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Free keywords:
Brain, children, hydrocephalus, magnetic resonance imaging, real-time magnetic resonance imaging, ultrafast magnetic resonance imaging
Abstract:
Background
Conventional MRI sequences are often affected in neuropediatric imaging by unavoidable movements. Therefore,
children younger than 6 years usually have to be examined under sedation/anesthesia. A new real-time MRI technique with
automatic slice advancement allows for motion-robust T2-weighted volume coverage of the whole brain within a few seconds in
adults.
Objective
To evaluate to which extent the new volume coverage method can be used to visualize cerebrospinal fluid and reduce the need for anesthesia in children.
Materials and methods
We assessed 30 children ages 6 years and younger with suspected or proven hydrocephalus, hygroma or
macrocephalus using volume coverage sequences with 20 slices per second in three planes. If necessary, a parent was placed in
the bore together with the child for calming and gentle immobilization. We compared visualization of cerebrospinal fluid spaces
and course of the shunt catheter in volume coverage sequences vs. fast spin-echo sequences.
Results
The clinical issue could be sufficiently assessed in all children with use of volume coverage sequences, whereas conventional fast spin-echo sequences performed moderately to poorly. Visualization of the tip of a shunt failed in 16% of volume coverage scans and 27% of turbo spin-echo scans. A subsequent examination under anesthesia was never necessary. None of the examinations had to be stopped prematurely.
Conclusion
The motion-robust volume coverage sequences with T2-type contrast can be used to avoid sedation of children in the
evaluation of cerebrospinal fluid spaces, even in the presence of vigorous motion. For other indications and contrasts, the
technique must still be evaluated.
