Abstract
Sterling cardiac magnetic resonance imaging (MRI) in newborns and children of younger age feasible only with the help of special MRI-compatible anaesthetic equipment. Aim of the study is to evaluate our experience of cardiac magnetic resonance imaging (CMRI) with contract ejection under general anesthesia (GA).
Material and methods. 54 children (29 male and 25 female) with cardiac pathology underwent CMRI with contrast ejection under GA. Age was from 2 months till 4.5 years. 2 patients were in critical state. Indications for CMRI were tactics determination in unoperated patients and surgery results evaluation during follow-up.
Results. CMRI was fully complete with no scan-interruption in all cases. Mean time was 80 (50–135) min. It should be noted, that patients with study time exceeding 120 min were arrhythmic patients from Intensive Care Unit and those with left ventricular tumor suspicion. All derived images were good, presence of metal implants did not affected image quality and further analysis.
Conclusion. CMRI is an important imaging modality that allows detailed and complex evaluation of not only cardiac structures, myocardial function and also quantitates flow which is important at surgery planning. Hence, basic condition for deriving of diagnostically significant images is patient’s quiescency which is difficult to obtain in infants and small children. In such circumstances GA or deep sedation comes out as an essential tool in investigating neonates and children of younger age.
References
- Sorensen C., Gach P., Pico H., Hugues N., Dabadie A., Desvignes C. et al. Cardiac CT or MRI in pediatric practice: Which one to choose? Diagn. Interv. Imaging. 2016; 97 (5): 513–7. DOI: 10.1016/j.diii.2016.02.006. Epub 2016 Mar 8.
- Newman B., Vasanawala S.S. Point/counterpoint: doserelated issues in cardiac CT imaging. Pediatr. Radiol. 2011; 41 (Suppl. 2): 528–33. DOI: 10.1007/s00247-011- 2153-9. Epub 2011 Aug 17.
- Fujii K., Akahane K., Miyazaki O., Horiuchi T., Shimada A., Nagmatsu H. et al. Evaluation of organ doses in CT examinations with an infant anthropomorphic phantom. Radiat. Prot. Dosimetry. 2011; 147 (1–2): 151–5. DOI: 10.1093/rpd/ncr289. Epub 2011 Jul 9.
- Dougeni E., Faulkner K., Panayiotakis G. A review of patient dose and optimisation methods in adult and paediatric CT scanning. Eur. J. Radiol. 2012; 81 (4): e665–83. DOI: 10.1016/j.ejrad.2011.05.025. Epub 2011 Jun 17.
- Young C., Taylor A.M., Owens C.M. Paediatric cardiac computed tomography: a review of imaging techniques and radiation dose consideration. Eur. Radiol. 2011; 21 (3): 518–29. DOI: 10.1007/s00330-010-2036-8. Epub 2010 Dec 28.
- Bockeria L.A., Makarenko V.N., Yurpol’skaya L.A. Magnetic resonance imaging in children with congenital heart defects: Atlas. 2nd edn. Moscow; 2015 (in Russ.).
- Sreevastava D.K., Setlur R. Anaesthesia for paediatric cardiac MRI. Med. J. Armed. Forces India. 2008; 64 (3): 204–7. DOI: 10.1016/S0377-1237(08)80092-5. Epub 2011 Jul 21.
- Odegard K.C., DiNardo J.A., Tsai-Goodman B., Powell A.J., Geva T., Laussen P.C. Anaesthesia considerations for cardiac MRI in infants and small children. Paediatr. Anaesth. 2004; 14 (6): 471–6. DOI: 10.1111/j.1460-9592.2004.01221.x
- Glazkova E.Yu., Aleksandrova S.A., Makarenko V.N. Cardiac magnetic resonance imaging in patients with prosthetic valves: Guidelines. Moscow; 2021 (in Russ.).
- Ramirez-Suarez K.I., Tierradentro-García L.O., Otero H.J., Rapp J.B., White A.M., Partington S.L. et al. Optimizing neonatal cardiac imaging (magnetic resonance/computed tomography). Pediatr. Radiol. 2022; 52 (4): 661–77. DOI: 10.1007/s00247-021-05201-w
- Muyskens S., Roshan T., Honan K., Umejiego J., Raynaud S., Ogunyankin F. Effect of general anesthesia on cardiac magnetic resonance-derived cardiac function in repaired tetralogy of Fallot. Pediatr. Cardiol. 2020; 41 (8): 1660–6. DOI: 10.1007/s00246-020-02425-9. Epub 2020 Aug 1.
