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Paediatric MRI under sedation: is it necessary? What is the evidence for the alternatives?

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Abstract

To achieve diagnostic images during MRI examinations, small children need to lie still to avoid movement artefact. To reduce patient motion, obviate the need for voluntary immobilisation or breath-holding and therefore obtain high-quality images, MRI of infants is frequently carried out under sedation or general anaesthesia, but this is not without risk and expense. However, many other techniques are available for preparing children for MRI, which have not been fully evaluated. Here, we evaluate the advantages and disadvantage of sedation and anaesthesia for MRI. We then evaluate the alternatives, which include neonatal comforting techniques, sleep manipulation, and appropriate adaptation of the physical environment. We summarize the evidence for their use according to an established hierarchy. Lastly, we discuss several factors that will influence the choice of imaging preparation, including patient factors, imaging factors and service provision. The choice of approach to paediatric MRI is multi-factorial, with limited scientific evidence for many of the current approaches. These considerations may enable others to image children using MRI under different circumstances.

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Acknowledgements

Dr Arthurs is funded by a Medical Research Council / Royal College of Radiologists Clinical Research Training Fellowship. Both authors have received funding from the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0807-14149). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. The authors thank Addenbrooke’s Charitable Trust for infrastructure support, and the NIHR comprehensive Biomedical Research Centre award to Cambridge University Hospitals NHS Foundation Trust in partnership with the University of Cambridge.

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  1. Department of Radiology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Box 218, Hills Road, Cambridge, CB2 0QQ, UK

    Andrea D. Edwards & Owen J. Arthurs

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  2. Owen J. Arthurs
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Correspondence to Owen J. Arthurs.

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Edwards, A.D., Arthurs, O.J. Paediatric MRI under sedation: is it necessary? What is the evidence for the alternatives?. Pediatr Radiol 41, 1353–1364 (2011). https://doi.org/10.1007/s00247-011-2147-7

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  • DOI: https://doi.org/10.1007/s00247-011-2147-7

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