Raschle Nora M, Lee Michelle, Buechler Roman, Christodoulou Joanna A, Chang Maria, Vakil Monica, Stering Patrice L, Gaab Nadine
Department of Developmental Medicine, Children's Hospital Boston, USA.
J Vis Exp. 2009 Jul 30(29):1309. doi: 10.3791/1309.
Within the last decade there has been an increase in the use of structural and functional magnetic resonance imaging (fMRI) to investigate the neural basis of human perception, cognition and behavior. Moreover, this non-invasive imaging method has grown into a tool for clinicians and researchers to explore typical and atypical brain development. Although advances in neuroimaging tools and techniques are apparent, (f)MRI in young pediatric populations remains relatively infrequent. Practical as well as technical challenges when imaging children present clinicians and research teams with a unique set of problems. To name just a few, the child participants are challenged by a need for motivation, alertness and cooperation. Anxiety may be an additional factor to be addressed. Researchers or clinicians need to consider time constraints, movement restriction, scanner background noise and unfamiliarity with the MR scanner environment. A progressive use of functional and structural neuroimaging in younger age groups, however, could further add to our understanding of brain development. As an example, several research groups are currently working towards early detection of developmental disorders, potentially even before children present associated behavioral characteristics. Various strategies and techniques have been reported as a means to ensure comfort and cooperation of young children during neuroimaging sessions. Play therapy, behavioral approaches and simulation, the use of mock scanner areas, basic relaxation and a combination of these techniques have all been shown to improve the participant's compliance and thus MRI data quality. Even more importantly, these strategies have proven to increase the comfort of families and children involved. One of the main advances of such techniques for the clinical practice is the possibility of avoiding sedation or general anesthesia (GA) as a way to manage children's compliance during MR imaging sessions. In the current video report, we present a pediatric neuroimaging protocol with guidelines and procedures that have proven to be successful to date in young children.
在过去十年中，结构和功能磁共振成像（fMRI）在研究人类感知、认知和行为的神经基础方面的应用有所增加。此外，这种非侵入性成像方法已发展成为临床医生和研究人员探索典型和非典型大脑发育的工具。尽管神经成像工具和技术取得了明显进展，但fMRI在幼儿群体中的应用仍然相对较少。对儿童进行成像时面临的实际和技术挑战给临床医生和研究团队带来了一系列独特的问题。仅举几例，儿童参与者需要有积极性、警觉性和合作能力，这对他们是一种挑战。焦虑可能是另一个需要解决的因素。研究人员或临床医生需要考虑时间限制、运动限制、扫描仪背景噪音以及对磁共振扫描仪环境的不熟悉。然而，在更年轻的年龄组中逐步使用功能和结构神经成像，可能会进一步增进我们对大脑发育的理解。例如，几个研究小组目前正在努力早期检测发育障碍，甚至可能在儿童出现相关行为特征之前。已经报道了各种策略和技术，作为确保幼儿在神经成像过程中感到舒适并进行合作的手段。游戏疗法、行为方法和模拟、使用模拟扫描仪区域、基本放松以及这些技术的组合，都已被证明可以提高参与者的依从性，从而提高磁共振成像数据的质量。更重要的是，这些策略已被证明可以提高所涉及家庭和儿童的舒适度。此类技术在临床实践中的一个主要进展是有可能避免使用镇静剂或全身麻醉（GA），以此来管理儿童在磁共振成像过程中的依从性。在当前的视频报告中，我们展示了一种儿科神经成像方案，其中包含迄今为止已被证明对幼儿有效的指导方针和程序。
