Gegenwärtiger Stand der funktionellen MRT bei Neugeborenen und Kindern im ersten Lebensjahr

Boecker, Henning; Scheef, Lukas; Jankowski, Jeffery J.; Zimmermann, Nicolle; Born, Michel; Heep, Andrea

doi:10.1055/s-2008-1027483

Cited by 3 publications

(2 citation statements)

References 54 publications

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“…Pancake-Reformation oder flat surface-projection), wodurch die gesamte Hirnoberfläche auf einer resultierenden Ebene abgebildet wird, kann im Einzelfall eine bessere Visualisierung suspekter Regionen erreicht werden [17,18]. Neben einer Verbesserung der räumlichen Auflösung durch hö-here Magnetfeldstärken und Weiterentwicklung von Spulensystemen kann auch die funktionelle MR-Bildgebung (fMRT) auf der Grundlage des BOLD ("Blood-oxygen-level-dependent")-Effekts hilfreiche Informationen in der Diagnostik von MKH bieten [19]. Mittels Arterial Spin Labeling (ASL) ist der zerebrale Blutfluss bestimmbar und somit kann die interiktale Hypoperfusion von epileptogenen Foci dargestellt werden [20].…”

Section: Mrt-bildgebungunclassified

Heterotopie, Polymikrogyrie, Lissenzephalie und Co – Malformationen der kortikalen Hirnentwicklung

Reiss-Zimmermann

Weber²,

Sorge³

et al. 2010

Fortschr Röntgenstr

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Migration disorders (MD) are increasingly recognized as an important cause of epilepsy and developmental delay. Up to 25 % of children with refractory epilepsy have a cortical malformation. MD encompass a wide spectrum with underlying genetic etiologies and clinical manifestations. Research regarding the delineation of the genetic and molecular basis of these disorders has provided greater insight into the pathogenesis of not only the malformation but also the process involved in normal cortical development. Diagnosis of MD is important since patients who fail three antiepileptic medications are less likely to have their seizures controlled with additional trials of medications and therefore epilepsy surgery should be considered. Recent improvements in neuroimaging have resulted in a significant increase in the recognition of MD. Findings can be subdivided in disorders due to abnormal neurogenesis, neuronal migration, neuronal migration arrest and neuronal organization resulting in different malformations like microcephaly, lissencephaly, schizencephaly and heterotopia. The examination protocol should include T 1-w and T 2-w sequences in adequate slice orientation. T 1-w turbo-inversion recovery sequences (TIR) can be helpful to diagnose heterotopia. Contrast agent is needed only to exclude other differential diagnoses.

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Section: Mrt-bildgebungunclassified

Heterotopie, Polymikrogyrie, Lissenzephalie und Co – Malformationen der kortikalen Hirnentwicklung

Reiss-Zimmermann

Weber²,

Sorge³

et al. 2010

Fortschr Röntgenstr

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“…Zwei der GK-MRT-Publikationen beschäftigten sich mit typischen Befunden und Protokollvorschlägen bei Kindern (Ley et al 2009 [12] und Schäfer et al al 2011 [13] [20]. Weitere methodische Themen, die in den vergangenen 3 Jahren publiziert wurden, sind Arbeiten zum Wert des DTI und zu Normalwerten der Diffusionsparameter am kindlichen Hirn [21], zur MRT-Diagnostik der Lunge bei Kindern [22] und zum Stand von funktionellen MRT-Untersuchungen bei Kindern im ersten Lebensjahr [23] sowie MRT-Diagnostik bei 3,0 T [24]. Die fetale MRT-Diagnostik ist in den letzten 3 Jahren zwar ein wichtiger klinischer Leistungspunkt innerhalb der pädiatri-schen Radiologie geworden, aus wissenschaftlicher Sicht wurde das Thema jedoch bisher nur zögerlich aufgegriffen [25], während bekanntermaßen in unseren Nachbarländern Öster-reich und Frankreich hier eine überaus rege wissenschaftliche Tätigkeit erkennbar ist.…”

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Ein Literatur-Review zur wissenschaftlichen Präsenz der deutschen Kinderradiologie in Publikationen der Jahre 2009 – 2011

Hirsch¹,

Sorge²

2011

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Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure

Raschle

Lee

Buechler

et al. 2009

JoVE

103

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Within the last decade there has been an increase in the use of structural and functional magnetic resonance imaging (fMRI) to investigate the neural basis of human perception, cognition and behavior 1, 2 . Moreover, this non-invasive imaging method has grown into a tool for clinicians and researchers to explore typical and atypical brain development. Although advances in neuroimaging tools and techniques are apparent, (f)MRI in young pediatric populations remains relatively infrequent 2 . Practical as well as technical challenges when imaging children present clinicians and research teams with a unique set of problems 3, 2 . To name just a few, the child participants are challenged by a need for motivation, alertness and cooperation. Anxiety may be an additional factor to be addressed. Researchers or clinicians need to consider time constraints, movement restriction, scanner background noise and unfamiliarity with the MR scanner environment 2,4-10 . A progressive use of functional and structural neuroimaging in younger age groups, however, could further add to our understanding of brain development. As an example, several research groups are currently working towards early detection of developmental disorders, potentially even before children present associated behavioral characteristics e.g.11 . Various strategies and techniques have been reported as a means to ensure comfort and cooperation of young children during neuroimaging sessions. Play therapy 12 , behavioral approaches 13,14,15,[16][17][18] and simulation 19 , the use of mock scanner areas 20,21 , basic relaxation 22 and a combination of these techniques 23 have all been shown to improve the participant's compliance and thus MRI data quality. Even more importantly, these strategies have proven to increase the comfort of families and children involved 12 . One of the main advances of such techniques for the clinical practice is the possibility of avoiding sedation or general anesthesia (GA) as a way to manage children's compliance during MR imaging sessions 19,20 . In the current video report, we present a pediatric neuroimaging protocol with guidelines and procedures that have proven to be successful to date in young children. ProtocolWe have incorporated general experimental testing guidelines as well as MRI specific approaches 12-23 into one complete neuroimaging protocol intended to guide researchers and clinicians during neuroimaging sessions with awake children as young as four years of age. First, we aim to emphasize general testing guidelines adapted for MRI examinations. Second, we provide a hands-on, step-by-step description of our neuroimaging protocol. In our experience, a single session of approximately 2.5 hours (including a maximal imaging time of 45-60 minutes) is sufficient to train and guide a child through a neuroimaging session. General GuidelinesAs in every testing session with pediatric populations, general guidelines and recommendations for how best to work with young children should be considered 24 . We highlight comfor...

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Gegenwärtiger Stand der funktionellen MRT bei Neugeborenen und Kindern im ersten Lebensjahr

Cited by 3 publications

References 54 publications

Heterotopie, Polymikrogyrie, Lissenzephalie und Co – Malformationen der kortikalen Hirnentwicklung

Heterotopie, Polymikrogyrie, Lissenzephalie und Co – Malformationen der kortikalen Hirnentwicklung

Ein Literatur-Review zur wissenschaftlichen Präsenz der deutschen Kinderradiologie in Publikationen der Jahre 2009 – 2011

Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure

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