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Updated: Dec 25, 2025
Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure
Published on: July 30, 2009
Pediatric Functional Neuroimaging: Practical Tips and Pearls
Jeremy Y Jones1, Bhavani Selvaraj1, Mai-Lan Ho1
1Department of Radiology, Nationwide Children's Hospital, 700 Children's Dr, ED4, Columbus, OH 43205.
Insights
Pediatric functional MRI (fMRI) aids in localizing brain function before surgery. Special considerations for children include preparation, study design, and interpretation due to developmental differences.
Area of Science:
- Neuroimaging
- Pediatric Radiology
Background:
- Functional MRI (fMRI) is crucial for pre-surgical mapping of eloquent cortex, particularly motor and language areas.
- Pediatric fMRI presents unique challenges including patient tolerance, anatomical differences, and developmental variations.
Purpose of the Study:
- To outline key considerations, potential challenges, and best practices for clinical pediatric fMRI.
- To provide guidance on fMRI principles, patient preparation, acquisition, processing, and interpretation in children.
Main Methods:
- Review of principles of blood oxygenation level-dependent (BOLD) imaging.
- Discussion of pediatric-specific patient preparation and study design strategies.
- Overview of data postprocessing and interpretation nuances for pediatric fMRI.
Main Results:
- Successful pediatric fMRI requires tailored approaches to overcome challenges related to age and development.
- Understanding developmental neuroanatomy and neuroplasticity is vital for accurate interpretation.
Conclusions:
- Clinical fMRI is essential for pre-surgical localization in pediatric patients with neurological conditions.
- Radiologists must be aware of pediatric-specific factors for effective fMRI application and interpretation.
Abstract:
OBJECTIVE. Functional MRI (fMRI) is clinically used for localization of eloquent cortex before surgical intervention, most commonly motor and language function in patients with tumors or epilepsy. In the pediatric population, special considerations for fMRI relate to limited examination tolerance, small head size, developing anatomy and physiology, and diverse potential abnormalities. In this article, we will highlight pearls and pitfalls of clinical pediatric fMRI including blood oxygenation level-dependent imaging principles, patient preparation, study acquisition, data postprocessing, and examination interpretation. CONCLUSION. Clinical fMRI is indicated for presurgical localization of eloquent cortex in patients with tumors, epilepsy, or other neurologic conditions and requires a solid understanding of technical considerations and data processing. In children, special approaches are needed for patient preparation as well as study design, acquisition, and interpretation. Radiologists should be cognizant of developmental neuroanatomy, causes of neuropathology, and capacity for neuroplasticity in the pediatric population.
