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Free-breathing magnetic resonance imaging with radial k-space sampling for neonates and infants to reduce anesthesia

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Abstract

Background

Conventional chest and abdominal MRI require breath-holds to reduce motion artifacts. Neonates and infants require general anesthesia with intubation to enable breath-held acquisitions.

Objective

We aimed to validate a free-breathing approach to reduce general anesthesia using a motion-insensitive radial acquisition with respiratory gating.

Materials and methods

We retrospectively enrolled children <3 years old who were referred for MRI of the chest or abdomen. They were divided into two groups according to MRI protocol: (1) breath-held scans under general anesthesia with T2-weighted single-shot fast spin-echo (SSFSE) and contrast-enhanced T1-weighted modified Dixon, and (2) free-breathing scans using radial sequences (T2-W MultiVane XD and contrast-enhanced T1-W three-dimensional [3-D] Vane XD). Two readers graded image quality and motion artifacts.

Results

We included 23 studies in the free-breathing cohort and 22 in the breath-hold cohort. The overall imaging scores for the free-breathing radial T2-W sequence were similar to the scores for the breath-held T2-W SSFSE sequence (chest, 3.6 vs. 3.2, P=0.07; abdomen, 3.9 vs. 3.7, P=0.66). The free-breathing 3-D radial T1-W sequence also had image quality scores that were similar to the breath-held T1-W sequence (chest, 4.0 vs. 3.0, P=0.06; abdomen, 3.7 vs. 3.9, P=0.15). Increased motion was seen in the abdomen on the radial T2-W sequence (P<0.001), but increased motion was not different in the chest (P=0.73) or in contrast-enhanced T1-W sequences (chest, P=0.39; abdomen, P=0.15). The mean total sequence time was longer in free-breathing compared to breath-held exams (P<0.01); however, this did not translate to longer overall exam times (P=0.94).

Conclusion

Motion-insensitive radial sequences used for infants and neonates were of similar image quality to breath-held sequences and had decreased sedation and intubation

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Authors and Affiliations

  1. Department of Radiology, Section of Pediatric Radiology, Children’s Hospital Colorado, University of Colorado Anschutz Medical Campus, 13123 East 16th Ave., Aurora, CO, 80045, USA

    Lorna P. Browne, LaDonna J. Malone, Erin K. Englund, Takashi Fujiwara, Chris Fluta & Alex J. Barker

  2. Philips Medical Systems, Best, the Netherlands

    Quin Lu

  3. Department of Pediatrics, Section of Neonatology, Children’s Hospital Colorado, Aurora, CO, USA

    Theresa R. Grover

  4. Division of Pediatric Anesthesiology, University of Colorado Anschutz Campus, 13123 East 16th Ave., Aurora, CO, 80045, USA

    Peter G. Fuhr

  5. Department of Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Alex J. Barker

Authors
  1. Lorna P. Browne
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  3. Erin K. Englund
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Correspondence to Lorna P. Browne.

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Quin Lu is an employee of Philips Healthcare. The remaining authors have no conflicts or competing interests relevant to this paper.

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Browne, L.P., Malone, L.J., Englund, E.K. et al. Free-breathing magnetic resonance imaging with radial k-space sampling for neonates and infants to reduce anesthesia. Pediatr Radiol 52, 1326–1337 (2022). https://doi.org/10.1007/s00247-022-05298-7

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  • DOI: https://doi.org/10.1007/s00247-022-05298-7

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