MSc projects 1112 006

Background: Attaining images of diagnostic quality can be challenging in paediatric neuroimaging as the child must lie still or be exposed to the risks of sedation or general anaesthesia. Many children with neurological conditions require repeat imaging, and multiple CT scans can lead to significant radiation exposure. Techniques to minimise movement artefact when acquiring MR data may allow diagnostic neuroimaging without anaesthetic or radiation risks.

Method: A literature search of the use of ultra-fast and PROPELLER techniques in paediatric brain imaging was undertaken to establish the imaging time, occurrence of movement artefact, need for anaesthesia, and diagnostic accuracy.

Results: Eighteen relevant studies were identified. Seven studies compared ultra-fast MR with standard MR; one study compared two ultra-fast techniques; four studies reviewed the use of ultra-fast techniques; five studies compared PROPELLER to standard MR; one study compared ultra-fast and PROPELLER MR. No studies directly compared ultra-fast or PROPELLER MR with CT. The majority of studies had low risk of bias and minimal applicability concerns on assessment with the QUADAS-2 tool. Ultra-fast techniques reduced imaging time compared to standard MR, whilst PROPELLER sequences had equal or longer imaging times compared with standard MR. Both ultra-fast and PROPELLER MR reduced movement artefact compared with standard MR. Both ultra-fast and PROPELLER techniques have been performed successfully without sedation.

Conclusions: Assessment of diagnostic accuracy of ultra-fast and PROPELLER techniques was difficult due to the heterogeneous patient populations, imaging indications, and reporting methods of studies. In hydrocephalus, both ultra-fast and PROPELLER techniques have adequate diagnostic accuracy. The use of ultra-fast or PROPELLER MR for other indications in paediatric neuroimaging requires further assessment of appropriate sequences.

• Systematic review

• Computed tomography (CT)
• Magnetic resonance (MR)

• Dr Susan Kealey

• 11-12