Brain Perfusion, Hippocampal Volumetric, and Diffusion-weighted Imaging Findings in Children with Prolonged Febrile Seizures and Focal Febrile Seizures

Application of eye and hand interventions in brain magnetic resonance imaging of young children

Objective

To explore the feasibility of eye and hand interventions in young children during brain magnetic resonance imaging (MRI).

Methods

A total of 414 4- to 6-year-old children who underwent brain MRI at our hospital were randomly divided into 4 groups: the routine posture group (n = 105), eye mask group (n = 102), fixed hand apron group (n = 108), and eye mask and fixed hand apron group (n = 99). All the children underwent brain MRI when they were awake (without using sedatives). The success rate of brain MRI and the quality of brain MR images were compared among the four groups.

Results

The success rate of brain MRI was the highest in the eye mask and fixed hand apron group (94.9 %), followed by the eye mask group (85.3 %) (P < 0.05). The brain MR image quality was the best for children wearing eye masks and fixed hand aprons (5 points, 69 patients), followed by those wearing eye masks (5 points, 53 patients) (P < 0.05).

Conclusion

When children undergo brain MRI, simultaneous eye and hand interventions can greatly improve the success rate of the examination and the quality of MR images. This study protocol was registered at the Chinese clinical trial registry (ChiCTR2100050248).

Vascular topology and blood flow are acutely impacted by experimental febrile status epilepticus

Febrile status epilepticus (FSE) is an important risk factor for temporal lobe epilepsy and early identification of those at high risk for epilepsy is vital. In a rat model of FSE, we identified an acute (2 hrs) novel MRI signal where reduced T2 relaxation values in the basolateral amygdala (BLA) predicted epilepsy in adulthood; this T2 signal remains incompletely understood and we hypothesized that it may be influenced by vascular topology. Experimental FSE induced in rat pups reduced blood vessel density of the cortical vasculature in a lateralized manner at 2 hrs post FSE. Middle cerebral artery (MCA) exhibited abnormal topology in FSE pups but not in controls. In the BLA, significant vessel junction reductions and decreased vessel diameter were observed, together with a strong trend for reduced vessel length. Perfusion weighted MRI (PWI) was acutely increased cerebral blood flow (CBF) in cortex, amygdala and hippocampus of FSE pups that correlated to decreased T2 relaxation values compared to controls. This is consistent with increased levels of deoxyhemoglobin associated with increased metabolic demand. In summary, FSE acutely modifies vascular topological and CBF in cortex and BLA that may underlie acute MRI signal changes that predict progression to future epilepsy.