Magnetic Resonance Imaging of Children Without Sedation: Preparation With Simulation

Rosenberg, David; Sweeney, John A.; Gillen, Joseph; Kim, Jae; Varanelli, Michael J.; O’Hearn, Kirsten; Erb, Patricia; Davis, Denise; Thulborn, Keith R.

doi:10.1097/00004583-199706000-00024

Cited by 162 publications

(122 citation statements)

References 13 publications

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“…MRI sessions in children have been reported to impose even higher levels of anxiety/distress 7,18 . However, Rosenberg et al, (1997) could show that distress in children aged 6 to 17 can be significantly reduced by careful subject preparation, including the use of mock scanners.…”

Section: Discussionmentioning

confidence: 99%

“…Even more importantly, these strategies have proven to increase the comfort of families and children involved 12 . One of the main advances of such techniques for the clinical practice is the possibility of avoiding sedation or general anesthesia (GA) as a way to manage children's compliance during MR imaging sessions 19,20 . In the current video report, we present a pediatric neuroimaging protocol with guidelines and procedures that have proven to be successful to date in young children.…”

Section: Introductionmentioning

confidence: 99%

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Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure

Raschle

Lee

Buechler

et al. 2009

JoVE

103

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Within the last decade there has been an increase in the use of structural and functional magnetic resonance imaging (fMRI) to investigate the neural basis of human perception, cognition and behavior 1, 2 . Moreover, this non-invasive imaging method has grown into a tool for clinicians and researchers to explore typical and atypical brain development. Although advances in neuroimaging tools and techniques are apparent, (f)MRI in young pediatric populations remains relatively infrequent 2 . Practical as well as technical challenges when imaging children present clinicians and research teams with a unique set of problems 3, 2 . To name just a few, the child participants are challenged by a need for motivation, alertness and cooperation. Anxiety may be an additional factor to be addressed. Researchers or clinicians need to consider time constraints, movement restriction, scanner background noise and unfamiliarity with the MR scanner environment 2,4-10 . A progressive use of functional and structural neuroimaging in younger age groups, however, could further add to our understanding of brain development. As an example, several research groups are currently working towards early detection of developmental disorders, potentially even before children present associated behavioral characteristics e.g.11 . Various strategies and techniques have been reported as a means to ensure comfort and cooperation of young children during neuroimaging sessions. Play therapy 12 , behavioral approaches 13,14,15,[16][17][18] and simulation 19 , the use of mock scanner areas 20,21 , basic relaxation 22 and a combination of these techniques 23 have all been shown to improve the participant's compliance and thus MRI data quality. Even more importantly, these strategies have proven to increase the comfort of families and children involved 12 . One of the main advances of such techniques for the clinical practice is the possibility of avoiding sedation or general anesthesia (GA) as a way to manage children's compliance during MR imaging sessions 19,20 . In the current video report, we present a pediatric neuroimaging protocol with guidelines and procedures that have proven to be successful to date in young children. ProtocolWe have incorporated general experimental testing guidelines as well as MRI specific approaches 12-23 into one complete neuroimaging protocol intended to guide researchers and clinicians during neuroimaging sessions with awake children as young as four years of age. First, we aim to emphasize general testing guidelines adapted for MRI examinations. Second, we provide a hands-on, step-by-step description of our neuroimaging protocol. In our experience, a single session of approximately 2.5 hours (including a maximal imaging time of 45-60 minutes) is sufficient to train and guide a child through a neuroimaging session. General GuidelinesAs in every testing session with pediatric populations, general guidelines and recommendations for how best to work with young children should be considered 24 . We highlight comfor...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure

Raschle

Lee

Buechler

et al. 2009

JoVE

103

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“…Subjects' heads were placed in a RF head coil packed with cushions in order to minimize head motion. Immediately prior to the imaging session, subjects spent approximately 20 min in a simulation scanner that reproduced the sounds and confinement of an MR scanner to acclimate them to the MR environment (Rosenberg et al, 1997).…”

Section: Tasksmentioning

confidence: 99%

Maturation of Widely Distributed Brain Function Subserves Cognitive Development

et al. 2001

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Cognitive and brain maturational changes continue throughout late childhood and adolescence. During this time, increasing cognitive control over behavior enhances the voluntary suppression of reflexive/impulsive response tendencies. Recently, with the advent of functional MRI, it has become possible to characterize changes in brain activity during cognitive development. In order to investigate the cognitive and brain maturation subserving the ability to voluntarily suppress context-inappropriate behavior, we tested 8 -30 year olds in an oculomotor response-suppression task. Behavioral results indicated that adult-like ability to inhibit prepotent responses matured gradually through childhood and adolescence. Functional MRI results indicated that brain activation in frontal, parietal, striatal, and thalamic regions increased progressively from childhood to adulthood. Prefrontal cortex was more active in adolescents than in children or adults; adults demonstrated greater activation in the lateral cerebellum than younger subjects. These results suggest that efficient top-down modulation of reflexive acts may not be fully developed until adulthood and provide evidence that maturation of function across widely distributed brain regions lays the groundwork for enhanced voluntary control of behavior during cognitive development.

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“…10,11 Finally, in pediatric imaging especially, the possibility of increased subject motion makes obtaining accurate and reproducible DTI parameter values difficult. 12,13 Artifact-reducing techniques can be used to overcome some of these issues. However, particularly in pediatric imaging, these techniques are not without challenges.…”

mentioning

confidence: 99%

Diffusion Tensor Imaging of the Normal Pediatric Spinal Cord Using an Inner Field of View Echo-Planar Imaging Sequence

Barakat¹,

Mohamed²,

Hunter³

et al. 2012

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: DTI in the brain has been well established, but its application in the spinal cord, especially in pediatrics, poses several challenges. The small cord size has inherent low SNR of the diffusion signal intensity, respiratory and cardiac movements induce artifacts, and EPI sequences used for obtaining diffusion indices cause eddy-current distortions. The purpose of this study was to 1) evaluate the accuracy of cervical spinal cord DTI in children using a newly developed iFOV sequence with spatially selective 2D-RF excitations, and 2) examine reproducibility of the DTI measures.

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Magnetic Resonance Imaging of Children Without Sedation: Preparation With Simulation

Cited by 162 publications

References 13 publications

Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure

Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure

Maturation of Widely Distributed Brain Function Subserves Cognitive Development

Diffusion Tensor Imaging of the Normal Pediatric Spinal Cord Using an Inner Field of View Echo-Planar Imaging Sequence

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