Prediction of compliance with MRI procedures among children of ages 3 years to 12 years

Abstract

Background: A number of children are unable to comply with an MRI procedure and require general anesthetic. However, we lack information about which factors are associated with MRI compliance in young children.

Objective: To determine the strongest predictors of MRI compliance, focusing on variables that can be easily rated by patients' parents.

Materials and methods: A sample of 205 children ages 3-11 years (mean age 6.6 years) who were at risk of non-compliance were recruited from a children's hospital. Their parents completed a behavior assessment scale for children as well as a questionnaire that assessed their expectations of compliance and perception of their child's typical medical compliance. The children subsequently completed a mock MRI with an educational play therapist and a clinical MRI, with the quality of the scan scored by the MRI technologist.

Results: Overall, 88.3% of children complied with the clinical scan and achieved diagnostic images, with age unrelated to compliance in this well-prepared patient group. The strongest predictors of MRI compliance were parental expectations and ratings of how well the child typically copes with medical procedures. Non-compliance was related to child attention problems and to poor adaptability among children. A total of 64 preschool-age children (91.4%) and 110 school-age children (95.7%) were correctly classified as compliant or non-compliant based on these predictor variables.

Conclusion: A child's temperament, medical experiences and parental expectations provide important information in predicting which children successfully comply with an MRI procedure and which require general anesthesia. Further study is needed to explore the utility of these variables in predicting compliance at sites that do not have access to an MRI simulator.