Pediatric brain disorders such as trauma, tumors, epilepsy, autism and other developmental disorders are common in children less than 5 years. These first 5 years of life are also key in the developing brain as neuronal specification and myelination occurs. During this time of rapid growth and development the brain is highly vulnerable to injury, exposures or errors in genetic expression. As with adults, MR imaging is the modality of choice for evaluating the pediatric brain yet the pediatric population is currently underserved by commercial vendors. None of the major vendors provide state-of-the-art pediatric sized head coils and third party vendors that do, use outdated technology. Due to the long scan times and likelihood of motion artifacts, MR requires sedation or anesthesia. In addition sedation and anesthesia come with risks of their own, particularly in the very young, reduces the availability of MR and increases the cost of MR scanning. As a result CT is often chosen for even though it is particularly insensitive to parenchymal abnormalities in the immature brain and comes with increased risk of radiation induced cognitive deficits. The overall goal of this project is to create age specific 32 channel head coils and accelerated motion insensitive pulse sequences which allow high quality sedation free scanning in 15 minutes for children less than 5 years of age.
The specific aims of this project are:
Specific Aim 1 : Design, develop and test 32 channel head coils for term infants, 6 month olds, 1 year olds and 2 - 4 year olds.
Specific Aim 2 : Design, develop and test motion insensitive sequences for T1 (3D FLASH) and T2 (T2 SPACE) contrast as well as Diffusion Tensor Imaging (DTI).
Specific Aim 3 : Perform a real world test of this motion insensitive accelerated protocol in 20 children less than 5 years of age. Age appropriate behavioral methods will be used to help the children undergo the 15 minute scan. We expect that these advances in coil technology and motion correction will significantly reduce imaging time and make pediatric MR imaging without sedation or anesthesia more feasible and there make MR imaging more available to our youngest and most vulnerable patients.
MR imaging is the safest and most sensitive modality for assessing brain abnormalities yet in young children because of the need for sedation or anesthesia, the risk is increased, the availability is limited and the expense is high. Decreasing scan times with pediatric specific multichannel head coils and designing motion insensitive pulse sequences would allow complete evaluation in 15 minutes instead of the current 45 minutes. These advances combined with age appropriate behavioral techniques has a high probability of making sedation free scanning possible in this young and vulnerable population.
