MRI Machine in Pediatrics
Understanding Magnetic Resonance Imaging for Children - Safety, Types, and Usage
Introduction to MRI Machines
Magnetic Resonance Imaging (MRI) is a medical imaging technology that uses powerful magnets, radio waves, and computer systems to create detailed pictures of organs, soft tissues, bones, and internal body structures. Unlike X-rays or CT scans, MRI does not use ionizing radiation, making it particularly valuable for pediatric imaging where radiation exposure is a major concern.
MRI machines are essential diagnostic tools in modern pediatric medicine, providing clear images that help doctors diagnose various conditions including brain disorders, spinal problems, joint injuries, tumors, and internal organ abnormalities without exposing children to harmful radiation.
Purpose and Clinical Applications
MRI machines serve multiple critical purposes in pediatric healthcare:
Primary Medical Uses
- Brain and Nervous System: Diagnosing epilepsy, brain tumors, developmental abnormalities, stroke, infections, and neurodegenerative conditions
- Spinal Conditions: Detecting spinal cord injuries, tumors, herniated discs, and congenital abnormalities
- Musculoskeletal System: Evaluating joint problems, sports injuries, bone infections, and growth plate disorders
- Abdominal Organs: Examining liver, kidneys, spleen, pancreas, and detecting tumors or congenital defects
- Cardiac Imaging: Assessing heart structure, congenital heart defects, and blood vessel abnormalities
- Chest Conditions: Evaluating lung masses, mediastinal tumors, and vascular malformations
Where MRI Machines Are Used
- Children's hospitals and pediatric specialty centers
- General hospitals with radiology departments
- Outpatient imaging centers
- Research institutions and academic medical centers
- Specialized neurology and orthopedic clinics
Types of MRI Machines
| Type | Description | Best For |
|---|---|---|
| Closed MRI (Traditional) | Tube-shaped magnet with patient lying inside a narrow tunnel. Field strength: 1.5T to 3T | High-quality detailed images, whole body scanning |
| Open MRI | Open on sides with magnets above and below patient. Field strength: 0.3T to 1.0T | Children with claustrophobia, larger body sizes, anxiety |
| Wide-Bore MRI | Larger diameter tunnel (70cm vs 60cm). Field strength: 1.5T to 3T | Balance between comfort and image quality |
| Extremity MRI | Small, dedicated scanner for arms, legs, hands, feet | Joint injuries, small bone imaging |
| Functional MRI (fMRI) | Specialized scanner measuring brain activity by blood flow | Brain research, pre-surgical planning, neurological studies |
How MRI Machines Work
Understanding the basic mechanism helps reduce anxiety:
- Magnetic Field: Powerful magnets align hydrogen atoms in the body in one direction
- Radio Waves: Radio frequency pulses knock these atoms out of alignment
- Signal Detection: When atoms return to normal position, they emit signals detected by the machine
- Image Creation: Computer processes these signals to create detailed cross-sectional images
- Multiple Views: Creates images in any plane (axial, sagittal, coronal) without moving the patient
User Guide: How to Use MRI for Pediatric Patients
Before the Scan: Preparation Steps
MRI requires a physician's prescription specifying the body part to be scanned and clinical indication. Schedule appointment considering child's daily routine (nap times for sedation cases).
- Complete safety questionnaire about metal implants, devices, or foreign objects
- Inform about any surgeries, medical devices, or dental work
- Disclose any allergies, especially to contrast agents
- Check if sedation or anesthesia is needed (for children under 6 years or unable to stay still)
If sedation is planned, follow fasting guidelines typically:
- No solid food: 6-8 hours before
- Clear liquids: 2-4 hours before
- Infants: Specific guidelines based on age and feeding type
- Explain procedure in age-appropriate language
- Use terms like "taking pictures inside body" instead of medical jargon
- Show pictures or videos of MRI machine beforehand
- Practice lying still at home
- Bring comfort items (if MRI-safe)
- Some centers offer mock MRI sessions for anxious children
During the Scan: Step-by-Step Process
Arrive 30-60 minutes early. Complete paperwork, verify insurance, and review safety screening again with MRI technologist.
