Neonatal brain and body imaging in the MR-compatible incubator

Abstract

Background. The use of a specialized MR-compatible incubator (INC) is very poorly described in the literature and only with regard to brain imaging. Objectives. To present our own experience with brain and body magnetic resonance imaging (MRI) in the INC in a large cohort of neonates. Material and methods. A total of 555 examinations were performed in 530 newborns with the use of a 1.5T system and Nomag IC 1.5 incubator, equipped with head and body coils. Results. More than half of neonates (54%) were prematurely born at 22 + 6-36 + 6 gestational weeks. They were examined from the first to 153 days of life (median: 18.5, mean: 37.7) with body weights 600-5000 g (mean: 3051 g), 23% of less than 2500 g. The proportion of brain MRIs to other body regions was 533:85 = 86%:14%. In 36.6% of cases, MRI showed more abnormalities than ultrasound (USG), in a further 21.8%, MRI diagnosis was completely different, in 4.7%, a pathology described on a USG was ruled out on MRI. The superiority of MRI over USG was 63. 1%. Conclusions. MR-compatible incubator significantly increased the availability of MRI to newborns, especially to premature and unstable newborns. The integration of body coils into the INC increased the spectrum of examinations and made possible the scanning not only of the brain but also the body. Dedicated neonatal coils improved image quality and allowed more accurate diagnosis than the previously used adult coils. Immobilization of the babies in the INC by means of Velcro belts and head fixation inserts is better than in adult coils. The closed space of the INC isolates newborns to a greater extent from the negative influence of noise in the MR environment.

Comprehensive Neonatal Cardiac, Feed and Wrap, Non‐contrast, Non‐sedated, Free‐breathing Compressed Sensing 4D Flow MRI Assessment

“…Due to acquiring our MRI compatible incubator during the study course, we could show as a secondary finding that our completion rate was improved, compared to when using the bassinet. This is in keeping with neonatal neuroimaging studies using an MRI-compatible incubator, which have shown shorter image acquisition time and improved image quality, potentially explained by enhanced noise cancellation [33][34][35] as well as externally controlled consistent ambient temperature for the neonate in the incubator.…”

Hypoxic-Ischemic Encephalopathy (HIE): Diagnostic, And Therapeutic Strategies: Clinical review

“…ROS-mediated molecular networks, like PI3K-Akt-mTOR, TLR-4, IGF, MAPK, and AMPK, rely upon a several distinct mechanisms including catalase or caspase activation of autophagy-related genes, and disturbances in the mitochondrial electron transport chain [55]. In any case, oxidative stress mediated autophagy in HIE stays dubious, and whether there is a beneficial or detrimental role of autophagy relies upon whether intracellular stresses have been resolved [56].…”

“…Neuroimaging is significant in determining the etiology of neonatal encephalopathy, guiding clinical decision making, giving prognosis after hypoxic ischaemic injury and informing risk management and medico-legal proceedings [56].…”

“…Cranial ultrasonography is important in identifying different causes for neonatal encephalopathy, for example, congenital anomalies as well as recognizing cerebral haemorrhages and antenatal brain injury. In HIE normal cranial ultrasound findings can be reassuring whereas anomalies in the thalamus and basal ganglia have been associated with adverse outcome [57]. Notwithstanding, predictive accuracy is poor, (sensitivity 0.76 95%CI 0.3-0.97, specificity 0.55 95% CI 0.39-0.7) [58,59].…”

“…MR imaging has been displayed to have greater diagnostic and prognostic accuracy than grey scale ultrasonography and is presently considered the imaging modality of choice in neonatal encephalopathy (NE) [56,67]. CT imaging ought to be limited to emergency situations where there is proof of birth trauma and urgent imaging is required on the grounds that acute neurosurgical intervention is being considered.…”