Pediatric brain MRI without sedation: Optimization by simulation

MRI in young children often requires general anesthesia (GA) due to distress and movement. While GA in general is considered safe, its use introduces risks and logistical challenges. Recent research indicates that simulation-based preparation using a mock MRI scanner may reduce the need for GA. To evaluate the role of a mock MRI scanner in preparing children aged 3–6 years for awake brain MRI scans. Forty children aged 3–6 years scheduled for brain MRI under GA were recruited. Each child underwent a simulation session in a mock MRI scanner. Children who completed the simulation proceeded to awake MRI. Data on awake MRI performance, image quality, and scan logistics were collected. Thirty-six children (90%) successfully completed the simulation, all of whom (100%) completed the subsequent awake MRI without GA. All awake scans were diagnostically adequate. Simulation sessions effectively identified which children could tolerate awake MRI, enabling efficient scheduling and avoiding repeat scans. The remaining four (10%) children underwent MRI under GA. A mock MRI scanner integrated into a structured preparatory program appears to enable the use of awake MRI in children aged 3–6 years. This approach reduced reliance on GA, maintained image quality, and improved workflow and efficiency. These findings support the routine use of simulation-based preparation in pediatric radiology.