MRI: How to perform a pediatric scan

Abstract

Magnetic resonance imaging (MRI) is rich in diagnostic information but requires optimization for use in children. The main problems are motion artifacts and poor signal-to-noise ratio (SNR). SNR is proportional to voxel volume, which must therefore not be too small, however, usually needs to be reduced compared to adult imaging to account for the finer anatomy of the child. The use of multi-channel coils with element sizes appropriate for the anatomy of interest ensures optimal baseline SNR. Longer acquisition time increases SNR (with a square-root factor), but the flip-side is that this allows more motion artifacts. Attention to patient preparation and to techniques for motion artifact reduction is therefore crucial, and the most important principles are discussed. Low SNR may in part be compensated by optimizing the image contrast by weighting (tissue and lesions T1 and T2 may differ from adults) and by using contrast agents. It is also powerful to combine different image contrasts during postprocessing. The basic principles are discussed, followed by an example scan protocol.