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Publications

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.

  1. The frequency of MR examinations done in 18 months periods each in unstable newborns with suspect central-nervous system (CNS) problems,
  2. The respective expenditure of time, and
  3. 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.

A. Panigrahy, S. Blüml; Top Magn Reson Imaging. 2007 Feb;18(1) :3-29.

Abstract

Magnetic resonance (MR) imaging has become an essential tool in the evaluation of neonatal encephalopathy. Magnetic resonance-compatible neonatal incubators allow sick neonates to be transported to the MR scanner, and neonatal head coils can improve signal-to-noise ratio, critical for advanced MR imaging techniques. Refinement of conventional imaging techniques include the use of PROPELLER techniques for motion correction. Magnetic resonance spectroscopic imaging and diffusion tensor imaging provide quantitative assessment of both brain development and brain injury in the newborn with respect to metabolite abnormalities and hypoxic-ischemic injury. Knowledge of normal developmental changes in MR spectroscopy metabolite concentration and diffusion tensor metrics is essential to interpret pathological cases. Perfusion MR and functional MR can provide additional physiological information. Both MR spectroscopy and diffusion tensor imaging can provide additional information in the differential of neonatal encephalopathy, including perinatal white matter injury, hypoxic-ischemic brain injury, metabolic disease, infection, and birth injury.

Ariel Prager, Sudipta Roychowdhury; Indian Journal of Pediatrics 2007 ;74 ;173-184

Abstract

Magnetic resonance (MR) imaging has become an essential tool in the evaluation of neonatal encephalopathy. Magnetic resonance-compatible neonatal incubators allow sick neonates to be transported to the MR scanner, and neonatal head coils can improve signal-to-noise ratio, critical for advanced MR imaging techniques. Refinement of conventional imaging techniques include the use of PROPELLER techniques for motion correction. Magnetic resonance spectroscopic imaging and diffusion tensor imaging provide quantitative assessment of both brain development and brain injury in the newborn with respect to metabolite abnormalities and hypoxic-ischemic injury. Knowledge of normal developmental changes in MR spectroscopy metabolite concentration and diffusion tensor metrics is essential to interpret pathological cases. Perfusion MR and functional MR can provide additional physiological information. Both MR spectroscopy and diffusion tensor imaging can provide additional information in the differential of neonatal encephalopathy, including perinatal white matter injury, hypoxic-ischemic brain injury, metabolic disease, infection, and birth injury.

Beth Miller; New England Journal of Medicine 355;685-94. Aug. 17, 2006.

Abstract

A Washington University pediatrician at St. Louis Children’s Hospital has found that performing MRI scans on pre-term infants’ brains assists dramatically in predicting the babies’ future developmental outcomes.

Laura A. Stokowski, RN, MS et al.; Advances in Neonatal Care 2005, Vol. 5, No. 1; p 14-2

Abstract

Magnetic resonance imaging (MRI) is a powerful and versatile diagnostic tool. Applications of MR technology are rapidly expanding for all patient populations, including infants receiving newborn intensive care. Millions of MR examinations have been conducted without incident or harm, yet rare accidents in the MR environment continue to occur. The infant is vulnerable to many of the potential hazards of MRI, including projectile accidents, radiofrequency electromagnetic field effects, noise hazards, physiologic instability, and adverse effects of transport, positioning, handling, and sedation. The MRI-compatible incubator is a promising means for safe imaging of smaller and less stable infants than previously possible. Proper education of staff and meticulous attention to detail in preparing the infants for MR examinations are the keys to safety during neonatal MRI.

Stefan Blüml, Philippe Friedlich, Stephan Erberich, John C. Wood, Istvan Seri, Marvin D. Nelson; Radiology 2004; 231:594-601; © 2004 RSNA

Abstract

To meet the needs of term and preterm neonates undergoing magnetic resonance (MR) imaging, an MR-compatible incubator with air, temperature, and humidity regulators and integrated radiofrequency coils was evaluated. Nine brain, tow cardiac, and two pelvic examinations were performed by using a 1.5-T clinical MR imaging unit. The axillary temperature of the newborns varied by less than 0.8°C, their vital signs remained stable, and no complications were encountered. The diagnostic quality of images obtained with the MR-compatible incubator was superior to that of images obtained with the standard MR imaging equipment. The use of an MR-compatible incubator for examinations of ill neonates is feasible and safe and yields excellent MR images.