Faculty of Medicine, University of British Columbia, T3B6A8, Vancouver, Canada.
Alberta Children's Hospital, T3B6A8, Calgary, Canada.
Pediatr Radiol. 2023 Jun;53(7):1476-1484. doi: 10.1007/s00247-023-05647-0. Epub 2023 Apr 3.
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.
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.
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.
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).
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.
需要临床磁共振成像（MRI）的幼儿可能会接受全身麻醉。全身麻醉有潜在的副作用，成本高，并带来后勤挑战。因此，让儿童进行清醒 MRI 扫描的方法是可取的。
比较模拟扫描仪训练、儿童生活专家主导的游戏式训练以及父母在家准备书籍和视频这三种方法，以允许 3-7 岁儿童在非镇静状态下进行临床 MRI 扫描。
邀请在艾伯塔省儿童医院接受临床 MRI 扫描的 3-7 岁儿童参与，并随机分为三组：家庭准备材料组、儿童生活专家培训组（无模拟 MRI）或儿童生活专家模拟 MRI 培训组。培训在 MRI 前几天进行。自我和家长报告的功能（PedsQL VAS）在培训前后（对于两个培训组）和 MRI 前后进行评估。扫描成功由儿科放射科医生确定。
总体而言，91%（111/122）的儿童成功完成了清醒 MRI。模拟扫描仪组（89%，32/36）、儿童生活组（88%，34/39）和家庭组（96%，45/47）之间没有显著差异（P=0.34）。各组总功能评分相似；然而，模拟扫描仪组在 MRI 前的自我报告恐惧（F=3.2，P=0.04）、家长报告悲伤（F=3.3，P=0.04）和担忧（F=3.5，P=0.03）方面得分明显较低。扫描不成功的儿童年龄较小（4.5 岁 vs. 5.7 岁，P<0.001）。
大多数幼儿可以耐受清醒 MRI 扫描，不需要常规麻醉。所有测试的准备方法，包括家庭准备材料，都是有效的。
