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Cited by 138Advanced MRI Techniques and ApplicationsFetal and Pediatric Neurological DisordersPediatric Pain Management Techniques

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Pediatric neuroimaging using magnetic resonance imaging during non-sedated sleep

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Dean, Douglas C., Dirks, Holly, O’Muircheartaigh, Jonathan, Walker, Lindsay, Jerskey, Beth A., Lehman, Katie, Han, Michelle, Waskiewicz, Nicole, Deoni, Sean C. L.·2014·Pediatric Radiology
DOI 10.1007/s00247-013-2752-8PMC PMC3889986
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Abstract

BACKGROUND: Etiological studies of many neurological and psychiatric disorders are increasingly turning toward longitudinal investigations of infant brain development in order to discern predisposing structural and/or functional differences prior to the onset of overt clinical symptoms. While MRI provides a noninvasive window into the developing brain, MRI of infants and toddlers is challenging due to the modality's extreme motion sensitivity and children's difficulty in remaining still during image acquisition. OBJECTIVE: Here, we outline a broad research protocol for successful MRI of children under 4 years of age during natural, non-sedated sleep. MATERIALS AND METHODS: All children were imaged during natural, non-sedated sleep. Active and passive measures to reduce acoustic noise were implemented to reduce the likelihood of the children waking up during acquisition. Foam cushions and vacuum immobilizers were used to limit intra-scan motion artifacts. RESULTS: More than 380 MRI datasets have been successfully acquired from 220 children younger than 4 years of age within the past 39 months. Implemented measures permitted children to remain asleep for the duration of the scan and allowed the data to be acquired with an overall 97% success rate. CONCLUSION: The proposed method greatly advances current pediatric imaging techniques and may be readily implemented in other research and clinical settings to facilitate and further improve pediatric neuroimaging.

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Fig. 1 Private sleeping room setup for an infant. Rooms are equipped with a crib (or bed in the case of an older child), rocking chairs, video baby monitor and snacks. Normal bedtime routines could be practiced so that children did not feel uncomfortable sleeping in a new environment
Fig. 1 Private sleeping room setup for an infant. Rooms are equipped with a crib (or bed in the case of an older child), rocking chairs, video baby monitor and snacks. Normal bedtime routines could be practiced so that children did not feel uncomfortable sleeping in a new environmentCC BY-NC · PubMed Central
Fig. 2 MRI scanner with sound-insulating foam insert (Ultra Barrier HD Composite; American Micro Industries, Chambersburg, PA, USA) being installed into the bore of the scanner. Straps are used to hold the foam insert tight to the bore of the scanner. Noise reductions of up to 20 dB can be achieved
Fig. 2 MRI scanner with sound-insulating foam insert (Ultra Barrier HD Composite; American Micro Industries, Chambersburg, PA, USA) being installed into the bore of the scanner. Straps are used to hold the foam insert tight to the bore of the scanner. Noise reductions of up to 20 dB can be achievedCC BY-NC · PubMed Central
Fig. 3 Logistics of setting up for scanning of a sleeping child. a Children fall asleep either in crib or on bed. b Once asleep, children are buckled into a MedVac immobilizer and transferred to a MRI compatible cart. c Children are then wheeled into the MRI suite (d) and moved to the MRI scanner’s bed. e Electrodynamic headphones are carefully positioned onto children’s ears and held in place using memory foam cushions. f Children are then landmarked and moved to the center of the bore for scanning
Fig. 3 Logistics of setting up for scanning of a sleeping child. a Children fall asleep either in crib or on bed. b Once asleep, children are buckled into a MedVac immobilizer and transferred to a MRI compatible cart. c Children are then wheeled into the MRI suite (d) and moved to the MRI scanner’s bed. e Electrodynamic headphones are carefully positioned onto children’s ears and held in place using memory foam cushions. f Children are then landmarked and moved to the center of the bore for scanningCC BY-NC · PubMed Central
Fig. 4 Anatomical T1-weighted and derived T1, T2, and myelin water fraction (MWF) maps from a representative 21-month-old depicting the quality of the acquired and calculated quantitative images. T2 values were calculated in voxels with T1 values below 3,500 ms
Fig. 4 Anatomical T1-weighted and derived T1, T2, and myelin water fraction (MWF) maps from a representative 21-month-old depicting the quality of the acquired and calculated quantitative images. T2 values were calculated in voxels with T1 values below 3,500 msCC BY-NC · PubMed Central
Fig. 5 Example of an inadequate scan that would necessitate either repeating or having the child return for a second visit. T1‐weighted SPGR images were acquired from a 3‐month‐old boy
Fig. 5 Example of an inadequate scan that would necessitate either repeating or having the child return for a second visit. T1‐weighted SPGR images were acquired from a 3‐month‐old boyCC BY-NC · PubMed Central
Fig. 6 Attrition rate and number of active study subjects enrolled in the longitudinal study. The number of active subjects included those whose MRI data has been acquired and subjects who are scheduled for a follow-up MRI scan. Attrition rates correspond to the attrition between follow-up visits
Fig. 6 Attrition rate and number of active study subjects enrolled in the longitudinal study. The number of active subjects included those whose MRI data has been acquired and subjects who are scheduled for a follow-up MRI scan. Attrition rates correspond to the attrition between follow-up visitsCC BY-NC · PubMed Central

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Metadata

Authors
Dean, D. C., Dirks, H., O’Muircheartaigh, J., Walker, L., Jerskey, B. A., Lehman, K., Han, M., Waskiewicz, N., & Deoni, S. C. L.
Affiliations
  • Brown University (US)
  • King's College London (GB)
Corresponding author
Dean, Douglas C.
ORCID
Venue
Pediatric Radiology
Publisher
Springer Science and Business Media LLC
Published
2013-08-06
Volume
44
Issue
1
Pages
64-72
ISSN
  • 0301-0449 (ISSN-L)
  • 1432-1998
DOI
10.1007/s00247-013-2752-8
PMC
PMC3889986
OpenAlex
W2012134441
Cited by
138
References
30
Citations by year
2026: 10 · 2025: 10 · 2024: 9 · 2023: 12 · 2022: 13 · 2021: 23 · 2020: 13 · 2019: 12 · 2018: 11 · 2017: 10 · 2016: 5 · 2015: 5 · 2014: 5
FWCI
3.87
Type
journal article
Language
en
Open access
Licence
Locations
  • Pediatric Radiology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (publishedVersion, other-oa)
Funders
  • Wellcome Trust (096195)
  • National Institute of Mental Health (R01MH087510)
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Keywords
pediatric neuroimaging, infant brain development, motion artifacts, acoustic noise reduction, immobilization, children under 4 years, longitudinal brain development
MeSH terms
Brain, Child, Preschool, Equipment Design, Humans, Image Enhancement, Infant, Magnetic Resonance Imaging, Male, Restraint, Physical, Sensitivity and Specificity, Sleep, Reproducibility of Results, Procedural Sedation, Equipment Failure Analysis, Patient Positioning, Neuroimaging

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