One of the most difficult challenges of being a radiologist is working with children. There are many considerations and challenges when doing an MRI for a child, whether it’s imaging technology issues or patient compliance.
Here are the most common pediatric MRI challenges for a radiologist.
Patient Compliance – One of the biggest challenges in working with young patients is getting them to cooperate and stay still for long periods of time. This is particularly difficult for an MRI, which requires the patient to stay still for the best-quality imaging. Many radiology departments have implemented “buddy systems” in which a parent or other caregiver stays in the room with the child to assist in keeping the child calm.
Limitations of Imaging Field-of-view – The smaller-sized bodies of children fewer present restrictions to body placing and contouring for inserting into traditional scanners, it can also produce limited field-of-view (FOV) images which do not have enough detail for someone, like a radiologist, to make an accurate decision ot diagnosis of the child’s body. Children’s imaging scanners can reduce these limits reachable to achieve FOV size, and depict increased anatomy information and physiology detail prognosing and dispositioning on the child’s condition.
Age-Weighted Imaging Technology – Radiologists are faced with another challenge, which is finding adequate imaging technology that is age-appropriate and can produce accurate results without stressing or burdening a young patient. Many imaging departments only carry adult-sized arrays.
Anesthesia – In certain situations, particularly when a child is having difficulty remaining quiet for the MRI scan, anesthetic may be necessary. However, anesthetic is in and of itself a risk, and this option should only be pursued if all other options have either been unsuitable or have been tried unsuccessfully. This risk needs to be carefully considered before anesthetic is given.
Anxious Parents – Parents often have anxiety about having their child undergo procedures such as an MRI – radiologists need to be especially careful when speaking to parents to not raise undue anxiety about the outcome of the procedure.
Limited Equipment – Many hospitals do not have access to specialized pediatric-sized body arrays that would enhance image quality and accuracy – Hospitals must use normal adult equipment, which creates lower quality images, partly due to suboptimal fit with smaller body sizes.
Conclusion
There are many issues in pediatric MR imaging, which, generally, can come from two interrelated areas: the subject group, and the MR environment. First, neonatal and pediatric patients are not simply smaller adults. Rather, relative to adults, they have notable differences in the structure and function of their central nervous systems.
Frequently Asked Questions
Q. What are the challenges of pediatric neuroimaging?
Neuroimaging in children is uniquely challenging because of the pace of development of children’s brains, their small size, and children’s ability to cooperate. Technical challenges include acquiring sufficient signals in small brains and accounting for motion artifacts. Practical challenges include difficulty performing some procedures on small children and ethical considerations around sedation.
Q. What are the risks of MRI in children?
MRI is usually safe for kids, but there are a few kinds of risks to be concerned about, especially with sedation and if contrast is used. The most common concerns are allergy to sedation drugs or contrast dye, and issues with implanted metal devices.
Q. What to expect from a pediatric MRI?
A pediatric MRI consists of placing the child onto an MRI table and moving the child into the scanner, which typically looks like a tunnel. We then ask the child to remain still for the duration of the scan (which may take anywhere from 20–90 minutes).
