Abstract：
BACKGROUND: The use of general anesthesia in infants involves both short-term and long-term risks. The aim of this study is to evaluate the efficacy of brain MRI without anesthesia in infants younger than 3-month-old immobilized with a pillow.
METHODS: This prospective case-control study was done in 2019. Cases were stable patients less than 3 months old who did not require ventilatory support for whom brain MRI was indicated. Patients were fed so they would fall asleep and placed in the scanner with an immobilizing pillow. Controls were clinically unstable patients matched for age and sex referred for brain MRI under general anesthesia. Three pediatric radiologists evaluated the success of the MRI study (whether it answered the clinical question), recorded whether it was necessary to repeat the study, and rated the presence of motion artifacts on a scale ranging from 1 to 4.
RESULTS: A total of 47 cases were included (28 boys and 19 girls; mean age, 31 days). Of these, 42 (89%) MRI studies were considered successful. The proportion of successful MRI studies was lower in outpatients than in inpatients (p = 0.02). The quality of MRI in cases was considered optimal in 60% and suboptimal (motion artifacts in one or two sequences) in 30%. No safety issues related with the technique were detected. The mean duration of the studies was 16.6 min (range, 6-30 min). All of the MRI studies in controls were considered successful; quality was considered optimal in 89% and suboptimal in 11%. In the first year in which we used this technique, we avoided the use of general anesthesia in 47 MRI studies in 42 newborns.
CONCLUSIONS: Brain MRI using the feed and sleep technique in infants younger than 3-month-old immobilized with a pillow can be done safely and efficaciously without general anesthesia.
METHODS: This prospective case-control study was done in 2019. Cases were stable patients less than 3 months old who did not require ventilatory support for whom brain MRI was indicated. Patients were fed so they would fall asleep and placed in the scanner with an immobilizing pillow. Controls were clinically unstable patients matched for age and sex referred for brain MRI under general anesthesia. Three pediatric radiologists evaluated the success of the MRI study (whether it answered the clinical question), recorded whether it was necessary to repeat the study, and rated the presence of motion artifacts on a scale ranging from 1 to 4.
RESULTS: A total of 47 cases were included (28 boys and 19 girls; mean age, 31 days). Of these, 42 (89%) MRI studies were considered successful. The proportion of successful MRI studies was lower in outpatients than in inpatients (p = 0.02). The quality of MRI in cases was considered optimal in 60% and suboptimal (motion artifacts in one or two sequences) in 30%. No safety issues related with the technique were detected. The mean duration of the studies was 16.6 min (range, 6-30 min). All of the MRI studies in controls were considered successful; quality was considered optimal in 89% and suboptimal in 11%. In the first year in which we used this technique, we avoided the use of general anesthesia in 47 MRI studies in 42 newborns.
CONCLUSIONS: Brain MRI using the feed and sleep technique in infants younger than 3-month-old immobilized with a pillow can be done safely and efficaciously without general anesthesia.
摘要：
背景：在婴儿中使用全身麻醉涉及短期和长期风险。这项研究的目的是评估未麻醉的3个月以下婴儿用枕头固定的脑MRI的疗效。
方法：这项前瞻性病例对照研究于2019年完成。病例为3个月以下的稳定患者，不需要通气支持，为脑MRI显示。患者被喂食，这样他们就可以入睡，并放置在带有固定枕头的扫描仪中。对照组是临床上不稳定的患者，其年龄和性别相匹配，在全身麻醉下进行脑部MRI检查。三位儿科放射科医生评估了MRI研究的成功（是否回答了临床问题），记录是否有必要重复研究，并在1到4的范围内对运动伪影的存在进行评级。
结果：共纳入47例（男28例，女19例；平均年龄，31天）。其中,42（89%）MRI研究被认为是成功的。门诊患者MRI研究成功的比例低于住院患者（p=0.02）。在病例中，MRI的质量在60％中被认为是最佳的，在30％中被认为是次优的（一个或两个序列中的运动伪影）。未检测到与该技术相关的安全问题。研究的平均持续时间为16.6分钟(范围，6-30分钟）。对照组的所有MRI研究均被认为是成功的；质量在89％中被认为是最佳的，在11％中被认为是次优的。在我们使用这种技术的第一年，在42例新生儿的47例MRI研究中,我们避免使用全身麻醉.
结论：使用喂养和睡眠技术对3个月以下用枕头固定的婴儿进行脑MRI可以安全有效地进行，无需全身麻醉。
方法：这项前瞻性病例对照研究于2019年完成。病例为3个月以下的稳定患者，不需要通气支持，为脑MRI显示。患者被喂食，这样他们就可以入睡，并放置在带有固定枕头的扫描仪中。对照组是临床上不稳定的患者，其年龄和性别相匹配，在全身麻醉下进行脑部MRI检查。三位儿科放射科医生评估了MRI研究的成功（是否回答了临床问题），记录是否有必要重复研究，并在1到4的范围内对运动伪影的存在进行评级。
结果：共纳入47例（男28例，女19例；平均年龄，31天）。其中,42（89%）MRI研究被认为是成功的。门诊患者MRI研究成功的比例低于住院患者（p=0.02）。在病例中，MRI的质量在60％中被认为是最佳的，在30％中被认为是次优的（一个或两个序列中的运动伪影）。未检测到与该技术相关的安全问题。研究的平均持续时间为16.6分钟(范围，6-30分钟）。对照组的所有MRI研究均被认为是成功的；质量在89％中被认为是最佳的，在11％中被认为是次优的。在我们使用这种技术的第一年，在42例新生儿的47例MRI研究中,我们避免使用全身麻醉.
结论：使用喂养和睡眠技术对3个月以下用枕头固定的婴儿进行脑MRI可以安全有效地进行，无需全身麻醉。
