Compliance of paediatric patients for MRI examinations.

Abstract

Magnetic resonance imaging (MRI) is an imaging modality which makes use of magnetic fields and radio waves to obtain a mathematically reconstructed image. A typical MRI scanner consists of a large circular magnet. Inside the magnet are the radiofrequency transmitter and receiver coils, as well as gradient coils to allow spatial localization of the MRI signal. The basic principles of MRI depend on the fact that the protons of certain elements (mostly hydrogen) align with the magnetic force when placed in a strong magnetic field. The lower the energy state of the protons the more they will align parallel to the magnetic field. (Hill, 2008) MRI is becoming more and more the modality of choice in nearly every part of the body; due to the high quality images obtained in three different planes and the ability to assess soft tissue characteristics, lesions and vascular pathologic conditions. It is becoming more used in cases of paediatrics due to its high diagnostic images and also as it uses no ionising radiation to obtain images. In the case of paediatrics this is a great advantage since they are more radiosensitive due to the continuous cellular development. However compliance of paediatric patients during the MRI examination is limited to the long scanning time in a noisy bore with limited space (Chan, 1999). There are different methods that can be used to get cooperation from paediatrics to avoid the use of general anaesthesia and I or sedation. Amorim et al., (2006) performed a study with the aim of using various methods to reduce the need of general anaesthesia and sedation. A test was considered as successful or not depending on the quality of the images obtained: if movement was present, the test failed, as images were not of good diagnostic quality. One way of obtaining paediatric compliance is by the use of comic books to provide information to patients in a way that they can easily understand (Marshfield Clinic, 2007). In Malta MRI examinations of paediatric patients is almost always performed under sedation. It is assumed that paediatric compliance to the requirements of the MRI examination is zero. MRI radiographers think otherwise and have been thinking of a method of how to gain paediatric patient's co-operation during MRI examinations, thus reducing sedation in a number of cases. Reducing the use of sedation reduces its risks. This study evaluates the use of comic books in the preparation of the paediatric patient and his/her parents with the aim to avoid sedation and still obtain good quality images.