Simulation can replace sedation for pediatric MRI exams

Having an MRI exam can be a frightening experience for both adults and children. Getting a pediatric patient to remain motionless during the procedure often requires sedation. But when given the chance to have a realistic, simulated MRI procedure in advance, children as young as 4 may voluntarily cooperate.

Clinicians from the VU University Medical Center in Amsterdam, Netherlands, achieved a high success rate in imaging children without sedation after first giving them a mock MRI exam training session, according to an article published online March 13 in the European Journal of Pediatrics.

Although time-consuming and labor-intensive, such training sessions may enable MRI exams to be used as a research tool when conducting pediatric research, because many ethics committees will not allow sedation to be administered in normally developing children for research studies.

Researchers evaluated the use of a mock scanner training protocol in a group of 90 children; 47 of the children were scheduled for an MRI exam by a referring physician and 43 were recruited for a controlled research study. The children ranged in age from 3 to 14 years, with a median age of 6.5 years. Children with developmental disorders or severe mental retardation were excluded from the study.

Each child and a parent were taken into a room containing a decommissioned MRI scanner. A pediatrician or an experienced child-life specialist explained why an exam was needed, told the child to lie very still, and showed how the scanner worked. Each child listened to a recording of the sounds that an MRI scanner makes.

A mock MRI procedure was conducted, and if a child wearing earphones could lie still on the machine while listening to MRI sounds for five minutes, they "passed" the training session. Children who failed could have another try on a subsequent day. Each session lasted between 30 and 60 minutes, according to principal investigator Henrica M. A. de Bie, a pediatric endocrinologist, and colleagues.

In all, 85 of the 90 children passed the training after a single session, including 92% of the 60 children younger than 7. When these children had their MRI exams with a parent sitting next to them in the exam room, structural scans of diagnostic quality were obtained for 81 of the 90 children, and functional MRI scans with sufficient quality for further analysis were obtained for 30 of 43 children participating in the research project.

Related Reading

Anesthesiologists refine pediatric sedation for MRI, October 25, 2007

Mock MRI exam preps children for the real deal, November 30, 2005

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