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Magnetic Resonance Imaging (MRI)

  • MRI is a routine diagnostic imaging exam that uses a large magnet, radio waves and a computer to produce 2- and 3-dimensional images of your child's body's organs, tissues and bones.

    An MRI scan is:

    • often the imaging method of choice because it does not use ionizing radiation (x-rays)
    • a way to better evaluate various parts of the body and certain diseases that may not be assessed adequately with other imaging technologies
    • painless, since the MRI scanner takes pictures without touching your child's body
    • safe
    • interpreted by a pediatric radiologist or pediatric neuroradiologist; the results are reported to your child's physician

    How Boston Children's Hospital approaches MRI

    Performing MRIs in children poses unique challenges. The Division of MRI at Boston Children's provides a soothing, kid-friendly environment with:

    • highly trained pediatric radiologists with expertise in supervising and interpreting MRI in children of all ages
    • technologists with years of experience in imaging children and teens
    • protocols and procedures specifically for pediatric use, which means age-appropriate care for children and the best possible images for the radiologists
    • distraction techniques that include music and video goggles
    • the Try Without program, which gives 4- to 6-year-olds the chance to try to undergo their MRIs without sedation.

    Magnetic Resonance Imaging (MR or MRI)

    Boston Children's Hospital of Waltham
    300 Longwood Avenue
    Boston, MA 02115
    617-355-6400
    fax 617-730-0566

  • What is an MRI scanner and how does it work?

    An MRI scanner is a large, tube-shaped magnet that provides a strong magnetic field around your child. A radiofrequency coil is placed over the part of your child's body that needs to be imaged. The magnetic field, along with applied radiofrequency waves, temporarily alters the alignment of hydrogen protons found in water molecules within the body. Computers construct the images based on the radiofrequency signals emitted by the protons.

    Why might an MRI be needed?

    MRI is often used to obtain specific diagnostic information not already provided by other imaging technologies such as computed tomography (CT), nuclear medicine, ultrasound and x-ray.

    How should I prepare my child for the MRI scan?

    • It is helpful to give your child a simple explanation as to why she needs an MRI and assure her that you will be with her for the entire time.
    • You may want to bring your child's favorite book, toy or comforting object to use while you wait.
    • If your child will be using the video goggles or listening to music, you can bring a favorite DVD or an iPod from home. The department also has a collection of movies available.
    • During the scan the machine makes noises but will not hurt your child.

    For abdominal scans, your child may be asked to refrain from eating or drinking for four to six hours and will be required to drink a solution upon arrival before the scan begins. It is important that you follow all instructions or the scan may need to be rescheduled.

    What should I expect when I bring my child to the hospital?

    When you arrive, please go to the MRI radiology check-in desk on the second floor of the main hospital in Boston or the first floor check-in desk at our Waltham facility. An ambulatory service representative will check your child in and verify her registration information.

    We will give you a safety screening questionnaire to fill out for your child:

    • This form will ensure that your child can be safely imaged in MRI.
    • If you plan to accompany your child into the scanner room, you must also fill out a form for yourself.
    • Please bring supporting documentation of MRI safety if you or your child have had any surgical implants or devices. Delays may result if devices need to be researched. Some exams may need to be cancelled if required MRI safety information cannot be obtained.

    When your paperwork is complete:

    • A member of the MRI team will come out to the waiting room to bring you and your child to the screening room. As part of the screening, your child may be weighed or measured.
    • Your child will change into hospital pajamas.
    • You and your child will need to remove all metal objects. Lockers are available for locking up any valuables.

    Your child may be able to watch a movie or listen to music during the scan. If you brought a movie or iPod from home, you can give it to the MRI team member. Otherwise, your child can choose a movie or music from the department's collection.

    What happens during the MRI scan?

    When your child is brought into the scanner room:

    • The MRI technologist positions your child on the scanning bed. The inside of an MRI machine looks like a tunnel. It is necessary for the body part that will be scanned to be in the center of the scanner, so the technologist will move the scanner bed into the tunnel until it is appropriately positioned.
    • We give your child earplugs to protect his or her ears because the MRI machine makes loud pulsing or knocking sounds.
    • The technologist asks your child to lie still while the scan is in progress.

    An MRI technologist will perform your child's scan. You may stay in the scanner room with your child unless the MRI safety screening questionnaire indicates that it is not safe for you to do so. You will also be given earplugs to wear in the room.

    Sometimes, patients receive a substance called gadolinium during the scan, which is needed to provide additional information about some parts of the body. Gadolinium is given through an injection into your child's vein.

