Unidad de Radiología Pediátrica, Servicio de Radiodiagnóstico, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
Unidad de Radiología Pediátrica, Servicio de Radiodiagnóstico, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
Radiologia (Engl Ed). 2022 Sep-Oct;64(5):415-421. doi: 10.1016/j.rxeng.2020.07.005. Epub 2022 Jun 2.
The use of general anesthesia in infants involves both short-term and long-term risks. The aim of this study is to evaluate the efficacy of brain MRI without anesthesia in infants younger than 3-month-old immobilized with a pillow.
This prospective case-control study was done in 2019. Cases were stable patients less than 3 months old who did not require ventilatory support for whom brain MRI was indicated. Patients were fed so they would fall asleep and placed in the scanner with an immobilizing pillow. Controls were clinically unstable patients matched for age and sex referred for brain MRI under general anesthesia. Three pediatric radiologists evaluated the success of the MRI study (whether it answered the clinical question), recorded whether it was necessary to repeat the study, and rated the presence of motion artifacts on a scale ranging from 1 to 4.
A total of 47 cases were included (28 boys and 19 girls; mean age, 31 days). Of these, 42 (89%) MRI studies were considered successful. The proportion of successful MRI studies was lower in outpatients than in inpatients (p = 0.02). The quality of MRI in cases was considered optimal in 60% and suboptimal (motion artifacts in one or two sequences) in 30%. No safety issues related with the technique were detected. The mean duration of the studies was 16.6 min (range, 6-30 min). All of the MRI studies in controls were considered successful; quality was considered optimal in 89% and suboptimal in 11%. In the first year in which we used this technique, we avoided the use of general anesthesia in 47 MRI studies in 42 newborns.
Brain MRI using the feed and sleep technique in infants younger than 3-month-old immobilized with a pillow can be done safely and efficaciously without general anesthesia.
在婴儿中使用全身麻醉会带来短期和长期风险。本研究旨在评估在不使用麻醉的情况下，使用枕头固定的 3 个月以下婴儿进行脑部 MRI 的效果。
这是一项前瞻性病例对照研究，于 2019 年进行。病例组为不需要通气支持且小于 3 个月大的稳定婴儿，这些婴儿因临床需要而进行脑部 MRI 检查。这些婴儿在进食后入睡并放置在扫描仪中，使用固定枕头进行固定。对照组为因临床需要进行脑部 MRI 检查且在全身麻醉下进行的不稳定婴儿，按照年龄和性别进行匹配。三名儿科放射科医生评估 MRI 研究的成功率（是否回答了临床问题）、记录是否需要重复研究，并对运动伪影的存在程度进行评分，范围从 1 到 4 分。
共纳入 47 例（28 名男孩和 19 名女孩；平均年龄 31 天）。其中，42 例（89%）MRI 研究被认为是成功的。门诊患者的 MRI 研究成功率低于住院患者（p=0.02）。病例组 MRI 的质量被认为是最佳的占 60%，次优的（一个或两个序列有运动伪影）占 30%。未发现与该技术相关的安全问题。研究的平均持续时间为 16.6 分钟（范围 6-30 分钟）。对照组的所有 MRI 研究均被认为是成功的，89%的质量被认为是最佳的，11%的质量是次优的。在我们使用该技术的第一年，我们避免了在 42 名新生儿的 47 次 MRI 研究中使用全身麻醉。
在使用枕头固定的 3 个月以下婴儿中，使用喂哺和睡眠技术进行脑部 MRI 可以在不使用全身麻醉的情况下安全有效地进行。
