Smith Alyssa E, Lewis Josiah B, Zhang Jingyi, Dedkov Igor, Roberts Heather, Streb Madison, Binkley Michael M, Mirro Amy, Rutlin Jerrel, Giourgas Barbra, Shimony Joshua S, Fields Melanie E, Guilliams Kristin P
Washington University in St. Louis, 660 S Euclid Ave MSC 8111-43-1260, St Louis, MO, 63110, United States.
Saint Louis University, St Louis, United States.
Pediatr Radiol. 2025 Aug 13. doi: 10.1007/s00247-025-06350-y.
Unsedated MRI use in pediatric clinical and research settings is often feasible, but advanced imaging techniques like cerebrovascular reactivity (CVR) may affect tolerability of unsedated MRIs. Exogenous carbon dioxide (CO) provides a CVR vasodilatory challenge, but its impact on unsedated children's MRI tolerability is unknown.
We hypothesized that children would tolerate MRI with exogenous CO as well as children undergoing only MRI.
Children with and without sickle cell disease and/or reactive airway disease participated in prospective, single-site unsedated MRI observational studies and completed a post-scan questionnaire. A RespirAct® device delivered CO during the scan for MRI-measured CVR. Head displacement across frames quantified motion. Tolerability was defined as MRI study completion without lasting symptoms or serious adverse events.
One-hundred children participated, with a median age of 14.0 years [11.0, 16.3]. Sickle cell disease and/or reactive airway disease was present in 35% (35/100) and 16% (16/100), respectively. CVR sessions occurred in 75 participants, while 25 had MRI only. All children tolerated and completed the scans; 77% (58/75) had usable CVR data. Motion was similar between those with and without CVR (P=0.33). Children undergoing CVR were more likely to report symptoms, mainly shortness of breath (42/75 vs 3/25; P<0.001), compared to MRI only. Eleven children reported mild, temporary symptoms post-CVR scan; all resolved within a few hours. No serious adverse events occurred. Three children (CVR group) reported unwillingness to repeat the scan.
Children tolerate MRI with exogenous CO for CVR measurement with mild, predictable transient symptoms.
在儿科临床和研究环境中，不使用镇静剂进行MRI检查通常是可行的，但诸如脑血管反应性（CVR）等先进成像技术可能会影响不使用镇静剂的MRI检查的耐受性。外源性二氧化碳（CO）可提供CVR血管舒张挑战，但其对不使用镇静剂的儿童MRI耐受性的影响尚不清楚。
我们假设儿童对使用外源性CO的MRI检查的耐受性与仅接受MRI检查的儿童相同。
患有和未患有镰状细胞病和/或反应性气道疾病的儿童参与了前瞻性、单中心不使用镇静剂的MRI观察性研究，并完成了扫描后问卷调查。在扫描过程中，使用RespirAct®设备输送CO以进行MRI测量的CVR。通过帧间头部位移来量化运动。耐受性定义为完成MRI检查且无持续症状或严重不良事件。
100名儿童参与研究，中位年龄为14.0岁[11.0, 16.3]。镰状细胞病和/或反应性气道疾病的发生率分别为35%（35/100）和16%（16/100）。75名参与者进行了CVR检查，25名仅进行了MRI检查。所有儿童均耐受并完成了扫描；77%（58/75）获得了可用的CVR数据。进行CVR检查和未进行CVR检查的儿童的运动情况相似（P=0.33）。与仅进行MRI检查的儿童相比，进行CVR检查的儿童更有可能报告症状，主要是呼吸急促（42/75 vs 3/25；P<0.001）。11名儿童在CVR扫描后报告了轻微的、暂时的症状；所有症状均在数小时内缓解。未发生严重不良事件。3名儿童（CVR组）表示不愿意重复扫描。
儿童对使用外源性CO进行CVR测量的MRI检查耐受性良好，仅出现轻微的、可预测的短暂症状。
