Pediatric neuro MRI: tricks to minimize sedation

Abstract

Magnetic resonance imaging (MRI) is the workhorse modality in pediatric neuroimaging because it provides excellent soft-tissue contrast without ionizing radiation. Until recently, studies were uninterpretable without sedation; however, given development of shorter sequences, sequences that correct for motion, and studies showing the potentially deleterious effects of sedation on immature laboratory animals, it is prudent to minimize sedation when possible. This manuscript provides basic guidelines for performing pediatric neuro MRI without sedation by both modifying technical factors to reduce scan time and noise, and using a multi-disciplinary team to coordinate imaging with the patient's biorhythms.

Keywords: Anesthesia; Children; Magnetic resonance imaging; Neuroradiology; Sedation.

Fig. 1

Photo shows a neonate wrapped in vacuum bean bag with noise attenuators in place, ready for transport to scanner suite

Fig. 2

Photo shows a neonate on the scanner table immediately prior to commencing feed-and-swaddle scan