Skip to main content
Top
Published in: Pediatric Radiology 2/2014

01-02-2014 | Original Article

High success rates of sedation-free brain MRI scanning in young children using simple subject preparation protocols with and without a commercial mock scanner–the Diabetes Research in Children Network (DirecNet) experience

Authors: Naama Barnea-Goraly, Stuart A. Weinzimer, Katrina J. Ruedy, Nelly Mauras, Roy W. Beck, Matt J. Marzelli, Paul K. Mazaika, Tandy Aye, Neil H. White, Eva Tsalikian, Larry Fox, Craig Kollman, Peiyao Cheng, Allan L. Reiss, on behalf of the Diabetes Research in Children Network (DirecNet)

Published in: Pediatric Radiology | Issue 2/2014

Login to get access

Abstract

Background

The ability to lie still in an MRI scanner is essential for obtaining usable image data. To reduce motion, young children are often sedated, adding significant cost and risk.

Objective

We assessed the feasibility of using a simple and affordable behavioral desensitization program to yield high-quality brain MRI scans in sedation-free children.

Materials and methods

222 children (4–9.9 years), 147 with type 1 diabetes and 75 age-matched non-diabetic controls, participated in a multi-site study focused on effects of type 1 diabetes on the developing brain. T1-weighted and diffusion-weighted imaging (DWI) MRI scans were performed. All children underwent behavioral training and practice MRI sessions using either a commercial MRI simulator or an inexpensive mock scanner consisting of a toy tunnel, vibrating mat, and video player to simulate the sounds and feel of the MRI scanner.

Results

205 children (92.3%), mean age 7 ± 1.7 years had high-quality T1-W scans and 174 (78.4%) had high-quality diffusion-weighted scans after the first scan session. With a second scan session, success rates were 100% and 92.5% for T1-and diffusion-weighted scans, respectively. Success rates did not differ between children with type 1 diabetes and children without diabetes, or between centers using a commercial MRI scan simulator and those using the inexpensive mock scanner.

