MRI scan: Video projections help children overcome their fear

Interview with Prof. Stefan Rohde, Medical Director of the Department of Radiology and Neuroradiology, Clinical Center Dortmund

22/08/2016

A beautiful field of flowers, a trip to the beach or a visit to the zoo. Children can experience all of these at the Clinical Center Dortmund in a 270- degree projection on the wall. The Center created a space that is designed to help its little patients overcome their fear of MRI scans.

Image: Prof. Stefan Rohde; Copyright: Klinikum Dortmund

Prof. Stefan Rohde; © Klinikum Dortmund

In 2015, the pediatric MRI unit was distinguished with the Fundraising Award 2015 as well as the German Hospital Award. More patient-oriented projects are in the works. Director Prof. Stefan Rohde explains how all of this works.

Prof. Rohde, how does the pediatric MRI system differ from a conventional unit?

Prof. Stefan Rohde: Technically, this magnetic resonance unit does not differ considerably from the standard machine. What makes the pediatric MRI at the Clinical Center Dortmund so unique is the interior design. The magnetic resonance unit is located in a room that we can transform into a dream world with the help of several ceiling mounted beamers. On the whole, we have six different video projections available; a space or beach setting, a zoo with animals or a flower field that we implemented together with director Adolf Winkelmann from Dortmund. The MRI device itself is also illuminated. This interior design is currently the only one of its kind in the world.

How is the MRI exam performed with children?

Before the exam, the children can select the different video sequences in a preparation room which are then started by the MRI staff. This way, the child is distracted from the upcoming scan and led into a dream world when it enters the MRI room. Once inside the unit, the little patients can look out the MRI system through a mirror that’s attached to the head section and continue to watch the film in the back of the room. In doing so, we create an almost perfect illusion.

What problems did you have with previous MRI exams?

Rohde: Many children are afraid of this exam since they are confronted with a large, unknown and noisy machine. Cancer patients, in particular, need to regularly lie in this type of a magnetic resonance unit to monitor their treatment success. What’s more, some children are also claustrophobic. The biggest challenge for children is to hold still for the 20 to 30 minutes the exam takes. This is especially important to obtain the "sharp" images, radiologists need to work with. Previously, we were often only able to accomplish this if we sedated the child. Thanks to the pediatric MRI, we can minimize this added stress and do without anesthesia whenever possible.  

Image: Girl in the MRI, physician besides; Copyright: Klinikum Dortmund/Dr. Lindel
Image: MRI with green light; Copyright: Klinikum Dortmund/Dr. Lindel
Image: Children points at a screen with different motifs; Copyright: Klinikum Dortmund/Dr. Lindel
Image: Hand points at screen; Copyright: Klinikum Dortmund/Dr. Lindel
Image: Children lying in MRI, space setting; Copyright: Klinikum Dortmund/Dr. Lindel
Image: Eyes see through a device; Copyright: Klinikum Dortmund/Dr. Lindel
Image: Girl smiles in MRI, owl projection besides her; Copyright: Klinikum Dortmund/Dr. Lindel
Image: Girl in MRI, another girl and woman behind; Copyright: Klinikum Dortmund/Dr. Lindel
Image: Girl in the MRI, physician besides; Copyright: Klinikum Dortmund/Dr. Lindel
Image: Girl in MRI, another girl and woman in front of her; Copyright: Klinikum Dortmund/Dr. Lindel
Image: Girl smiles and sits on MRI; Copyright: Klinikum Dortmund/Dr. Lindel
Image: Girl in the MRI, physician besides; Copyright: Klinikum Dortmund/Dr. Lindel
Image: Girl in MRI, another girl and woman in front of her; Copyright: Klinikum Dortmund/Dr. Lindel

How are the children introduced to the impending exam?

One important element of the pediatric MRI project is the practice MRI unit in the children’s clinic where the children are first playfully introduced to the exam. Obviously, there is no conventional MRI machine in the preparation room; instead, it’s made of plastic but in a 1:1 scale. The children can practice the situation with their parents. Child psychologists and social workers observe it all and are subsequently able to determine whether the child is capable of managing an exam in the real unit without sedation.

How does the machine take away the child’s fear and anxiety?

Rohde: I believe the deciding factor is that you can practice on the plastic model beforehand so that the unknown situation is getting resolved. And of course, there is the distraction of the video installation and the softer noises. Thanks to the mirror, the patients also feel like they are being pushed out of the machine again in the back. This helps them to better cope with the cramped space. The large opening – 70 centimeters compared to the typical 55 centimeters diameter of many machines – also allows parents to lie down with their children and put their minds at ease. Especially very little children are not distracted by the video installation.

Is the unit only suited for children?

The concept is definitely also suited for adult patients who suffer from claustrophobia, dementia or disorientation because you can also distract adults with the video projection. That’s why we also use the machine for adult patients in some cases.

How do you rate the success after the launch?

Rohde: Our assessment is definitely positive. We are already able to forego between 40 and 50 percent of anesthesia for children up to ten years of age. The children like to come to our exams which was previously not the case. The parents also approve of the pediatric MRI unit. Usually, they are more worried than their children and are glad that the upcoming exam can be more relaxed and stress-free.

More information (only in German) about the pediatic MRI at: www.klinikumdo.de
Image: Lorraine Dindas; Copyright: B. Frommann

© B. Frommann

This interview was conducted by Lorraine Dindas and translated from German by Elena O'Meara.
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