Paediatric magnetic resonance imaging adaptations without the use of sedation or anaesthesia: A narrative review

Anwar, Iffah; McCabe, Beatrice; Simcock, Clare; Malamateniou, Christina

doi:10.1016/j.jmir.2022.04.048

Cited by 9 publications

(3 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thoughtful use of MRI is important to minimize risks to patients as well as preserve finite hospital resources and decrease costs. Thirty-nine percent of MRIs performed at our institution required sedation, and nearly all (98%) received intravenous contrast, both of which are important risk factors to consider when additional MRI studies are pursued 10–13 . Future efforts to implement rapid, nonsedated, noncontrasted MRI studies for AHO may help to decrease the risks and costs associated with obtaining follow-up imaging in children with AHO.…”

Section: Discussionmentioning

confidence: 99%

Clinical Utility of Repeat Magnetic Resonance Imaging Studies Among Children With Acute Hematogenous Osteomyelitis

Thorne,

Moss,

Sanders

et al. 2024

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

Background and Objectives: There is limited guidance for whether repeat magnetic resonance imaging (MRI) studies are clinically impactful among children with acute hematogenous osteomyelitis (AHO) who fail to improve as expected. This study aimed to determine whether repeat MRIs changed management among children with AHO and identify clinical characteristics predictive of which patients benefit from repeat MRIs. Methods: Children admitted to a quaternary care pediatric hospital with AHO were identified during a 9-year period. Patients with chronic symptoms, non-hematogenous infections, or significant contributing comorbidities were excluded. Medical records were retrospectively reviewed for all MRIs performed 3 weeks before admission to 24 months after discharge. An MRI was considered clinically impactful if it identified a new infectious process (eg, abscess not seen on the initial MRI) or if it resulted in surgical intervention within 24 hours. Bivariable comparisons of categorical variables were performed, and multivariable logistic regression was used to assess the clinical factors of impactful repeat MRIs. Results: Among the 239 included patients, 41 (17%) had more than 1 MRI performed during their clinical course, the majority of whom (53.7%) had a repeat MRI that impacted care. Patients who underwent repeat MRIs had longer hospitalizations (7 vs. 5 d, P<0.01), were more likely to have C-reactive protein (CRP) levels >20 mg/dL (41% vs. 10%, P<0.01), and were more likely to have a delayed transition to oral antimicrobials (8.4 vs. 3.3 d, P<0.01). Peak CRP >20 mg/dL and prolonged bacteremia were found to be associated with increased odds of having an impactful repeat MRI, with adjusted odds ratios of 3.9 (P=0.007) and 3.4 (P=0.03), respectively. Conclusions: When used judiciously among ill children with complicated AHO, repeat MRI can be clinically impactful. Prospective studies are needed to better define which children with AHO benefit from repeat MRI. Level of Evidence: Level II evidence—this is a retrospective cohort study interested in determining the clinical utility of repeat magnetic resonance imaging studies for children with osteomyelitis.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical Utility of Repeat Magnetic Resonance Imaging Studies Among Children With Acute Hematogenous Osteomyelitis

Thorne,

Moss,

Sanders

et al. 2024

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

show abstract

“…[4][5][6][7] Magnetic resonance imaging (MRI) is a medical imaging examination used for a wide range of clinical conditions, that allows delineation of fine anatomical details in the human body and therefore enables optimal diagnosis and treatment. However, as we explain below, it remains a lengthy, anxietyprovoking, challenging examination with moderate acceptance from patients, 8 despite some early efforts to optimise its clinical practice for the general population [9][10][11] and for autistic people, in particular. 12,13 Autistic people may need to undergo MRI examinations, either as part of a research project studying autism, or for clinical concerns, such as persistent headaches, low back pain, injuries, accidents, or falls.…”

Section: Introductionmentioning

confidence: 99%

Toward Autism-Friendly Magnetic Resonance Imaging: Exploring Autistic Individuals' Experiences of Magnetic Resonance Imaging Scans in the United Kingdom, a Cross-Sectional Survey

