Woodfield Julie, Kealey Susan
Child Life and Health, University of Edinburgh, 20 Sylvan Place, Edinburgh, EH9 1UW, UK,
Pediatr Radiol. 2015 Aug;45(9):1271-81. doi: 10.1007/s00247-015-3333-9. Epub 2015 Mar 28.
Attaining paediatric brain images of diagnostic quality can be difficult because of young age or neurological impairment. The use of anaesthesia to reduce movement in MRI increases clinical risk and cost, while CT, though faster, exposes children to potentially harmful ionising radiation. MRI acquisition techniques that aim to decrease movement artefact may allow diagnostic paediatric brain imaging without sedation or anaesthesia. We conducted a systematic review to establish the evidence base for ultra-fast sequences and sequences using oversampling of k-space in paediatric brain MR imaging. Techniques were assessed for imaging time, occurrence of movement artefact, the need for sedation, and either image quality or diagnostic accuracy. We identified 24 relevant studies. We found that ultra-fast techniques had shorter imaging acquisition times compared to standard MRI. Techniques using oversampling of k-space required equal or longer imaging times than standard MRI. Both ultra-fast sequences and those using oversampling of k-space reduced movement artefact compared with standard MRI in unsedated children. Assessment of overall diagnostic accuracy was difficult because of the heterogeneous patient populations, imaging indications, and reporting methods of the studies. In children with shunt-treated hydrocephalus there is evidence that ultra-fast MRI is sufficient for the assessment of ventricular size.
由于年龄小或存在神经功能障碍,获取具有诊断质量的儿科脑部图像可能会很困难。在磁共振成像(MRI)中使用麻醉来减少运动干扰会增加临床风险和成本,而计算机断层扫描(CT)虽然速度更快,但会使儿童暴露于潜在有害的电离辐射中。旨在减少运动伪影的MRI采集技术可能允许在不使用镇静剂或麻醉的情况下进行儿科脑部诊断成像。我们进行了一项系统综述,以建立儿科脑部磁共振成像中超快速序列和使用k空间过采样序列的证据基础。对这些技术进行了成像时间、运动伪影的发生情况、镇静需求以及图像质量或诊断准确性等方面的评估。我们确定了24项相关研究。我们发现,与标准MRI相比,超快速技术的成像采集时间更短。使用k空间过采样的技术所需的成像时间与标准MRI相同或更长。与标准MRI相比,超快速序列和使用k空间过采样的序列在未使用镇静剂的儿童中均减少了运动伪影。由于研究中的患者群体、成像指征和报告方法存在异质性,因此很难评估总体诊断准确性。在接受分流治疗的脑积水儿童中,有证据表明超快速MRI足以评估脑室大小。