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Reducing Sedation and Anesthesia in Pediatric Radiology

A Degnan1*, G El Fakhri2*, R MacDougall3*, S Brady4*, (1) Children's Hospital of Philadelphia, Philadelphia, PA, (2) Massachusetts General Hospital, Boston, MA, (3) Boston Children's Hospital, Boston, MA, (4) Cincinnati Childrens Hospital Med Ctr, Cincinnati, OH





Presentations

(Thursday, 7/18/2019) 7:30 AM - 9:30 AM

Room: 221CD

Sedation and anesthesia are frequently used in pediatric hospitals as patients are scared, very sick and otherwise unable to remain still for the duration of the imaging exam. The effects of general anesthesia (GA) on young patients is an area of active research but several studies have demonstrated adverse cognitive effects for the youngest patients (<3 years old). Consequently, efforts to minimize the use of GA should be a priority in pediatric radiology department with the same level of priority as reduction in radiation exposure.

In this education session, a variety of tools approaches are presented to reduce sedation/GA for pediatric patients. Methods are categorized by 1) patient preparation, 2) image acquisition and c) age reconstruction.

Learning Objective 1. Understand methods of patient preparation. Patient preparation should start as soon as the exam has been ordered and can include at-home simulation tools to acclimate the patient to the imaging equipment (e.g. CT and MRI scanner). The day of exam, additional tools including mock scans, virtual reality and interaction with a child life specialist can help prepare the patient before the scan.

Learning Objective 2. Understand state-of-the-art methods for fast Image acquisition: During the imaging exam, fast acquisition techniques (so called "fast scans") for MRI and CT should be employed to reduce motion artifacts. Examples include high pitch or volumetric protocols for CT and single shot, sparse data MRI protocols. Technical details of such imaging techniques and protocols will be reviewed in detail.

Learning Objective 3. Image reconstruction techniques. Techniques for reconstruction motion-corrupted data are introduced and technical details are reviewed. Devices to track motion in real time will be introduced and preliminary results presented.

Handouts

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