    MRI scans consist of several sequences of a few minutes' duration each that, in total, take anywhere from 20 to 90 minutes, depending on the information required by the radiologist and your physician. We will give you a more specific time frame before the scan begins.

    What does an MRI sound like?

    Sound 1
    Sound 2
    Sound 3
    Sound 4
    MR makes music!

    What happens after the MRI scan?

    When the MRI scan is done, your child will be ready to go home. The radiologist will review the images and create a report of the findings and diagnosis for your referring doctor.

    How do I learn the results of the MRI scan?

    The radiologist's report will be sent to the physician who requested the exam and your child's doctor will then discuss the results with you. If there is a finding on the scan that requires urgent attention, we will contact the referring physician in order to discuss the findings and plan further treatment.

  • Sedation-free MRI resonates with younger patients

    MRI (magnetic resonance imaging) is one of the safest technologies that clinicians can use to image the body for signs of illness or injury. Using a powerful magnet, radio waves and advanced imaging technology, MRI produces detailed, cross-sectional images of organs, the skeleton and soft tissues—all without radiation. But for many patients, having an MRI can be a frightening experience. First, there is the big tube or “doughnut” the head and body disappear into. Then patients must lie immobile for the 20 to 45 minutes or more that an imaging study requires. Then there’s the loud clanging, rapid tapping and thumping that a patient hears during an MRI.

    Now imagine you're a young child faced with going into the magnet. For many years, Children’s Hospital Boston has put itself in patients’ shoes, using headphones and more recently video goggles to distract older children during MRIs. Children younger than 8 years old were routinely given sedation, but in 2009, a pilot study—Try Without Sedation—was undertaken to reduce the age of children undergoing MRI without sedation to 5 years and even younger.

    According to the Director of MRI, Caroline Robson, MB, ChB, there were a number of compelling reasons to try this. “There is growing recognition among clinicians that there may be small, subtle effects of GA [general anesthesia] or sedation on the developing brains of children,” says Robson. “Eliminating unnecessary sedation or GA avoids this risk, as well as the post-anesthesia recovery period.” In addition, wait times for the limited appointments when sedation or GA is offered can be long, and the cost of administering the MRI is lower when it’s not required. “This program is very popular with parents,” says Robson. “We are providing safer care, the experience for the family is better, and the costs are lower. It is a win for everyone.” Try Without Sedation lowers the cost of an MRI by approximately $1,750.

    In Try Without Sedation, MR technologists like project leader Stephanie DeHart, RT, examine a protocoled imaging study to determine if it can be completed in the 20 to 60 minutes that best allows children to hold still. Then, during the routine pre-procedure phone screening, Margo Coakley, RN, or another MR nurse involved in the program asks parents whether they might be interested in trying the exam without sedation and if they think their child might be able to remain still for the procedure. When a child is found to be a candidate, the family is scheduled for an evening appointment, when the department is quieter and child life specialist Angela Franceschi, MEd, CCLS II, has time to prepare the child. Franceschi demonstrates the procedure with a doll and a toy MRI, and the family is able to see the magnet up close before the procedure. “I tell children that the MRI is a big camera that takes pictures of the inside of their body,” says Franceschi, “and I ask them to lie as still as a statue, because if they move, the picture will be fuzzy, just like with their parents’ camera.” Patients are given video goggles and headphones, and many bring in their own favorite movie.

    Because the appointments are in the evening, children often come in their pajamas. “We bundle them up in blankets and padding before they go into the magnet, and some sleep through the whole procedure,” says Pauline Connaughton, RT, MR technologist. “Others are wide awake and having a great time. They want to stay to see the end of the movie.”

    During the procedure, radiologists check the images to ensure the child is holding still enough to give a precise interpretation. By all measures, the program has been a success. Since its start in 2009, more than 230 children have gone through Try Without Sedation, with a 95 percent success rate. Today, the program is routinely offered to children as young as 4, and children as young as 2 and 3 have successfully gone through it.

    According to Coakley, the key to the program’s success is its team approach. “The physicians are completely in support of this, and the department gives us the time we need to prepare families in advance. Before families even arrive, a nurse and Angela have already spoken to them, sometimes several times. The MR technologists are great at making them comfortable for the procedure.”

    Patient families are pleased with whole experience and usually proud of their child for staying calm and still through the whole procedure. “With sedation, patients can’t eat for eight hours before the procedure; they are here for a couple of hours and then they have to spend one or two hours in recovery,” says DeHart. “Now when they are done, they can just get up and go. They love it.”

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