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Magnetic resonance imaging of children without sedation: preparation with simulation
D R Rosenberg1, J A Sweeney, J S Gillen
1Department of Psychiatry, University of Pittsburgh Medical Center, PA 15213, USA. Rosenbergdr@al.isd.upmc.edu
Insights
A novel scanner simulator effectively prepared pediatric patients for magnetic resonance imaging (MRI) scans, reducing distress and eliminating the need for sedation. This simulation method ensures high-quality MRI studies for children.
Area of Science:
- Pediatric radiology
- Medical simulation
- Neuroimaging
Background:
- Pharmacological sedation is often required for pediatric magnetic resonance imaging (MRI) to ensure diagnostic quality.
- Sedation carries risks and increases costs, necessitating alternative preparation methods for pediatric patients.
Purpose of the Study:
- To evaluate the efficacy of a scanner simulator in preparing pediatric subjects for MRI examinations without pharmacological sedation.
- To assess the impact of simulator training on subject distress and heart rate during MRI.
Main Methods:
- A cohort of 16 healthy children and 16 children with obsessive-compulsive disorder (ages 6-17) were matched and underwent simulator training.
- Distress levels were monitored using heart rate and a self-report scale during simulation and actual MRI scans.
- A control group of 10 healthy children underwent MRI without prior simulation.
Main Results:
- Simulator training led to significant decreases in heart rate and self-reported distress, which were maintained throughout the actual MRI scan.
- All simulation-trained subjects successfully completed diagnostic-quality MRI examinations without sedation.
- Subjects without simulator training exhibited higher heart rates and distress levels during the MRI scan.
Conclusions:
- Scanner simulation is a viable and effective method for preparing pediatric subjects for high-quality MRI examinations without the need for pharmacological sedation.
- Simulation offers a promising alternative to sedation for routine MRI procedures in children aged 6 and older, including those with anxiety or obsessive-compulsive disorder.
Objective:
It was hypothesized that a scanner simulator that replicates the magnetic resonance imaging (MRI) environment could be used to prepare pediatric subjects for successful completion of a diagnostic-quality MRI examination without pharmacological sedation.
Method:
Sixteen healthy children, 6 to 17 years of age, were matched for age and sex with 16 psychotropic medication-naive children with obsessive-compulsive disorder. Distress was measured throughout simulation and scanning procedures using heart rate and a self-report distress scale. Ten healthy children, 6 to 17 years of age, also underwent the same actual MRI scanning procedure but did not undergo the simulation scanning procedure.
Results:
Significant decreases in heart rate and self-reported distress level were observed in all subjects during the simulator session that were maintained to the end of the actual scanner experience. All subjects successfully completed MRI examinations without chemical restraint. Subjects who were not trained in the simulator had higher heart rates and self-reported distress levels in the actual scanner than did simulation-trained subjects.
Conclusions:
Simulation without pharmacological sedation successfully prepared pediatric subjects in this pilot study for high-quality MRI studies. Subject preparation may be an alternative procedure to sedation for routine MRI examination in healthy and anxious children 6 years of age and older.