Pediatr Radiol (2008) 38:270 DOI 10.1007/s00247-007-0706-8
COMMENTARY
Preparing children for MRI Frank P. MacMaster & David R. Rosenberg
Received: 9 November 2007 / Accepted: 13 November 2007 / Published online: 21 December 2007 # Springer-Verlag 2007
Acquiring quality data with minimal risk to the subject has been a problem in pediatric MRI studies. Subject motion and non-adherence can easily confound scan acquisition. Indeed, fewer studies have been conducted in children and adolescents than in adults, in part as a result of these concerns [1]. The option of general anesthesia, though it increases data quality, substantially increases the risk to the child. The effect of sedation is not well understood and may confound data, especially brain chemistry as measured with MR spectroscopy. The question remains as to how to minimize risks while maximizing the quality of the data for research or clinical uses. The study by Hallowell et al. [2] provides an important answer to that question and adds to a growing literature regarding strategies to improve scan quality and adherence in pediatric MRI studies [3, 4]. Often lack of adherence is due to anxiety and a lack of coping strategies. The authors use a practice MRI intervention (PMRI) led by an educational play therapist (EPT) to increase the coping skill set and familiarity of the child with regard to participating in an MR study. In their study, 82.5% of the children achieved a pass at the PMRI session.
F. P. MacMaster : D. R. Rosenberg (*) Department of Psychiatry, Children’s Hospital of Michigan, Wayne State University School of Medicine, 4201 St. Antoine St, Detroit, MI 48201, USA e-mail:
[email protected] F. P. MacMaster e-mail:
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During the clinical scan, images of diagnostic quality were obtained from 90.8% of the children. Although the study had notable limitations, as acknowledged by the authors, such as a lack of a control group, they do not detract from the meritorious nature of this study. If widely implemented in pediatric MRI acquisitions, methods such as PMRI can improve data quality and patient experience.
References 1. Hinton VJ (2002) Ethics of neuroimaging in pediatric development. Brain Cogn 50:455–468 2. Hallowell LM, Stewart SE, de Amorim e Silva CJ et al (2007) Reviewing the process of preparing children for MRI. Pediatr Radiol. DOI 10.1007/s00247-007-0704 3. Rosenberg DR, Sweeney JA, Gillen JS et al (1997) Magnetic resonance imaging of children without sedation: preparation with simulation. J Am Acad Child Adolesc Psychiatry 36:853–859 4. Khatib D, Condon R, MacMaster FP et al (2007) Magnetic resonance imaging of pediatric children with behavioral problems using an MRI simulator and play therapy. Proceedings of the 15th Annual Meeting of the Section for Magnetic Resonance Technologists