- Change into hospital gown (no metal zippers, snaps, or decorations)
- Remove all metal objects: jewelry, watches, hairpins, glasses, hearing aids
- Remove clothing with metal threads or magnetic strips
- Leave phones, wallets, credit cards outside scanning room
- Child lies on padded scanning table (usually on back)
- Positioning depends on body part being scanned
- Foam pads or straps help child stay still
- Coil (antenna device) placed over or around area being imaged
- Earplugs or headphones provided (machine is loud)
- Emergency squeeze ball given to alert technologist if needed
Pediatric anesthesiologist or sedation specialist administers medication through:
- IV line (most common for MRI sedation)
- Oral medication (for mild sedation)
- Mask inhalation (for general anesthesia)
- Continuous monitoring throughout scan
If contrast-enhanced MRI is needed, gadolinium-based contrast is injected through IV line. This helps certain tissues show up more clearly. Administered either before scan starts or midway through.
- Table slides into MRI machine tunnel
- Technologist operates scanner from control room
- Two-way intercom allows communication
- Parent may stay in room (after metal screening) for non-sedated children
- Multiple sequences taken, each lasting 2-15 minutes
- Must remain completely still during each sequence
- Loud knocking, tapping, or buzzing sounds are normal
- Total scan time: 15-90 minutes depending on area and sequences
- Table slides out of machine
- If sedated, child moves to recovery area
- Monitoring continues until fully awake and stable
- Can resume normal activities immediately if no sedation used
- Encourage fluid intake if contrast was used
- Radiologist reviews and interprets images
- Report sent to ordering physician (usually 1-3 days)
- Doctor discusses results and treatment plan with family
- Images stored digitally and available on CD/DVD if requested
Precautions and Safety Measures
Absolute Contraindications (Cannot Have MRI)
- Cochlear implants (most types)
- Certain cardiac pacemakers and defibrillators (older models)
- Metal fragments in eyes
- Some types of cerebral aneurysm clips
- Certain metallic implants or devices not certified as MRI-safe
- Implanted nerve stimulators (some types)
Relative Contraindications (Require Evaluation)
- MRI-conditional pacemakers (newer models may be safe with precautions)
- Surgical clips, pins, screws, or plates (many are MRI-safe)
- Dental braces and retainers (usually safe but may cause image distortion)
- Insulin pumps (must be removed before scan)
- Tattoos (rarely cause issues, may have warming sensation)
- Pregnancy (especially first trimester, avoided unless medically necessary)
Sedation-Related Precautions
- Follow fasting instructions strictly to prevent aspiration
- Inform about all medications child currently takes
- Disclose any previous reactions to anesthesia or sedation
- Child must be accompanied by responsible adult for 24 hours after sedation
- No driving, operating machinery, or important decisions on sedation day
Contrast Agent Precautions
- Inform about kidney problems (contrast is filtered by kidneys)
- Blood tests may be needed to check kidney function before contrast
- Allergies to contrast agents are rare but possible
- Stay hydrated before and after contrast administration
- Breastfeeding mothers can continue nursing after gadolinium contrast
General Safety Guidelines
- Answer all screening questions truthfully and completely
- Remove all metal before entering MRI room
- Do not bring credit cards, watches, or electronics near magnet
- Inform staff immediately if child has fever or illness on scan day
- Child must inform technologist of any discomfort during scan
- Use call button or squeeze ball if feeling unwell during procedure
Potential Risks and Complications
| Risk Category | Description | Prevention |
|---|---|---|
| Metal-Related Injuries | Metal objects becoming projectiles or heating up | Thorough screening, remove all metal, check implant safety |
| Claustrophobia | Anxiety or panic in enclosed space | Open MRI option, sedation, psychological preparation |
| Noise Damage | Loud scanning sounds (up to 120 decibels) | Earplugs, headphones, hearing protection mandatory |
| Contrast Reactions | Allergic reactions, kidney problems (very rare) | Screen for allergies, check kidney function, use lowest dose |
| Sedation Complications | Respiratory depression, allergic reactions, prolonged sedation | Proper fasting, monitoring by trained staff, emergency equipment ready |
| Burns | From RF heating or metal touching skin | Remove metal, avoid skin-to-skin contact, proper positioning |
Frequently Asked Questions
Yes, MRI is very safe for children. It uses no radiation, only magnetic fields and radio waves. When proper safety screening is done and protocols are followed, MRI is one of the safest imaging methods available.
