Related Experiment Video
Updated: Jun 12, 2025
Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure
Published on: July 30, 2009
Child life specialists predict successful MRI scanning in unsedated children 4 to 12 years old
Jennifer H Staab1,2, Angela C Yoder3, John T Brinton3
1Children's Hospital Colorado, Aurora, CO, USA. Jennifer.Staab@childrenscolorado.org.
Insights
Certified child life specialists can predict which children can complete MRI scans without sedation using screening questions. This method improves successful MRI completion rates for pediatric patients, reducing the need for anesthesia.
Area of Science:
- Pediatric Radiology
- Medical Imaging Technology
- Child Life Services
Background:
- Pediatric magnetic resonance imaging (MRI) often requires general anesthesia due to children's difficulty cooperating.
- Current practices frequently rely on arbitrary age cutoffs for anesthesia decisions.
- Anesthesia necessity is often determined by schedulers lacking specialized training in pediatric patient compliance.
Purpose of the Study:
- To assess the efficacy of screening questions administered by certified child life specialists (CCLS) in predicting successful MRI completion without sedation in children.
- To develop a reliable method for identifying pediatric patients suitable for non-sedated MRI scans.
Main Methods:
- A retrospective study involving 403 children aged 4-12 years scheduled for MRI.
- Screening of children by CCLS using a questionnaire, recording parent responses, CCLS recommendations, and scan details.
- Development of a predictive model incorporating child's age, estimated scan length, scan difficulty, and parent screening responses.
Main Results:
- 79% of screened children (317/403) were recommended for MRI without anesthesia.
- 97.5% of these children (309/317) successfully completed their MRI on the first attempt.
- A predictive model demonstrated excellent performance (AUC=0.89) using clinical information and parent screening questions.
Conclusions:
- Screening by CCLS, combined with child's age, scan length, and difficulty, effectively predicts successful non-sedated MRI completion in children.
- This approach offers a more accurate alternative to simple age cutoffs for determining anesthesia needs.
- Implementation of this screening tool can enhance patient care and optimize resource utilization in pediatric imaging.
Background:
It can be challenging for children to cooperate for a magnetic resonance imaging (MRI) exam. General anesthesia is often used to ensure a high-quality image. When determining the need for general anesthesia, many institutions use a simple age cutoff. Decisions on the necessity for anesthesia are often left to schedulers who lack training on determination of patient compliance.
Objective:
The study aimed to evaluate whether screening questions administered by certified child life specialists (CCLS) could successfully predict which children could complete an MRI without sedation.
Materials And Methods:
This is a retrospective, institutional review board approved study. Data was collected as part of a quality improvement program, where a CCLS screened 4- to 12-year-old children scheduled for MRI scanning using a questionnaire. Parent responses to the screening questions, CCLS's recommendation for scheduling the MRI awake, start and end time for the MRI scan, and scan success were recorded. A predictive model for the CCLS's recommendation was developed using the child's age, estimated scan length, scan difficulty, and the parent's responses to the screening questions. The primary outcome measure was a successfully completed MRI not requiring additional imaging under anesthesia.
Results:
Of the 403 screened children, 317 (79%) were recommended to attempt the MRI without anesthesia. The median age of participants was 7 (IQR 4-17) years. Overall, 309 of 317 (97.5%) participants, recommended by the CCLS for the program, met the primary outcome of successful MRI completion on their first attempt. The multivariable regression model which included clinical information about the child's age, estimated scan length, scan difficulty, and four of the six parent screening questions had excellent performance (area under the curve = 0.89).
Conclusion:
Information collected by the CCLS via screening along with the child's age, the estimated scan length, and difficulty can help predict which children are likely to successfully complete a non-sedate MRI.
Related Concept Videos
01:14Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
01:24Magnetic Resonance Imaging
01:30Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...