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

Introduction: 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. Methods: 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. Results: 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 ( Discussion: 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.