Comparison of neonatal MRI examinations with and without an MR-compatible incubator: Advantages in examination feasibility and clinical decision-making
Z. Rona, K. Klebermass, F. Cardona, C.D. Czaba, P.C. Brugger, M.Weninger, A. Pollak, D. Prayer; European Journal of Paediatric Neurology 14 (2010) 410-417
Abstract
Purpose: To assess the utility of an MRI-compatible incubator (INC) by comparing.
- The frequency of MR examinations done in 18 months periods each in unstable newborns with suspect central-nervous system (CNS) problems,
- The respective expenditure of time, and
- The amount of necessary sedatives with and without the INC.
Methods: In a retrospective study, the clinical and radiological aspects of 129 neonatal MRI examinations during a 3 year period were analyzed. Routine protocols including fast spinecho T2-weighted (w) sequences, axial T1w, Gradient-echo, diffusion sequences, and 3D T1 gradient-echo sequences were performed routinely, angiography and spectroscopy were added in some cases. Diffusion-tensor imaging was done in 50% of the babies examined in the INC and 26% without INC. Sequences, adapted from fetal MR-protocols were done in infants younger than 32 gestational weeks. Benefit from MR-information with respect to further management was evaluated.
Results: The number of the examinations increased (30e99), while the mean age (43e38, 8 weeks of gestational age) and weight (3308e2766 g) decreased significantly with the use of the MR-compatible incubator. The mean imaging time (34, 43e30, 29 min) decreased, with a mean of one additionally performed sequence in the INC group. All infants received sedatives according to our anaesthetic protocol preceding imaging, but a repeated dose was never necessary (10% without INC) using the INC. Regarding all cases, MR-based changes in clinical management were initiated in 58%, while in 57% of cases the initial ultrasound diagnosis was changed or further specified.