For children with epilepsy, Magnetic Resonance Imaging (MRI) may be ordered to detect any damage or scar tissue in the brain that may be causing seizures. MRI scans are large, tunnel-like machines that use a large magnet, radio waves and a computer to make clear, detailed pictures of the inside of the body. MRI is painless, does not use radiation and has few known side effects. During the test, your child will lie flat on an examination table that slides into the MRI machine.
MRI uses magnetic fields and radio waves to make detailed maps of the brain. The resulting data is analyzed by a team of specialists to determine areas of the brain that are abnormal, including soft tissue and vascular structures.
Functional MRI (fMRI)
fMRI uses the same scanner as an MRI but studies different aspects of the brain. Instead of studying the structure of the brain, fMRI studies function of the brain. When a section of the brain is in use, blood flow will increase to that portion of the brain. (i.e., If a person is speaking, the part of the brain that controls language will be in use. If a person is waving, the part of the brain that controls movement will be in use.) The blood flow and oxygenation levels of the blood are recorded during a fMRI to identify areas of the brain that are not functioning optimally.
During a standard MRI test, a patient will remain completely still, while during a fMRI your child may be requested to perform a variety of tasks. Tasks such as speaking or moving will help doctors identify areas of the brain that may be causing seizure activity.
Resting-State fMRI (R-fMRI)
R-fMRI uses the same technique as a fMRI, studying blood flow in the brain, but analyzes the data when a patient is at rest, rather than performing particular tasks or function. Research has shown that when a child is at rest, certain networks are universally connected in healthy brain tissue. The purpose of this test is to study the brain in a resting state and identify any anomalies in the connectivity.
Intraoperative MRI
An intraoperative MRI is an MRI scan that is incorporated into an operating room. Intraoperative MRI is used while a patient is actively undergoing brain surgery. During surgery, neurosurgeons use the intraoperative MRI as a type of high-tech “GPS” into the brain to ensure that unhealthy tissue is completely resected and to protect healthy tissue, leaving it unharmed and in-tact.
Texas Children’s Hospital is one of the few pediatric centers in the country using intraoperative MRI during neurosurgery. To learn more about how the procedure works, please visit the Texas Children’s Epilepsy Center’s Minimally Invasive Epilepsy Surgery page.
Magnetic Resonance Spectroscopy (MRS)
MRS takes place in an MRI scan and studies the metabolic activity in the brain, specifically protons and hydrogen ions. By understanding the metabolic functions in the brain, doctors can distinguish between healthy brain tissue and abnormal brain tissue. The ability to differentiate between the tissue helps identify the source of seizure activity. If a tumor is present, an MRS scan can determine the aggressiveness of the tumor or if the tumor’s cell growth is decreasing as a result of radiation or other treatments.
Texas Children’s Department of Radiology
MRI tests are given at the Texas Children’s Department of Radiology, one of the nation’s largest and most experienced pediatric imaging departments. Our radiology department is home to the latest, most advanced technology. In addition, the radiological technicians at Texas Children’s have specialized expertise in personalized, child-friendly care.
Because Texas Children’s radiology department focus only on babies, children, and teens, we offer specialized equipment and techniques that ensure accurate and safe MRIs, including:
3T and 1.5T machines
Wide-bore 1.5T machine for larger patients
fMRI (functional MRI)
Board-certified pediatric radiologists and pediatric neuroradiologists
Specially trained technicians and support staff
A variety of tools to help your child relax during the procedure, including child-life specialists, movies and music and a soothing, child-friendly environment
Girls 6 years and above and boys 8 years and above (who are developmentally typical) will be scheduled without sedation. Texas Children’s offers motion correction for some testing sequences for children who have difficulty remaining still, which may help reduce the need for sedation.
