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Strategies to minimize sedation in pediatric body magnetic resonance imaging

  • Pediatric Body MRI
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Abstract

The high soft-tissue contrast of MRI and the absence of ionizing radiation make it a valuable tool for assessment of body pathology in children. Infants and young children are often unable to cooperate with awake MRI so sedation or general anesthesia might be required. However, given recent data on the costs and potential risks of anesthesia in young children, there is a need to try to decrease or avoid sedation in this population when possible. Child life specialists in radiology frequently use behavioral techniques and audiovisual support devices, and they practice with children and families using mock scanners to improve child compliance with MRI. Optimization of the MR scanner environment is also important to create a child-friendly space. If the child can remain inside the MRI scanner, a variety of emerging techniques can reduce the effect of involuntary motion. Using sequences with short acquisition times such as single-shot fast spin echo and volumetric gradient echo can decrease artifacts and improve image quality. Breath-holding, respiratory triggering and signal averaging all reduce respiratory motion. Emerging techniques such as radial and multislice k-space acquisition, navigator motion correction, as well as parallel imaging and compressed sensing reconstruction methods can further accelerate acquisition and decrease motion. Collaboration among radiologists, anesthesiologists, technologists, child life specialists and families is crucial for successful performance of MRI in young children.

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Acknowledgments

We thank Shreyas Vasanawala, Jesse Courtier, Geetika Khanna, Sabah Servaes and Kawin Setsompop for providing images, and Katie Weagle for providing helpful suggestions on the manuscript.

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Authors and Affiliations

  1. Division of Pediatric Imaging, Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Ellison 237, Boston, MA, 02114, USA

    Camilo Jaimes & Michael S. Gee

  2. Department of Radiology, Harvard Medical School, Boston, MA, USA

    Camilo Jaimes & Michael S. Gee

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  1. Camilo Jaimes
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  2. Michael S. Gee
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Correspondence to Michael S. Gee.

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The authors have no financial interests, investigational or off-label uses to disclose.

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Jaimes, C., Gee, M.S. Strategies to minimize sedation in pediatric body magnetic resonance imaging. Pediatr Radiol 46, 916–927 (2016). https://doi.org/10.1007/s00247-016-3613-z

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  • DOI: https://doi.org/10.1007/s00247-016-3613-z

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