Effects of an MRI Try Without program on patient access

Rudder, Barbra S; Easley, Sara J; Robinson, A.; Noel-Macdonnell, Janelle R; Nielsen, David

doi:10.1007/s00247-019-04487-1

Cited by 15 publications

(19 citation statements)

References 27 publications

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“…MRI without sedation is feasible in selected pediatric patients and should be performed whenever possible [9 ▪ ]. Some of the advantages of MRIs without sedation are waiting list 60% shorter [16] and up to fourfold cost saving [11,38] compared to MRIs under sedation/anesthesia.…”

Section: Strategies To Perform Magnetic Resonance Imaging With No Sed...mentioning

confidence: 99%

“…Scans under general anesthesia or sedation may be three to eight times more expensive than in awake patients and the number of requests often surpasses the capacity of anesthesia departments, posing a significant burden on hospital resources and waiting lists [11,12 ▪▪ ]. Thus, several studies investigated the possibility to safely perform MRI with sedation provided by non-anesthesiologists [13,14] or with no sedation at all [9 ▪ ,15,16,17]. Each approach (anesthesiologist and non-anesthesiologist driven sedation or nonsedated MRI) requires specific considerations [18].…”

Section: Introductionmentioning

confidence: 99%

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Anesthesia for pediatric magnetic resonance imaging: a review of practices and current pathways

Fonseca

Garbin

Bertolizio

2023

Current Opinion in Anaesthesiology

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Purpose of review Magnetic resonance imaging (MRI) is an ever-expanding investigation modality in children. This review aims to present current strategies to perform MRI in pediatrics efficiently and safely. The latest evidence on approaches, safety and costs of MRI with no sedation or with sedation provided by anesthesiologists and non-anesthesiologists are outlined and discussed. Recent findings MRI under sedation provided by either anesthesiologists or non-anesthesiologists has a low incidence of minor adverse events and rarely severe complications. Propofol infusion with or without dexmedetomidine appears the ideal anesthetic, as it allows spontaneous breathing and fast turnover. Intranasal dexmedetomidine is safe and the most effective medication when a nonintravenous route is employed. New scanning techniques and patient's preparation methods can increase the chances to successfully perform MRI with no sedation by shortening sequences, reducing artifacts, and improving child's cooperation. Summary MRI under sedation can be considered safe. Proper patient selection, clear decision-making and medico-legal pathways are particularly necessary for nurse-only sedated scans. Nonsedated MRIs are feasible and cost-effective but require optimal scanning techniques and patient's preparation to be successful. Further research should be focused on identifying the most effective modalities to perform MRI without sedation and clarify protocols for the nurse-only sedations. Anesthesia service will likely remain pivotal for complex and critically ill patients and to provide assistance in case of adverse events.

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Section: Strategies To Perform Magnetic Resonance Imaging With No Sed...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anesthesia for pediatric magnetic resonance imaging: a review of practices and current pathways

Fonseca

Garbin

Bertolizio

2023

Current Opinion in Anaesthesiology

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“…B. Angst 14 , Schmerz 15 und Stress 30 haben können. In weiteren Beobachtungsstudien wird berichtet, dass sich CLS-Interventionen zudem förderlich auf die Behandlungszufriedenheit der Eltern auswirken 30 , die Wartezeit für MRT-Aufnahmen durch eine Steigerung der Effizienz in Klinikabläufen verkürzen 16 und den Bedarf an Sedativa während radiologischer Untersuchungen senken 31 . Diese Ergebnisvariablen sind bislang jedoch nicht in randomisierten kontrollierten Studien untersucht worden.…”

Section: Diskussionunclassified

„Child Life Specialist“-Interventionen in der klinischen pädiatrischen Versorgung: Ein systematischer Review zu Effekten auf psychische Gesundheitsparameter von Kindern und Jugendlichen

