Shariat Masoud, Mertens Luc, Seed Mike, Grosse-Wortmann Lars, Golding Fraser, Mercer-Rosa Laura, Harris Matthew, Whitehead Kevin K, Li Christine, Fogel Mark A, Yoo Shi-Joon
Department of Medical Imaging, University Health Network, University of Toronto, 585 University Ave., Toronto, ON, M5G 2N2, Canada,
Pediatr Cardiol. 2015 Apr;36(4):809-12. doi: 10.1007/s00246-014-1084-2. Epub 2014 Dec 20.
Utilization of cardiovascular magnetic resonance (CMR) is limited in young children because of the need for sedation or general anesthesia (GA). It has been previously shown that CMR can be performed without sedation or GA in young infants who are prone to fall asleep after being fed and swaddled. The purpose of this study was to prospectively prove the feasibility of the feed-and-sleep CMR technique in larger cohorts in the two institutions where the technique was initially developed. This was a prospective dual-center cohort study over a two-year period. All infants younger than 6 months old with complex congenital cardiovascular anomaly who required CMR were recruited for this study. The exclusion criteria included mechanical ventilation, oxygen dependence, feeding difficulties, and any contraindication to CMR. The feed-and-sleep study was performed by fasting the infant for a period of 4 h prior to the scan, placing the infant in a vacuum immobilizer, and feeding the infant just prior to the CMR. The CMR sequences were prioritized to target the area of most importance first. A study was considered complete and diagnostic if the clinical question was answered. A total of 60 infants (39 from center A and 21 from center B) were recruited for this study, 32 male and 28 female, ages ranging from 1 to 177 days (50 ± 54). The CMR studies were diagnostic and answered the clinical questions in all patients. All infants tolerated the procedure well, and no complications were noted in any of the patients. The CMR duration ranged between 4-132 minutes (45 ± 21). The feed-and-sleep approach in selected patients obviates the need of sedation or GA for CMR in infants younger than 6 months old. Therefore, CMR can be utilized whenever echocardiography fails to provide the complete information required for the patients' management.
由于需要镇静或全身麻醉（GA），心血管磁共振成像（CMR）在幼儿中的应用受到限制。先前的研究表明，对于那些喂食并包裹后容易入睡的小婴儿，可以在不使用镇静或全身麻醉的情况下进行CMR检查。本研究的目的是在前瞻性地证明这种喂食入睡CMR技术在最初开发该技术的两家机构中更大队列中的可行性。这是一项为期两年的前瞻性双中心队列研究。本研究招募了所有6个月以下患有复杂先天性心血管异常且需要进行CMR检查的婴儿。排除标准包括机械通气、氧依赖、喂养困难以及任何CMR检查的禁忌症。喂食入睡研究的操作方法是：在扫描前让婴儿禁食4小时，将婴儿放入真空固定器中，并在CMR检查前立即喂食。CMR序列优先针对最重要的区域。如果临床问题得到解答，则认为该研究完整且具有诊断价值。本研究共招募了60名婴儿（中心A有39名，中心B有21名），其中男性32名，女性28名，年龄在1至177天之间（平均50±54天）。所有患者的CMR检查均具有诊断价值并解答了临床问题。所有婴儿对该检查耐受良好，且未发现任何并发症。CMR检查持续时间在4至132分钟之间（平均45±21分钟）。对于选定的患者，喂食入睡方法避免了6个月以下婴儿进行CMR检查时使用镇静或全身麻醉的需要。因此，只要超声心动图无法提供患者管理所需的完整信息，就可以使用CMR检查。
