ORIGINAL RESEARCH article

Front. Pediatr.

Sec. General Pediatrics and Pediatric Emergency Care

Volume 13 - 2025 | doi: 10.3389/fped.2025.1559935

This article is part of the Research TopicNovel targets in pediatrics: advances in diagnostic and therapeutic approachesView all 13 articles

Parental presence improves pediatric MRI success without sedation: a prospective randomized study

Provisionally accepted
Hideyuki  IwayamaHideyuki Iwayama1*Noriko  HayataNoriko Hayata1Mizuki  TakagiMizuki Takagi1Ryohei  FukatsuRyohei Fukatsu1Kohei  KawaharaKohei Kawahara1Hiroaki  SomiyaHiroaki Somiya1Jun  SadaJun Sada1Shingo  NumotoShingo Numoto1Kiyoshi  YamakawaKiyoshi Yamakawa1Ryosuke  MiyamotoRyosuke Miyamoto1Hiromitsu  MoriHiromitsu Mori1Taichiro  MutoTaichiro Muto1Hirokazu  KurahashiHirokazu Kurahashi1Mio  AndoMio Ando1Makoto  EndoMakoto Endo1Wataru  OhashiWataru Ohashi1Sachiko  KitagawaSachiko Kitagawa2Yoshinori  ItoYoshinori Ito1Akihisa  OkumuraAkihisa Okumura1
  • 1Aichi Medical University, Nagakute, Japan
  • 2Daiyukai General Hospital, Ichinomiya, Aichi, Japan

The final, formatted version of the article will be published soon.

Magnetic resonance imaging (MRI) requires children to remain still for extended periods, often necessitating sedation, which carries risks and raises costs. Non-pharmacologic strategies such as video goggles, evening scheduling, mock MRI training, and child life specialist-led preparation have been explored. The effectiveness of parental presence, especially in younger children, remains underexamined.This prospective, single-center, randomized controlled trial included children aged 3-10 years referred for short stature evaluation. All were admitted for GH testing and underwent pituitary MRI if peak GH was ≤6.0 ng/mL. Participants were stratified by age (3-6 and 7-10 years) and randomized to parent present or absent groups using block randomization. MRI success was assessed in three steps: Step 1, completion of all sequences; Step 2, image quality (no, mild, or severe artifacts) evaluated blindly by two pediatricians; Step 3, final success defined as completion with no or mild artifacts. Exploratory variables included sibling number and crying during routine vaccinations.Eighty children were enrolled, with 40 assigned to each group. Step 1: Completion rates were 30/40 (75.0%) in the parent present group and 22/40 (55.0%) in the parent absent group (P = 0.25). In children aged 3-6 years, completion was significantly higher in the parent present group (13/22, 59.1%) than in the parent absent group (4/22, 18.2%) (P = 0.012).Step 2: Among 52 who completed MRI, image quality was no/mild/severe artifact in 11/17/2 children (parent present) and 12/10/0 (parent absent) (P = 0.38).Step 3: Final success was achieved in 28/40 (70.0%) in the parent present group and 22/40 (55.0%) in the parent absent group (P = 0.25). In the 3-6-year subgroup, success was significantly higher in the parent present group (P = 0.012; OR = 6.50, 95% CI: 1.64-25.76). No difference was observed in the 7-10-year subgroup. Crying during vaccinations and sibling number were not associated with MRI success.Parental presence significantly improved non-sedated MRI success in children aged 3-6 years. Compared to other interventions, it is simple, safe, low-cost, and requires no specialized resources, supporting its use as a first-line strategy in younger children.

Keywords: non-sedated MRI, Parental presence, Pediatric imaging, Success rate, Randomized controlled study, image quality assessment

Received: 13 Jan 2025; Accepted: 04 Jun 2025.

Copyright: © 2025 Iwayama, Hayata, Takagi, Fukatsu, Kawahara, Somiya, Sada, Numoto, Yamakawa, Miyamoto, Mori, Muto, Kurahashi, Ando, Endo, Ohashi, Kitagawa, Ito and Okumura. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Hideyuki Iwayama, Aichi Medical University, Nagakute, Japan

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