et al. 2021

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Zusammenfassung Ziel der Studie Krankenhausaufenthalte können bei Kindern zu psychischen Belastungen führen, die in der Regelversorgung häufig nicht ausreichend adressiert werden. Ein neuer Ansatz ist es, spezialisierte psychosoziale Fachkräfte, sog. Child Life Specialists (CLS), in die klinische Versorgung einzubinden. CLS begleiten Kinder durch den Klinikalltag und können Belastungen durch gezielte Interventionen auffangen und das Wohlbefinden der PatientInnen fördern. Ziel dieser Arbeit ist es, die Effekte von CLS-Interventionen auf Angst, Schmerz und Stress von Kindern im klinischen Kontext zu analysieren. Methodik Es wurde eine systematische Literatursuche in den Datenbanken Medline, Embase und PsycINFO durchgeführt. Die Ergebnisse wurden in tabellarischer und graphischer Form dargestellt. Ergebnisse Es wurden vier randomisierte kontrollierte Studien (RCTs) eingeschlossen, die die Effekte von CLS-Interventionen bei 459 Kindern im Alter von 0–15 Jahren untersuchten. Eine signifikante Verbesserung der Zielkriterien wurde jeweils in mindestens einer Studie berichtet. Bei allen Studien ist von einem mittleren bis hohen Verzerrungsrisiko auszugehen. Schlussfolgerung In den eingeschlossenen RCTs werden positive Effekte von CLS-Interventionen auf Ergebnisvariablen psychischer Gesundheit von Kindern im klinischen Setting berichtet. Aufgrund der geringen Anzahl von Studien sowie deren Heterogenität und Qualität ist weitere Forschung notwendig.

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“…• C 2020 by the American Society of Neuroimaging patients undergoing clinical imaging participate in programs to minimize the use of sedation and anesthesia. [17][18][19][20][21] The availability of additional motion robust imaging strategies would facilitate the further reduction in the use of sedation and anesthesia for MRI.…”

Section: Introductionmentioning

confidence: 99%

“…The effect of motion can be mitigated using sedation or anesthesia; however, while sedation and anesthesia can be carried out safely, they both create a risk of adverse events, including acute respiratory or cardiac dysfunction, and are associated with dramatically increased expense in providing imaging. Consequently, research subjects typically do not undergo sedation or anesthesia, and many patients undergoing clinical imaging participate in programs to minimize the use of sedation and anesthesia 17–21 . The availability of additional motion robust imaging strategies would facilitate the further reduction in the use of sedation and anesthesia for MRI.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous Motion and Distortion Correction Using Dual‐Echo Diffusion‐Weighted MRI

Afacan

Hoge

Wallace

et al. 2020

Journal of Neuroimaging

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Geometric distortions resulting from large pose changes reduce the accuracy of motion measurements and interfere with the ability to generate artifact-free information. Our goal is to develop an algorithm and pulse sequence to enable motion-compensated, geometric distortion compensated diffusion-weighted MRI, and to evaluate its efficacy in correcting for the field inhomogeneity and position changes, induced by large and frequent head motions. METHODS: Dual echo planar imaging (EPI) with a blip-reversed phase encoding distortion correction technique was evaluated in five volunteers in two separate experiments and compared with static field map distortion correction. In the first experiment, dual-echo EPI images were acquired in two head positions designed to induce a large field inhomogeneity change. A field map and a distortion-free structural image were acquired at each position to assess the ability of dual-echo EPI to generate reliable field maps and enable geometric distortion correction in both positions. In the second experiment, volunteers were asked to move to multiple random positions during a diffusion scan. Images were reconstructed using the dual-echo correction and a slice-to-volume registration (SVR) registration algorithm. The accuracy of SVR motion estimates was compared to externally measured ground truth motion parameters. RESULTS:Our results show that dual-echo EPI can produce slice-level field maps with comparable quality to field maps generated by the reference gold standard method. We also show that slice-level distortion correction improves the accuracy of SVR algorithms as slices acquired at different orientations have different levels of distortion, which can create errors in the registration process. CONCLUSIONS: Dual-echo acquisitions with blip-reversed phase encoding can be used to generate slice-level distortion-free images, which is critical for motion-robust slice to volume registration. The distortion corrected images not only result in better motion estimates, but they also enable a more accurate final diffusion image reconstruction.

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Effects of an MRI Try Without program on patient access

Cited by 15 publications

References 27 publications

Anesthesia for pediatric magnetic resonance imaging: a review of practices and current pathways

Anesthesia for pediatric magnetic resonance imaging: a review of practices and current pathways

„Child Life Specialist“-Interventionen in der klinischen pädiatrischen Versorgung: Ein systematischer Review zu Effekten auf psychische Gesundheitsparameter von Kindern und Jugendlichen

Simultaneous Motion and Distortion Correction Using Dual‐Echo Diffusion‐Weighted MRI

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