It depends on age, anxiety level, and ability to stay still. Children under 6 years typically need sedation. Older children who can follow instructions may not need it. Your doctor and radiologist will decide based on individual circumstances.
Scanning time ranges from 15 to 90 minutes depending on body area and number of sequences needed. Total appointment time including preparation and recovery is usually 2-4 hours.
If your child is not sedated, one parent can usually stay in the MRI room after completing metal screening. If child is sedated, parents wait in waiting area and join child in recovery.
No, MRI scanning itself is painless. Child may feel slight discomfort from lying still or from IV placement if contrast or sedation is used. The loud noises can be startling but not painful.
Braces, fillings, and most dental work are safe for MRI. They may cause some image distortion near the mouth but do not prevent scanning. Inform technologist about any dental implants.
If no sedation is planned, normal eating is fine. If sedation is required, fasting is mandatory (typically 6-8 hours for solids, 2-4 hours for clear liquids). Follow specific instructions provided by imaging center.
Gadolinium is a contrast agent injected through IV to enhance certain tissues on MRI. It is very safe with allergic reactions being extremely rare. It does not contain iodine. Approved for pediatric use.
Radiologist typically reviews images within 24-72 hours. Report is sent to ordering physician who will discuss results with family. Urgent findings are communicated immediately.
No. MRI is excellent for soft tissues, brain, spinal cord, and joints but other tests may be better for certain conditions. X-rays are better for bone fractures, CT for lung problems. Your doctor chooses appropriate imaging.
If child becomes too anxious, uncomfortable, or uncooperative, scan may be stopped. Options include rescheduling with sedation, using open MRI, or considering alternative imaging methods. Discuss with physician.
Alternatives include CT scan, ultrasound, or X-ray depending on clinical question. Each has different advantages. MRI is chosen when detailed soft tissue imaging without radiation is needed.
Maintaining MRI Equipment Safety
For Healthcare Facilities
- Zone System: Maintain four safety zones with increasing magnetic field strength and access restrictions
- Regular Maintenance: Schedule preventive maintenance every 3-6 months by qualified technicians
- Magnet Monitoring: Daily checks of helium levels, temperature, and magnetic field homogeneity
- Safety Equipment: Keep emergency quench button accessible, maintain fire extinguishers rated for MRI environment
- Staff Training: Annual MRI safety training mandatory for all personnel with access to scanner
- Metal Detection: Install metal detectors at entry points to scanning room
- Emergency Protocols: Establish clear procedures for patient emergencies, equipment failures, and quench situations
- Screening Process: Double-check all screening forms before allowing access to MRI room
Quality Control Measures
- Daily phantom scans to verify image quality
- Weekly checks of RF coils and cables
- Monthly evaluation of signal-to-noise ratio
- Quarterly assessment of gradient performance
- Annual comprehensive system evaluation by manufacturer
- Document all quality control results
- Calibrate monitoring equipment regularly
For Parents and Caregivers
- Choose accredited imaging centers (ACR accreditation)
- Verify facility has pediatric-specific protocols and trained staff
- Ensure facility has emergency equipment and trained personnel
- Ask about radiologist's experience in pediatric imaging
- Confirm all safety screening is thorough and repeated before scan
- Keep copy of screening form and contrast consent if applicable
Special Considerations for Pediatric MRI
Age-Specific Guidelines
| Age Group | Typical Approach | Special Considerations |
|---|---|---|
| Newborns to 3 months | Feed and wrap technique or sedation | Natural sleep after feeding, specialized neonatal coils, temperature regulation |
| 3 months to 6 years | Usually requires sedation or general anesthesia | Cannot follow instructions, movement risk high, safety monitoring critical |
| 6 to 12 years | May cooperate without sedation with preparation | Child life specialists helpful, practice sessions, reward systems work well |
| 12 years and older | Usually cooperative without sedation | Address anxiety, explain clearly, allow questions, respect privacy |
