An MRI system for imaging neonates in the NICU: initial feasibility study

Tkach, Jean A.; Hillman, Noah H.; Jobe, Alan H.; Loew, Wolfgang; Pratt, R. G.; Daniels, Barret R.; Kallapur, Suhas G.; Kline‐Fath, Beth M.; Merhar, Stephanie L.; Giaquinto, Randy O.; Winter, Patrick M.; Liu, Yu; Ikegami, Machiko; Whitsett, Jeffrey A.; Dumoulin, Charles L.

doi:10.1007/s00247-012-2444-9

Cited by 47 publications

(67 citation statements)

References 44 publications

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“…A small-footprint 1.5-T orthopedic MRI scanner (ONI Medical Systems, currently GE Healthcare, Waukesha, WI) was previously adapted for clinical use in our NICU (17)(18)(19); the scanner's 18-cm bore can accommodate infants weighting up to approximately 4,000 g. Using this scanner, standard axial three-dimensional fast gradient echo (FGRE) images were acquired in all 18 patients (repetition time/echo time [TR/TE] z7/1.9 ms; 10 8 flip angle; 18-20 cm field of view; 3 mm slice thickness; 5-10 averages). Additionally, fast spin echo (FrFSE) images were acquired for 10 patients (TR/TE 3,000/11.6 ms; 16 cm field of view; 3 mm slice thickness; echo train length 5) and Propeller images (TR/TE 3,750/32.5 ms; 16 cm field of view; 3 mm slice thickness; echo train length 10) were acquired for 11 patients.…”

Section: Image Acquisitionmentioning

confidence: 99%

“…Pulmonary MRI of the neonate is additionally confounded by small patient size and the delicate nature of transporting a NICU patient to the scanner. To overcome the latter two challenges, we extend the application of a unique, small footprint 1.5-T MRI scanner designed by our colleagues in the Imaging Research Center at Cincinnati Children's Hospital for installation and clinical use in our NICU (17)(18)(19) to image neonatal lungs. Using this scanner, commercial MRI sequences, and quantitative analysis, we demonstrate the ability of MRI to spatially map and quantify lung pathology associated with premature birth in quietly breathing neonates.…”

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confidence: 99%

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Quantitative Magnetic Resonance Imaging of Bronchopulmonary Dysplasia in the Neonatal Intensive Care Unit Environment

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Tkach²,

Higano

et al. 2015

Am J Respir Crit Care Med

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Rationale: Bronchopulmonary dysplasia (BPD) is a prevalent yet poorly characterized pulmonary complication of premature birth; the current definition is based solely on oxygen dependence at 36 weeks postmenstrual age without objective measurements of structural abnormalities across disease severity.Objectives: We hypothesize that magnetic resonance imaging (MRI) can spatially resolve and quantify the structural abnormalities of the neonatal lung parenchyma associated with premature birth.Methods: Using a unique, small-footprint, 1.5-T MRI scanner within our neonatal intensive care unit (NICU), diagnostic-quality MRIs using commercially available sequences (gradient echo and spin echo) were acquired during quiet breathing in six patients with BPD, six premature patients without diagnosed BPD, and six fullterm NICU patients (gestational ages, 23-39 wk) at near termequivalent age, without administration of sedation or intravenous contrast. Images were scored by a radiologist using a modified Ochiai score, and volumes of high-and low-signal intensity lung parenchyma were quantified by segmentation and threshold analysis.Measurements and Main Results: Signal increases, putatively combinations of fibrosis, edema, and atelectasis, were present in all premature infants. Infants with diagnosed BPD had significantly greater volume of high-signal lung (mean 6 SD, 26.1 6 13.8%) compared with full-term infants (7.3 6 8.2%; P = 0.020) and premature infants without BPD (8.2 6 6.4%; P = 0.026). Signal decreases, presumably alveolar simplification, only appeared in the most severe BPD cases, although cystic appearance did increase with severity.Conclusions: Pulmonary MRI reveals quantifiable, significant differences between patients with BPD, premature patients without BPD, and full-term control subjects. These methods could be implemented to individually phenotype disease, which may impact clinical care and predict future outcomes.

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Section: Image Acquisitionmentioning

confidence: 99%

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Quantitative Magnetic Resonance Imaging of Bronchopulmonary Dysplasia in the Neonatal Intensive Care Unit Environment

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Tkach²,

Higano

et al. 2015

Am J Respir Crit Care Med

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“…A second report from the Hammersmith team specific to neonates with BPD found higher relative proton density in BPD patients versus controls and described 2 types of parenchymal abnormalities in BPD infants: focal high-density areas and low-density, cystlike abnormalities. 43 Colleagues at Cincinnati Children's Hospital Medical Center designed and modified a small-footprint 1.5-T orthopedic MRI scanner for use in the authors' NICU, [44][45][46] and they recently reported success imaging nonsedate, free-breathing BPD patients using this scanner and standard MRI pulse sequences. 47 Stark and significant differences in parenchymal signal intensity were observed in the BPD patients compared with full-term control NICU patients (Fig.…”

Section: Conventional 1 H Mrimentioning

confidence: 97%

Newer Imaging Techniques for Bronchopulmonary Dysplasia

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Woods

2015

Clinics in Perinatology

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“…Higher magnetic field strengths provide increased signal to noise which can be used to improve temporal and/or spatial resolution. However, 3T MRI also increases artifacts, such as susceptibility and chemical shift can be used in advanced imaging such as fMRI, SWI and MRS.(16,22,28,31-37)…”

Section: Improvements and Implications Of Increased Magnetic Field Stmentioning

confidence: 99%

MRI evaluation and safety in the developing brain

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Kline‐Fath

Kanal

et al. 2015

Seminars in Perinatology

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Magnetic resonance imaging (MRI) evaluation of the developing brain has dramatically increased over the last decade. Faster acquisitions and the development of advanced MRI sequences such as magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI), perfusion imaging, functional MR imaging (fMRI), and susceptibility weighted imaging (SWI), as well as the use of higher magnetic field strengths has made MRI an invaluable tool for detailed evaluation of the developing brain. This article will provide an overview of the use and challenges associated with 1.5T and 3T static magnetic fields for evaluation of the developing brain. This review will also summarize the advantages, clinical challenges and safety concerns specifically related to MRI in the fetus and newborn, including the implications of increased magnetic field strength, logistics related to transporting and monitoring of neonates during scanning, sedation considerations and a discussion of current technologies such as MRI-conditional neonatal incubators and dedicated small-foot print neonatal intensive care unit (NICU) scanners.

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An MRI system for imaging neonates in the NICU: initial feasibility study

Cited by 47 publications

References 44 publications

Quantitative Magnetic Resonance Imaging of Bronchopulmonary Dysplasia in the Neonatal Intensive Care Unit Environment

Quantitative Magnetic Resonance Imaging of Bronchopulmonary Dysplasia in the Neonatal Intensive Care Unit Environment

Newer Imaging Techniques for Bronchopulmonary Dysplasia

MRI evaluation and safety in the developing brain

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