Alyssa E Smith, Josiah B Lewis, Jingyi Zhang, Igor Dedkov, Heather Roberts, Madison Streb, Michael M Binkley, Amy Mirro, Jerrel Rutlin, Barbra Giourgas, Joshua S Shimony, Melanie E Fields, Kristin P Guilliams
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Exogenous carbon dioxide (CO<sub>2</sub>) provides a CVR vasodilatory challenge, but its impact on unsedated children's MRI tolerability is unknown.</p><p><strong>Objective: </strong>We hypothesized that children would tolerate MRI with exogenous CO<sub>2</sub> as well as children undergoing only MRI.</p><p><strong>Materials and methods: </strong>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<sub>2</sub> 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.</p><p><strong>Results: </strong>One-hundred children participated, with a median age of 14.0 years [11.0, 16.3]. 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引用次数: 0
摘要
背景：在儿科临床和研究环境中使用非镇静MRI通常是可行的，但脑血管反应性（CVR）等先进成像技术可能会影响非镇静MRI的耐受性。外源性二氧化碳（CO2）提供CVR血管扩张挑战，但其对未镇静儿童MRI耐受性的影响尚不清楚。目的：我们假设儿童能够耐受外源性CO2的MRI以及仅接受MRI的儿童。材料和方法：患有或不患有镰状细胞病和/或反应性气道疾病的儿童参与前瞻性、单点非镇静MRI观察研究，并完成扫描后问卷调查。在mri测量CVR的扫描过程中，呼吸器设备会释放二氧化碳。头部位移跨帧量化运动。耐受性定义为MRI研究完成后无持续症状或严重不良事件。结果：100名儿童参与，中位年龄为14.0岁[11.0,16.3]。镰状细胞病和/或反应性气道疾病分别占35%（35/100）和16%（16/100）。75名参与者进行了CVR治疗，而25名仅进行了MRI治疗。所有儿童都容忍并完成了扫描；77%（58/75）有可用的CVR数据。有无CVR患者的运动相似（P=0.33）。接受CVR的儿童更有可能报告症状，主要是呼吸短促(42/75 vs 3/25；结论：儿童耐受外源性CO2 MRI测量CVR，具有轻度、可预测的短暂症状。
Unsedated cerebrovascular reactivity imaging is well-tolerated in children.
Background: 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 (CO2) provides a CVR vasodilatory challenge, but its impact on unsedated children's MRI tolerability is unknown.
Objective: We hypothesized that children would tolerate MRI with exogenous CO2 as well as children undergoing only MRI.
Materials and methods: 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 CO2 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.
Results: 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.
Conclusion: Children tolerate MRI with exogenous CO2 for CVR measurement with mild, predictable transient symptoms.
期刊介绍：
Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology
Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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