Cardiovascular magnetic resonance: Diagnostic utility and specific considerations in the pediatric population

Table 1 Tips for a successful pediatric cardiovascular magnetic resonance scan

Before the scan

Begin preparation for the scan well in advance of the appointment

If multiple children from the same family require scans (such as when screening for hereditary conditions), where possible arrange for all children to be scanned at a similar time (ideally on the same day) so they can prepare together

Discuss the procedure with the child in an age-appropriate manner and provide parents with a detailed description of the procedure so they can be of assistance

Play therapists can help prepare the child by talking them through pictures of the scan, and using dummy scanners to practice lying still and breath-holding

Arranging a pre-scan visit to the CMR department and allowing the child to see the scanner before their scheduled appointment may help reduce anxiety

Perform a full metal screen on parents so that they can demonstrate going into the scanner if the child is anxious, and so that they can remain in the room for the duration of the scan to reassure the child if necessary

Some modern scanners have MRI compatible audio-visual equipment, where this is available allow the child to pre-select their own music or movie to play during the scan (ideally bringing a favourite one from home) – this may help them tolerate longer scanning times

Within reason, allocate a lengthier appointment for the scan to give the child time to get accustomed to the magnet, coils, ear protection and breath-holding instructions

During the scan

Be patient and flexible

Minimize the time the child must spend in the scanner by only running sequences that will directly answer the relevant clinical questions

Run the most essential sequences first bearing in mind that the child may not tolerate the whole scan

For a breath-holding child, use short sequences only as they may struggle with a long breath-hold

An inspiratory breath-hold is easier for a child to understand and achieve compared to an end-expiratory breath-hold

For stress perfusion studies provide the child with a stress ball that can be repeatedly squeezed during administration of the stress agent to minimize side effects (61)

After the scan

Praise and reward the child with stickers and certificates even if the scan was not entirely successful, bearing in mind that for many conditions repeat scanning may be required in future so all attempts to alleviate bad experiences should be made