Conclusion

Behavioral training can lead to a high success rate for obtaining high-quality T1-and diffusion-weighted brain images from a young population without sedation.
Literature
1.
go back to reference Sun L (2010) Early childhood general anaesthesia exposure and neurocognitive development. Br J Anaesth 105:i61–i68PubMedCrossRef Sun L (2010) Early childhood general anaesthesia exposure and neurocognitive development. Br J Anaesth 105:i61–i68PubMedCrossRef
2.
go back to reference Loepke AW, Soriano SG (2008) An assessment of the effects of general anesthetics on developing brain structure and neurocognitive function. Anesth Analg 106:1681–1707PubMedCrossRef Loepke AW, Soriano SG (2008) An assessment of the effects of general anesthetics on developing brain structure and neurocognitive function. Anesth Analg 106:1681–1707PubMedCrossRef
3.
go back to reference Rizzi S, Ori C, Jevtovic-Todorovic V (2010) Timing versus duration: Determinants of anesthesia-induced developmental apoptosis in the young mammalian brain. Ann N Y Acad Sci 1199:43–51PubMedCentralPubMedCrossRef Rizzi S, Ori C, Jevtovic-Todorovic V (2010) Timing versus duration: Determinants of anesthesia-induced developmental apoptosis in the young mammalian brain. Ann N Y Acad Sci 1199:43–51PubMedCentralPubMedCrossRef
4.
go back to reference Jevtovic-Todorovic V, Hartman RE, Izumi Y et al (2003) Early exposure to common anesthetic agents causes widespread neurodegeneration in the developing rat brain and persistent learning deficits. J Neurosci 23:876–882PubMed Jevtovic-Todorovic V, Hartman RE, Izumi Y et al (2003) Early exposure to common anesthetic agents causes widespread neurodegeneration in the developing rat brain and persistent learning deficits. J Neurosci 23:876–882PubMed
5.
go back to reference Wilder RT, Flick RP, Sprung J et al (2009) Early exposure to anesthesia and learning disabilities in a population-based birth cohort. Anesthesiology 110:796–804PubMedCentralPubMedCrossRef Wilder RT, Flick RP, Sprung J et al (2009) Early exposure to anesthesia and learning disabilities in a population-based birth cohort. Anesthesiology 110:796–804PubMedCentralPubMedCrossRef
6.
go back to reference Kalkman CJ, Peelen L, Moons KG et al (2009) Behavior and development in children and age at the time of first anesthetic exposure. Anesthesiology 110:805–812PubMedCrossRef Kalkman CJ, Peelen L, Moons KG et al (2009) Behavior and development in children and age at the time of first anesthetic exposure. Anesthesiology 110:805–812PubMedCrossRef
7.
go back to reference Bartels M, Althoff RR, Boomsma DI (2009) Anesthesia and cognitive performance in children: No evidence for a causal relationship. Twin Res Hum Genet 12:246–253PubMedCrossRef Bartels M, Althoff RR, Boomsma DI (2009) Anesthesia and cognitive performance in children: No evidence for a causal relationship. Twin Res Hum Genet 12:246–253PubMedCrossRef
8.
go back to reference Cejda K, Smeltzer M, Hansbury E et al (2012) The impact of preparation and support procedures for children with sickle cell disease undergoing MRI. Pediatr Radiol 42:1223–1228PubMedCrossRef Cejda K, Smeltzer M, Hansbury E et al (2012) The impact of preparation and support procedures for children with sickle cell disease undergoing MRI. Pediatr Radiol 42:1223–1228PubMedCrossRef
9.
go back to reference De Bie HM, Boersma M, Wattjes MP et al (2010) Preparing children with a mock scanner training protocol results in high quality structural and functional MRI scans. Eur J Pediatr 169:1079–1085PubMedCentralPubMedCrossRef De Bie HM, Boersma M, Wattjes MP et al (2010) Preparing children with a mock scanner training protocol results in high quality structural and functional MRI scans. Eur J Pediatr 169:1079–1085PubMedCentralPubMedCrossRef
10.
go back to reference Carter AJ, Greer ML, Gray SE et al (2010) Mock MRI: Reducing the need for anaesthesia in children. Pediatr Radiol 40:1368–1374PubMedCrossRef Carter AJ, Greer ML, Gray SE et al (2010) Mock MRI: Reducing the need for anaesthesia in children. Pediatr Radiol 40:1368–1374PubMedCrossRef
11.
go back to reference Nordahl C, Simon T, Zierhut C et al (2008) Brief report: Methods for acquiring structural MRI data in very young children with autism without the use of sedation. J Autism Dev Disord 38:1581–1590PubMedCrossRef Nordahl C, Simon T, Zierhut C et al (2008) Brief report: Methods for acquiring structural MRI data in very young children with autism without the use of sedation. J Autism Dev Disord 38:1581–1590PubMedCrossRef
12.
go back to reference Wechsler D (2002) Wechsler preschool and primary scale of intelligence third edition. Psychological Corp, San Antonio Wechsler D (2002) Wechsler preschool and primary scale of intelligence third edition. Psychological Corp, San Antonio
13.
go back to reference Wechsler D (1999) Wechsler adult scale of intelligence. Harcourt Brace & Co., Psychological Corp, New York Wechsler D (1999) Wechsler adult scale of intelligence. Harcourt Brace & Co., Psychological Corp, New York
14.
go back to reference Racschle NM, Lee M, Buechler R et al (2009) Making MR imaging child’s play—pediatric neuroimaging protocol, guidelines and procedure. J Vis Exp 30:1–5 Racschle NM, Lee M, Buechler R et al (2009) Making MR imaging child’s play—pediatric neuroimaging protocol, guidelines and procedure. J Vis Exp 30:1–5
15.
Metadata
Title
High success rates of sedation-free brain MRI scanning in young children using simple subject preparation protocols with and without a commercial mock scanner–the Diabetes Research in Children Network (DirecNet) experience
Authors
Naama Barnea-Goraly
Stuart A. Weinzimer
Katrina J. Ruedy
Nelly Mauras
Roy W. Beck
Matt J. Marzelli
Paul K. Mazaika
Tandy Aye
Neil H. White
Eva Tsalikian
Larry Fox
Craig Kollman
Peiyao Cheng
Allan L. Reiss
on behalf of the Diabetes Research in Children Network (DirecNet)
Publication date
01-02-2014
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 2/2014
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-013-2798-7

Other articles of this Issue 2/2014

Pediatric Radiology 2/2014 Go to the issue

Hermes

Hermes