Children with Special Needs
- Extra preparation time may be needed
- Visual schedules and social stories can help
- Sensory-friendly approaches for children with autism
- Communication with familiar caregivers is essential
- Consider sedation even for older children if needed
- Allow comfort items if MRI-safe
- Extended time slots may be necessary
International Considerations
MRI availability and protocols vary globally:
- High-income countries: Most major hospitals have MRI. Wait times range from same-day to several weeks
- Middle-income countries: MRI available in urban centers, may require travel. Cost varies significantly
- Low-income countries: Limited MRI availability, often concentrated in capital cities. Alternative imaging may be used
- Sedation practices: Vary by country. Some nations use less sedation, relying more on child preparation techniques
- Cost coverage: Universal healthcare countries typically cover medically necessary MRI. Private insurance or out-of-pocket payment required in others
Cost and Insurance Considerations
- MRI costs vary widely: typically $400 to $3500 depending on country, facility type, and body area
- Pediatric MRI with sedation costs more than standard MRI
- Hospital-based MRI generally more expensive than outpatient centers
- Insurance pre-authorization usually required
- Check if facility is in-network with insurance plan
- Ask about payment plans if paying out-of-pocket
- Emergency MRI may have different coverage rules
- Contrast administration and sedation may be billed separately
When to Contact Healthcare Provider
- Child develops fever or illness before scheduled scan
- New medical condition or surgery occurs between scheduling and scan date
- Child receives any new implants or medical devices
- Pregnancy is discovered before scan (for adolescent girls)
- Any concerns about metal fragments or foreign objects
- Previous reaction to MRI contrast agents
- Difficulty breathing or persistent cough after sedation
- Severe allergic reaction (hives, swelling, difficulty breathing)
- Excessive drowsiness lasting beyond expected recovery time
- Severe headache, nausea, or vomiting
- Skin burns or unusual pain at any site
- Any unexpected or concerning symptoms
Additional Resources
Recommended Reading
- Books: "MRI: The Basics" by Ray Hashemi and William Bradley (medical reference), "My MRI Adventure" by Kenneth Redding (children's book)
- Professional Guidelines: American College of Radiology (ACR) MRI Safety Guidelines, American Academy of Pediatrics Section on Radiology
- Online Resources: RadiologyInfo.org (patient education), American College of Radiology website, Society for Pediatric Radiology
What to Bring on MRI Day
- Doctor's prescription or referral
- Insurance cards and identification
- List of current medications
- Previous imaging studies if available
- Completed screening forms
- MRI-safe comfort item for child (soft toy without metal)
- Change of clothes
- Snacks and drinks for after procedure
- Entertainment for waiting (books, tablets with downloaded content)
Medical Disclaimer
This guide provides general information about MRI machines in pediatric healthcare for educational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always seek the advice of your pediatrician, radiologist, or other qualified healthcare provider with any questions you may have regarding your child's medical condition or imaging procedures.
The information presented here is based on current medical knowledge and practices, but medical technology and protocols evolve. Always follow the specific instructions provided by your healthcare facility and medical team, as they may differ based on individual circumstances, local protocols, equipment specifications, and your child's unique medical needs.
Never disregard professional medical advice or delay seeking it because of information found in this guide. In case of medical emergency, call emergency services immediately. The authors and PediaDevices assume no liability for any injury or damage resulting from the use or misuse of information contained in this guide.
MRI safety screening is critical. Always provide complete and accurate information about your child's medical history, implants, and any metal in or on their body. When in doubt about any aspect of the MRI procedure, ask your healthcare provider.
This guide has been checked and reviewed by a qualified pediatrician to ensure medical accuracy and safety.
Last Updated: January 2026
Labels: Radiology