Purpose or Case Report: Pediatric patients are often sedated for MRI scans to ensure images are of diagnostic quality. However, access time for MRIs requiring sedation in is often long due to high patient volumes. In 2014, an MRI Try Without (MTW) program was established at our institution to facilitate eligible patients to ‘try’ their MRI without sedation with the help of a dedicated team comprised of child life specialists (CLS), radiology nurses and scheduling as well as MRI technologists. During their MTW appointment, patients and families met with a CLS who used various preparation tools and methods, such as showing videos and pictures, utilizing a mock MRI, listening to sample noises, rehearsing laying still, and choosing a movie to watch during the MRI. The goal of this program was to decrease the wait time for obtaining an MRI, while ensuring diagnostic-quality images for the interpreting radiologist.
Methods & Materials: A retrospective chart review on subjects who utilized our MTW program from April 2014 through June 2015 at a dedicated pediatric institution. CLS preparations utilized as well as the access time from when the exam was ordered versus when it was completed were recorded. MRI images were evaluated for image quality by a pediatric neuroradiologist. This study was approved by our institutional review board.
Results: A total of 107 patients participated in our MTW program. The average age was seven (SD ±1.56) years and 55 (50.5%) were male. All 107 patients received individual contact from CLS and MRI preparation utilizing teaching materials, explanation of sequence of events and sensory information prior to receiving their MRI. Eighty-four (79.2%) patients rehearsed holding still and 86 (81.8%) patients assisted in developing a coping plan for the MRI with CLS. The average number of days between when the order was placed to when the exam was completed using the MTW program was 15.91 (SD± 19.16) days versus the third-available appointment with sedation was 37 (range 0-60) days, respectively. Majority of the patients had an MRI of their brain (n=91, 83.5%) and 21 (22.1%) required contrast. Twenty (18.3%) patients required repeated sequences and 96 (88%) received a retrospective “good” (n=31, 28.4%) or “very good” (67, 61.5%) image quality rating by a pediatric neuroradiologist.
Conclusions: Our study proved that incorporating CLS in preparation for MRI examinations decreased the wait time for obtaining an MRI while still providing diagnostic-quality images.