German radiologists at one facility classified 97 percent of pediatric MR exams as diagnostically relevant after clinicians implemented a motion-reduction technique and pediatric preparation program.
Although pediatric MR eliminates exposure to ionizing radiation, it presents additional challenges. Specifically, pediatric patients are prone to movement, which can make it difficult to achieve diagnostic quality images for diagnosis. Thus, pediatric MR patients are often sedated, which is an added risk and expense.
Christoph M. Heyer, MD, of BG Bergmannsheil University Hospital in Bochum, Germany, has devised an alternate method. Heyer and colleagues enrolled 326 patients referred for a brain MRI between January 2009 and December 2010 in an MR preparation program.
All patients (average age, 7.2 years) were prepared for the MRI in an age-appropriate manner, given time to visit the scanner room, were allowed to take their cuddly toys into the MRI and their parents were with them. In addition, clinicians recorded MRI sequences using the BLADE technique (Siemens Healthcare) to minimize blurring.
Of the 2,461 image sequences recorded with 326 patients, the two participating radiologists classified 97 percent as diagnostically relevant. Sedation was used if strong motion artifacts occurred. Specifically, the protocol allowed physicians to examine 41 percent of three-year olds, 91 percent of four-year olds and 98 percent of patients older than the age of five without sedation.
“Age-adjusted preparation and implementation of a pediatric cranial MRI may reduce the need for sedation. BLADE sequences abate motion artifacts, thus enabling acquisition of diagnostic images even in young children. In patients older than three years, performance of MRI scans without sedation should be considered,” Heyer and colleagues concluded in the abstract.
The study was published in the November issue of the journal RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren.