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Magnetic resonance imaging of neonates in the magnetic resonance compatible incubator

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: The authors present the first experience in neonatal magnetic resonance imaging (MRI) examinations using an MR compatible incubator (INC) at the Institute of Mother and Child.

Material and methods: Forty-nine examinations of 47 newborns (20 girls, 27 boys) were performed using the GE Signa HDxt 1.5T system and INC Nomag IC 1.5. Demographic data, anesthetic methods and MRI findings in the INC in comparison with previously performed imaging were analyzed.

Results: Thirty-two neonates were prematurely born (68.1%) at gestational age 23–37 weeks, mean: 29.9 weeks. They were examined at 26 weeks postmenstrual age to 1 month corrected age, mean: 37.5 weeks. Body weight of newborns on the study day was 600–4300 g, mean: 2724 g. Seventeen (34.7%) children were examined in physiological sleep, 32 (65.3%) anesthetized. In none of them did anesthesiological complications or disease worsening occur. In 43 (91.5%) children brain MRI was performed, in 4 (8.5%) MRI of the spinal cord and canal and of the abdomen/pelvis. In children prenatally examined by MRI, the INC provided new diagnostic information in 5 (83.3%) cases, in neonates studied after birth by ultrasound in 32 (82%). Magnetic resonance imaging in the INC did not entail additional knowledge in 9 (18.7%) cases.

Conclusions: The INC enables MRI in preterm newborns and those with low/extremely low body weight. These studies are necessary to assess the extent of changes in the central nervous system and other organs. Incubator coils, designed specifically for neonates, allow more accurate diagnosis than previously used coils for adults. MRI results allow one to determine prognosis, for more accurate planning of diagnostics, helping to make appropriate therapeutic decisions.

No MeSH data available.


Related in: MedlinePlus

Term female neonate examined at the age of 11 days, body weight 4300 g. The cystic mass in the midline does not show any relationship with the liver and biliary system or the ovaries
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Figure 0002: Term female neonate examined at the age of 11 days, body weight 4300 g. The cystic mass in the midline does not show any relationship with the liver and biliary system or the ovaries

Mentions: It should also be noted that although brain abnormalities are the main indication to perform MRI in neonates, it is not the only one. In our material it is illustrated by the following figures: MR imaging of the brain was performed in 91.5% of cases, and in 8.5% it was used to evaluate the spine and spinal canal, abdomen and pelvis. Technical progress allowed the incorporation in incubators not only of the coils to study the brain, but also of the coils to study the whole body of the newborn. This is the second report on the studies not only of the brain in the world literature. Among the very few – seven – original works published since 2002 and devoted to neonatal MRI studies in the INC, the absolute majority discuss only brain imaging [3, 7–12]; one cannot even say neuroimaging studies, because the term “neuroimaging” refers also to the spinal cord, and this has hitherto been unavailable to studies in the INC. Only one publication describes – among 13 MRI studies – two cardiac and two pelvic examinations in the INC [13]. In our first case which did not concern the brain an unusual pathology was found in the form of myelomeningocele under the skin of a newborn, and additionally renal agenesis, ectopic kidney and unicornuate uterus. In the second case we excluded the relationship of the abdominal cyst to the biliary ducts and ovaries and established the most probable diagnosis of gastrointestinal duplication cyst; the differential diagnosis was mesenteric cyst (Figure 2). Intraoperatively duplication of the gastrointestinal tract was confirmed. In the third case the examination showed no connection between the visible and palpable seeping thickening of the skin in the coccygeal area and vertebral canal. Low position of the medullary cone was detected at the level of the L5 vertebra with lack of hindbrain herniation. In the fourth case lipomyelomeningocele was detected in the sacral spine with a minimal fatty component in the spinal canal and a bigger one in the subcutaneous tissue with a tethered cord, without hindbrain herniation as well.


Magnetic resonance imaging of neonates in the magnetic resonance compatible incubator
Term female neonate examined at the age of 11 days, body weight 4300 g. The cystic mass in the midline does not show any relationship with the liver and biliary system or the ovaries
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016588&req=5

Figure 0002: Term female neonate examined at the age of 11 days, body weight 4300 g. The cystic mass in the midline does not show any relationship with the liver and biliary system or the ovaries
Mentions: It should also be noted that although brain abnormalities are the main indication to perform MRI in neonates, it is not the only one. In our material it is illustrated by the following figures: MR imaging of the brain was performed in 91.5% of cases, and in 8.5% it was used to evaluate the spine and spinal canal, abdomen and pelvis. Technical progress allowed the incorporation in incubators not only of the coils to study the brain, but also of the coils to study the whole body of the newborn. This is the second report on the studies not only of the brain in the world literature. Among the very few – seven – original works published since 2002 and devoted to neonatal MRI studies in the INC, the absolute majority discuss only brain imaging [3, 7–12]; one cannot even say neuroimaging studies, because the term “neuroimaging” refers also to the spinal cord, and this has hitherto been unavailable to studies in the INC. Only one publication describes – among 13 MRI studies – two cardiac and two pelvic examinations in the INC [13]. In our first case which did not concern the brain an unusual pathology was found in the form of myelomeningocele under the skin of a newborn, and additionally renal agenesis, ectopic kidney and unicornuate uterus. In the second case we excluded the relationship of the abdominal cyst to the biliary ducts and ovaries and established the most probable diagnosis of gastrointestinal duplication cyst; the differential diagnosis was mesenteric cyst (Figure 2). Intraoperatively duplication of the gastrointestinal tract was confirmed. In the third case the examination showed no connection between the visible and palpable seeping thickening of the skin in the coccygeal area and vertebral canal. Low position of the medullary cone was detected at the level of the L5 vertebra with lack of hindbrain herniation. In the fourth case lipomyelomeningocele was detected in the sacral spine with a minimal fatty component in the spinal canal and a bigger one in the subcutaneous tissue with a tethered cord, without hindbrain herniation as well.

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: The authors present the first experience in neonatal magnetic resonance imaging (MRI) examinations using an MR compatible incubator (INC) at the Institute of Mother and Child.

Material and methods: Forty-nine examinations of 47 newborns (20 girls, 27 boys) were performed using the GE Signa HDxt 1.5T system and INC Nomag IC 1.5. Demographic data, anesthetic methods and MRI findings in the INC in comparison with previously performed imaging were analyzed.

Results: Thirty-two neonates were prematurely born (68.1%) at gestational age 23–37 weeks, mean: 29.9 weeks. They were examined at 26 weeks postmenstrual age to 1 month corrected age, mean: 37.5 weeks. Body weight of newborns on the study day was 600–4300 g, mean: 2724 g. Seventeen (34.7%) children were examined in physiological sleep, 32 (65.3%) anesthetized. In none of them did anesthesiological complications or disease worsening occur. In 43 (91.5%) children brain MRI was performed, in 4 (8.5%) MRI of the spinal cord and canal and of the abdomen/pelvis. In children prenatally examined by MRI, the INC provided new diagnostic information in 5 (83.3%) cases, in neonates studied after birth by ultrasound in 32 (82%). Magnetic resonance imaging in the INC did not entail additional knowledge in 9 (18.7%) cases.

Conclusions: The INC enables MRI in preterm newborns and those with low/extremely low body weight. These studies are necessary to assess the extent of changes in the central nervous system and other organs. Incubator coils, designed specifically for neonates, allow more accurate diagnosis than previously used coils for adults. MRI results allow one to determine prognosis, for more accurate planning of diagnostics, helping to make appropriate therapeutic decisions.

No MeSH data available.


Related in: MedlinePlus