Effectiveness of training before unsedated MRI scans in young children: a randomized control trial

• Published in: Pediatric radiology Vol. 53; no. 7; pp. 1476 - 1484
• Main Authors: Fletcher, Sarah, Lardner, David, Bagshawe, Mercedes, Carsolio, Lisa, Sherriff, Martin, Smith, Cathy, Lebel, Catherine
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2023; Springer Nature B.V
• Subjects: Anesthesia; Anesthesia, General; Anxiety; Child; Child, Preschool; Children; Children & youth; Effectiveness; General anesthesia; Hospitals, Pediatric; Humans; Imaging; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Medicine; Medicine & Public Health; Neuroradiology; Nuclear Medicine; Oncology; Original Article; Parents; Pediatrics; Radiology; Scanners; Side effects; Training; Ultrasound; Radiology; Anesthesia; Sedation; Magnetic resonance imaging; Child life; Child
• ISSN: 1432-1998; 0301-0449; 1432-1998
• DOI: 10.1007/s00247-023-05647-0

Background Young children requiring clinical magnetic resonance imaging (MRI) may be given general anesthesia. General anesthesia has potential side effects, is costly, and introduces logistical challenges. Thus, methods that allow children to undergo awake MRI scans are desirable. Objectives To compare the effectiveness of mock scanner training with a child life specialist, play-based training with a child life specialist, and home book and video preparation by parents to allow non-sedated clinical MRI scanning in children aged 3–7 years. Materials and methods Children (3–7 years, n =122) undergoing clinical MRI scans at the Alberta Children’s Hospital were invited to participate and randomized to one of three groups: home-based preparation materials, training with a child life specialist (no mock MRI), or training in a mock MRI with a child life specialist. Training occurred a few days prior to their MRI. Self- and parent-reported functioning (PedsQL VAS) were assessed pre/post-training (for the two training groups) and pre/post-MRI. Scan success was determined by a pediatric radiologist. Results Overall, 91% (111/122) of children successfully completed an awake MRI. There were no significant differences between the mock scanner (89%, 32/36), child life (88%, 34/39), and at-home (96%, 45/47) groups ( P =0.34). Total functioning scores were similar across groups; however, the mock scanner group had significantly lower self-reported fear ( F =3.2, P =0.04), parent-reported sadness ( F =3.3, P =0.04), and worry ( F =3.5, P =0.03) prior to MRI. Children with unsuccessful scans were younger (4.5 vs. 5.7 years, P <0.001). Conclusions Most young children can tolerate awake MRI scans and do not need to be routinely anesthetized. All preparation methods tested, including at-home materials, were effective. Graphical abstract