Stogiannos

Brammer

McNulty

et al. 2023

Autism in Adulthood

View full text Add to dashboard Cite

Background: Autistic individuals might undergo a magnetic resonance imaging (MRI) examination for clinical concerns or research. Increased sensory stimulation, lack of appropriate environmental adjustments or lack of streamlined communication in the MRI suite may pose challenges to autistic patients and render MRI scans inaccessible. This study aimed to i) explore the MRI scan experiences of autistic adults in the UK, ii) identify barriers and enablers towards successful and safe MRI examinations, iii) assess autistic individuals' satisfaction with MRI service, and iv) inform future recommendations for practice improvement. Methods:We distributed an online survey to the autistic community on social media, using snowball sampling. Inclusion criteria were: being older than 16, have an autism diagnosis or self-diagnosis, self-reported capacity to consent and having had an MRI scan in the UK. We used descriptive statistics for demographics, inferential statistics for group comparisons/correlations, and content analysis for qualitative data. Results:We received 112 responses. A total of 29.6% of the respondents reported not being sent any information before the scan. Most participants (68%) confirmed that radiographers provided detailed information on the day of the examination but only 17.1% reported that radiographers offered some reasonable environmental adjustments. Only 23.2% of them confirmed they disclosed their autistic identity when booking MRI scanning. We found that quality of communication, physical environment, patient emotions, staff training and confounding societal factors impacted autistic people's experiences. Autistic individuals rated their overall MRI experience as neutral and reported high levels of claustrophobia (44.8%). Conclusion:The study highlighted a lack of effective communication and coordination of care, either between healthcare services or between patients and radiographers, and lack of reasonable adjustments as vital for more accessible and person-centred MRI scanning for autistic individuals. Enablers of successful scans included effective communication, adjusted MRI environment, scans tailored to individuals' needs/preferences, and well-trained staff.'' Request a private waiting room, if possible. Use any relaxation aids that they can provide. Make sure staff know of any autism-related factors you have, e.g. hyperacusis; it's LOUD in there''. Table 3. Key recommendations for practice. Challenge Implication Recommendations • Poor communication and lack of adequate information provided to service user by radiology prior to scanning. • Adjust communication style to the individual. 10,21 • Ensure communication and coordination of services between GPs/referring consultants and Radiology. 24 • Implement tailored pre-scan communication COMFORT

show abstract

“…These preparatory methods employ various tools and content, all of which share the common objective of familiarizing children with the characteristics of an MRI scanner (including the noise, confined space, duration, and appearance) and training them to remain still for extended periods [7]. However successful these preparation protocols may be, their implementation necessitates specific and sometimes costly equipment, such as booklets, instruction movies, mock scanners, or virtual reality goggles, and are typically conducted by dedicated child specialists, which demands a substantial time investment from highly specialized professionals [2,[8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Testing a Home Solution for Preparing Young Children for an Awake MRI: A Promising Smartphone Application

Geuens,

Lemiere,

Nijs

et al. 2023

Children

View full text Add to dashboard Cite

Thanks to its non-invasive nature and high-resolution imaging capabilities, magnetic resonance imaging (MRI) is a valuable diagnostic tool for pediatric patients. However, the fear and anxiety experienced by young children during MRI scans often result in suboptimal image quality and the need for sedation/anesthesia. This study aimed to evaluate the effect of a smartphone application called COSMO@home to prepare children for MRI scans to reduce the need for sedation or general anesthesia. The COSMO@home app was developed incorporating mini-games and an engaging storyline to prepare children for learning goals related to the MRI procedure. A multicenter study was conducted involving four hospitals in Belgium. Eligible children aged 4–10 years were prepared with the COSMO@home app at home. Baseline, pre-scan, and post-scan questionnaires measured anxiety evolution in two age groups (4–6 years and 7–10 years). Eighty-two children participated in the study, with 95% obtaining high-quality MRI images. The app was well-received by children and parents, with minimal technical difficulties reported. In the 4–6-year-old group (N = 33), there was a significant difference between baseline and pre-scan parent-reported anxiety scores, indicating an increase in anxiety levels prior to the scan. In the 7–10-year-old group (N = 49), no significant differences were observed between baseline and pre-scan parent-reported anxiety scores. Overall, the COSMO@home app proved to be useful in preparing children for MRI scans, with high satisfaction rates and successful image outcomes across different hospitals. The app, combined with minimal face-to-face guidance on the day of the scan, showed the potential to replace or assist traditional face-to-face training methods. This innovative approach has the potential to reduce the need for sedation or general anesthesia during pediatric MRI scans and its associated risks and improve patient experience.

show abstract

Paediatric magnetic resonance imaging adaptations without the use of sedation or anaesthesia: A narrative review

Cited by 9 publications

References 40 publications

Clinical Utility of Repeat Magnetic Resonance Imaging Studies Among Children With Acute Hematogenous Osteomyelitis

Clinical Utility of Repeat Magnetic Resonance Imaging Studies Among Children With Acute Hematogenous Osteomyelitis

Toward Autism-Friendly Magnetic Resonance Imaging: Exploring Autistic Individuals' Experiences of Magnetic Resonance Imaging Scans in the United Kingdom, a Cross-Sectional Survey

Testing a Home Solution for Preparing Young Children for an Awake MRI: A Promising Smartphone Application

Contact Info

Product

Resources

About