- Merlocco A., Olivieri L., Kellman P., Xue H., Cross R. Improved workflow for quantification of right ventricular volumes using free-breathing motion corrected cine imaging. Pediatr. Cardiol. 2019; 40 (1): 79–88. DOI: 10.1007/s00246-018-1963-z. Epub 2018 Aug 22.
- Dong S.Z., Zhu M., Bulas D. Techniques for minimizing sedation in pediatric MRI. J. Magn. Reson. Imaging. 2019; 50 (4): 1047–54. DOI: 10.1002/jmri.26703. Epub 2019 Mar 14.
- Christopher A.B., Quinn R.E., Zoulfagharian S., Matisoff A.J., Cross R.R., Xue H. et al. Motion-corrected cardiac MRI is associated with decreased anesthesia exposure in children. Pediatr. Radiol. 2020; 50 (12): 1709–16. DOI: 10.1007/s00247-020-04766-2. Epub 2020 Jul 21.
- Deen J., Vandevivere Y., Van de Putte P. Challenges in the anesthetic management of ambulatory patients in the MRI suites. Curr. Opin. Anaesthesiol. 2017; 30 (6): 670–5. DOI: 10.1097/ACO.0000000000000513.
- Nedoma J., Fajkus M., Martinek R., Nazeran H. Vital sign monitoring and cardiac triggering at 1.5 Tesla: a practical solution by an MR-ballistocardiography fiber-optic sensor. Sensors (Basel). 2019; 19 (3): 470. DOI: 10.3390/s19030470
- Coté C.J., Wilson S. Guidelines for monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures. Pediatr. Dent. 2019; 41 (4): 259–60.
- Kamat P.P., McCracken C.E., Gillespie S.E., Fortenberry J.D., Stockwell J.A. Cravero J.P., Hebbar K.B. Pediatric critical care physician-administered procedural sedation using propofol: a report from the Pediatric Sedation Research Consortium Database. Pediatr. Crit. Care Med. 2015; 16 (1): 11–20. DOI: 10.1097/PCC. 0000000000000273
- Barton K., Nickerson J.P., Higgins T., Williams R.K. Pediatric anesthesia and neurotoxicity: what the radiologist needs to know. Pediatr. Radiol. 2018; 48 (1): 31–6. DOI: 10.1007/s00247-017-3871-4. Epub 2017 May 3.
- Boothroyd A. Magnetic resonance – its current and future role in paediatric cardiac radiology. Eur. J. Radiol. 1998; 26 (2): 154–62. DOI: 10.1016/s0720-048x(97) 00091-0
- Didier D., Ratib O., Beghetti M., Oberhaensli I., Friedli B. Morphologic and functional evaluation of congenital heart disease by magnetic resonance imaging. J. Magn. Reson. Imaging. 1999; 10 (5): 639–55. DOI: 10.1002/(sici)1522-2586(199911)10:5<639::aid-jmri7>3.0.co;2-l
- Malviya S., Voepel-Lewis T., Eldevik O.P., Rockwell D.T., Wong J.H., Tait A.R. Sedation and general anaesthesia in children undergoing MRI and CT: adverse events and outcomes. Br. J. Anaesth. 2000; 84 (6): 743–8. DOI: 10.1093/oxfordjournals.bja.a013586
About the authors
- Tat’yana V. Mataeva, Cand. Med. Sci., Radiologist, ORCID
- Svetlana A. Aleksandrova, Cand. Med. Sci., Head of Department; ORCID
- Vladimir N. Makarenko, Dr. Med. Sci., Professor, Chief Researcher; ORCID
- Mikhail M. Rybka, Dr. Med. Sci., Head of Department; ORCID
- Aleksey V. Dorofeev, Cand. Med. Sci., Head of Department; ORCID
- Andrey A. Goncharov, Anesthesiologist-Resuscitator; ORCID
