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Real-time MRI: a new tool of radiologic imaging in small children
Franz Wolfgang Hirsch1, Jens Frahm2, Ina Sorge3
1Department of Pediatric Radiology, University Hospital, Leipzig, Germany. franzwolfgang.hirsch@medizin.uni-leipzig.de.
Abstract:
Real-time MRI (rt-MRI) in children is a new imaging technique that combines the advantages of US - at frame rates of up to 50 images per second - with the quality and features of MRI. Although still subject of research, it has become a standard tool in the diagnostic portfolio of two pediatric radiology departments in Germany. Based on ultrashort acquisition times, any detrimental effects of macroscopic movements of the child and the physiological movements of the organs are negligible. Especially in pediatric brain imaging, rt-MRI has already proven its value. With suitable indications, rt-MRI can reduce anesthesia and sedation examinations in children below 6 years of age by 40% due to its very short examination time and its robustness to motion. There is a high level of acceptance among parents and referrers when diagnostic possibilities and limitations are communicated correctly.
Conclusion:
Completely new diagnostic possibilities arise in the imaging of the moving lung, the beating heart, joint movements, and speaking and swallowing, as demonstrated in this video-backed review.
What Is Known:
• MRI in moving children has been burdened with severe artifacts. • Gross motion usually has to be handled by sedation and periodic motion of the heart and lungs has to be compensated with time-consuming techniques until now.
What Is New:
• Real-time MRI allows image acquisition with up to 50 frames per second similar to ultrasound frame rate. • Real-time MRI proofs to be very promising for imaging children, reducing examination time and sedation rate drastically.
Insights
Real-time MRI (rt-MRI) offers a new, fast imaging method for children, significantly reducing the need for sedation and anesthesia. This advanced technique overcomes motion artifacts, enabling clearer pediatric brain scans and new diagnostic capabilities.
Area of Science:
- Pediatric Radiology
- Medical Imaging Technology
Background:
- Traditional MRI in children is limited by motion artifacts, often necessitating sedation or anesthesia.
- Physiological movements of organs and patient motion have historically posed significant challenges in pediatric MRI acquisition.
Discussion:
- Real-time MRI (rt-MRI) achieves high frame rates (up to 50 images/sec), comparable to ultrasound, while retaining MRI's image quality.
- This technique minimizes artifacts from macroscopic patient movement and physiological organ motion due to ultrashort acquisition times.
- rt-MRI has been implemented in German pediatric radiology departments, demonstrating its clinical utility.
Key Insights:
- rt-MRI significantly reduces the need for anesthesia and sedation in children under 6 by up to 40%.
- The robustness to motion and speed of rt-MRI enhance diagnostic capabilities, particularly in pediatric brain imaging.
- High acceptance rates among parents and referring physicians are observed when diagnostic information is clearly communicated.
Outlook:
- rt-MRI opens new diagnostic avenues for imaging dynamic processes like lung movement, cardiac function, joint motion, and swallowing.
- Further research and clinical integration of rt-MRI are expected to expand its applications in pediatric diagnostics.
- The technology promises to revolutionize the imaging of pediatric patients, improving both diagnostic accuracy and patient experience.
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