devices in this patient population. It may be more prudent to use a different airway device and/or anesthetic technique when MRIs of these neck masses are undertaken. KEYWORDS airway management, general anesthesia, laryngeal mask airway, magnetic resonance imaging, pediatrics, radiology 1 | INTRODUCTION General anesthesia with a supraglottic airway (SGA) or endotracheal tube (ETT) is used routinely in some hospitals to limit motion artifact and improve image quality during imaging studies of children. While SGAs are typically safe, effective airway devices for children under- going general anesthesia for diagnostic studies, there is a paucity of literature describing their potential for producing in vivo magnetic Received: 4 August 2018 | Revised: 29 August 2018 | Accepted: 17 September 2018 DOI: 10.1111/pan.13510 Pediatric Anesthesia. 2018;1–6. wileyonlinelibrary.com/journal/pan © 2018 John Wiley & Sons Ltd | 1