Purpose or Case Report: 1. To review clinical strategies for reducing the anesthesia exposure for magnetic resonance imaging exams.
2. To review magnetic resonance imaging protocols to reduce examination time.
Methods & Materials: Content Organization:

- Background information: Recent anesthesia literature suggests there are likely detrimental long term, dose dependent effects on cognitive and behavioral outcomes in infants and young children. Increased magnetic resonance imaging utilization requires better strategies to reduce such exposure.

- Preclinical strategies: Exam selection and appropriateness. Patient selection, predominantly depending on age. Selection amongst anxiolytics, sedation, and general anesthesia. Child life assessments and education prior to exams.

- Clinical strategies: Sleep deprivation, feed, swaddle, and scan in infants. Child life specialists participation in exams. Breathing instruction and exercises. Distraction techniques.

- Environmental optimization: Various themed suites and machines from different vendors.

- Protocols: Coil selection. Quiet gradients. Respiratory triggering. Radial motion averaging/correction. Signal averaging. Fast imaging. Differents ways to fill k-space, such as non-cartesian (radial), simultaneous multislice, and undersampling techniques.

- Protocol examples for specific exams and sample cases.
Results:
Conclusions: The major teaching points of this exhibit are:
1. Reiterate the potential long term effects of early anesthesia exposure.
2. Review the clinical strategies to avoid and reduce anesthesia exposure for magnetic resonance imaging examinations.
3. Provide specific protocol examples to reduce examination length.