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The impact of preparation and support procedures for children with sickle cell disease undergoing MRI

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Abstract

Background

Children with sickle cell disease (SCD) often undergo MRI studies to assess brain injury or to quantify hepatic iron. MRI requires the child to lie motionless for 30–60 min, thus sedation/anesthesia might be used to facilitate successful completion of exams, but this poses additional risks for SCD patients. To improve children’s ability to cope with MRI examinations and avoid sedation, our institution established preparation and support procedures (PSP).

Objective

To investigate the impact of PSP in reducing the need for sedation during MRI exams among children with SCD.

Materials and methods

Data on successful completion of MRI testing were compared among 5- to 12-year-olds who underwent brain MRI or liver R2*MRI with or without receiving PSP.

Results

Seventy-one children with SCD (median age 9.85 years, range 5.57–12.99 years) underwent a brain MRI (n = 60) or liver R2*MRI (n = 11). Children who received PSP were more likely to complete an interpretable MRI exam than those who did not (30 of 33; 91% vs. 27 of 38; 71%, unadjusted OR = 4.1 (P = 0.04) and OR = 8.5 (P < 0.01) when adjusting for age.

Conclusion

PSP can help young children with SCD complete clinically interpretable, nonsedated MRI exams, avoiding the risks of sedation/anesthesia.

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Acknowledgments

The authors thank Shawna Grissom, MS, CCLS, CEIM, for supporting the implementation of the PSP program; Banu Aygun, MD, Amy Kimble, FNP, and Nicole Mortier, PA-C, MHS, for excellence in patient care and support with patient referral to PSP; and Winfred Wang, MD, and Vani Shanker, PhD, for editing the manuscript.

Disclaimer

The study was supported in part by the American Lebanese Syrian Associated Charities (ALSAC). The authors have no conflicts of interest to declare.

Author information

Authors and Affiliations

  1. Child Life Program, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Mail Stop 121, Memphis, TN, 38105, USA

    Katherine R. Cejda

  2. Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Matthew P. Smeltzer

  3. Baylor International Hematology Center of Excellence and the Texas Children’s Center for Global Health, Houston, TX, USA

    Eileen N. Hansbury

  4. Department of Hematology, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Jane S. Hankins

  5. Department of Radiological Sciences, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Mary Elizabeth McCarville & Kathleen J. Helton

Authors
  1. Katherine R. Cejda
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  2. Matthew P. Smeltzer
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  3. Eileen N. Hansbury
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  4. Mary Elizabeth McCarville
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  5. Kathleen J. Helton
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  6. Jane S. Hankins
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Corresponding author

Correspondence to Katherine R. Cejda.

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Cejda, K.R., Smeltzer, M.P., Hansbury, E.N. et al. The impact of preparation and support procedures for children with sickle cell disease undergoing MRI. Pediatr Radiol 42, 1223–1228 (2012). https://doi.org/10.1007/s00247-012-2422-2

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  • DOI: https://doi.org/10.1007/s00247-012-2422-2

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