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Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure
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Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure

Published on: July 30, 2009

Fast-brain MRI in children is quick, without sedation, and radiation-free, but beware of limitations

Katya Rozovsky1, Enrique C G Ventureyra, Elka Miller

  • 1Department of Diagnostic Imaging, Children's Hospital of Eastern Ontario, Ottawa, Canada. ROZ@hadassah.org.il

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|December 26, 2012
PubMed

Insights

Fast-brain MRI is useful for assessing shunt position in children but has limitations. Radiologists should be aware of potential difficulties in detecting venous sinus thrombosis and bleeding.

Area of Science:

  • Pediatric Radiology
  • Neuroimaging
  • Medical Imaging Techniques

Background:

  • Conventional MRI in young children often necessitates anesthesia, posing risks.
  • Fast-brain MRI offers a potential alternative, but its limitations require careful consideration.
  • The Fast Imaging Employing sTeady State Acquistion (FIESTA) protocol is one such technique.

Purpose of the Study:

  • To review and document the pitfalls of fast-brain MRI in non-sedated children.
  • To evaluate the effectiveness of the FIESTA protocol in pediatric neuroimaging.
  • To identify areas for improvement in fast-brain MRI protocols for pediatric patients.

Main Methods:

  • Retrospective review of 50 fast-brain MRI studies using the FIESTA protocol in 30 non-sedated children (aged 1 day to 5 years).
  • Studies were performed on a 1.5-Tesla GE Signa Excite HD scanner between January 2008 and August 2010.
  • Findings were compared to the most recent MRI or CT scan available for each patient.

Main Results:

  • Fast-brain MRI (FIESTA protocol) satisfactorily assessed ventriculoperitoneal (VP) shunt position and the size of fluid-filled structures in all patients.
  • Limitations were identified in 14% of studies (7/50), including undetected venous sinus thrombosis (one patient), subdural hematoma (three), difficulty differentiating blood products (two), and limited evaluation of extra-axial collections (one).
  • Indications for the scans included VP shunt management (40%), postoperative follow-up (18%), congenital abnormalities (30%), and complications of prematurity (12%).

Conclusions:

  • The FIESTA fast-brain MRI protocol is effective for evaluating VP shunt position and fluid-filled structures in non-sedated children.
  • Radiologists must be aware of the limitations of this technique, particularly in the depiction of venous sinus thrombosis and bleeding.
  • Modifications to fast-brain MRI protocols may be necessary to overcome these limitations and improve diagnostic accuracy in pediatric neuroimaging.

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