Advertisement

Neuroradiology

, Volume 55, Issue 10, pp 1241–1249 | Cite as

Evaluation of 100 brain examinations using a 3 Tesla MR-compatible incubator—safety, handling, and image quality

  • Selma SirinEmail author
  • Sophia L. Goericke
  • Britta M. Huening
  • Anja Stein
  • Sonja Kinner
  • Ursula Felderhoff-Mueser
  • Bernd Schweiger
Paediatric Neuroradiology

Abstract

Introduction

Several studies have revealed the importance of brain imaging in term and preterm infants. The aim of this retrospective study was to review safety, handling, and image quality of MR brain imaging using a new 3 Tesla MR-compatible incubator.

Methods

Between 02/2011 and 05/2012 100 brain MRIs (84 infants, mean gestational age 32.2 ± 4.7 weeks, mean postmenstrual age at imaging 40.6 ± 3.4 weeks) were performed using a 3 Tesla MR-compatible incubator with dedicated, compatible head coil. Seventeen examinations (13 infants, mean gestational age 35.1 ± 5.4 weeks, mean postmenstrual age at imaging 47.8 ± 7.4 weeks) with a standard head coil served as a control. Image analysis was performed by a neuroradiologist and a pediatric radiologist in consensus.

Results

All but two patients with known apnea were transferred to the MR unit and scanned without problems. Handling was easier and faster with the incubator; relevant motion artifacts (5.9 vs. 10.8 %) and the need for repetitive sedation (43.0 vs. 86.7 %) were reduced. Considering only images not impaired by motion artifacts, image quality (4.8 ± 0.4 vs. 4.3 ± 0.8, p = 0.047) and spatial resolution (4.7 ± 0.4 vs. 4.2 ± 0.6, p = 0.011) of T2-weighted images were scored significantly higher in patients imaged with the incubator. SNR increased significantly (171.6 ± 54.5 vs. 80.5 ± 19.8, p < 0.001) with the use of the incubator.

Conclusion

Infants can benefit from the use of a 3 Tesla MR-compatible incubator because of its safety, easier, and faster handling (compared to standard imaging) and possibility to obtain high-quality MR images even in unstable patients.

Keywords

MRI Incubator Infant Preterm Brain 

Notes

Conflict of interest

We declare that we have no conflict of interest.

References

  1. 1.
    De Vries LS, Van Haastert IL, Rademaker KJ, Koopman C, Groenendaal F (2004) Ultrasound abnormalities preceding cerebral palsy in high-risk preterm infants. J Pediatr 144:815–820PubMedGoogle Scholar
  2. 2.
    Krishnamoorthy KS, Kuban KC, O'Shea TM, Westra SJ, Allred EN, Leviton A, ELGAN Study Co-investigators (2011) Early cranial ultrasound lesions predict microcephaly at age 2 years in preterm infants. J Child Neurol 26:188–194PubMedCrossRefGoogle Scholar
  3. 3.
    O'Shea TM, Kuban KC, Allred EN et al (2008) Neonatal cranial ultrasound lesions and developmental delays at 2 years of age among extremely low gestational age children. Pediatrics 122:e662–e669PubMedCrossRefGoogle Scholar
  4. 4.
    Bhat V, Karam M, Saslow J, Taylor H, Pyon K, Kemble N, Stahl G, Goodman M, Aghai ZH (2012) Utility of performing routine head ultrasounds in preterm infants with gestational age 30–34 weeks. J Matern Fetal Neonatal Med 25:116–119PubMedCrossRefGoogle Scholar
  5. 5.
    Sie LT, van der Knaap MS, van Wezel-Meijler G, Taets van Amerongen AH, Lafeber HN, Valk J (2000) Early MR features of hypoxic-ischemic brain injury in neonates with periventricular densities on sonograms. AJNR 21:852–861PubMedGoogle Scholar
  6. 6.
    Maalouf EF, Duggan PJ, Counsell SJ, Rutherford MA, Cowan F, Azzopardi D, Edwards AD (2001) Comparison of findings on cranial ultrasound and magnetic resonance imaging in preterm infants. Pediatrics 107:719–727PubMedCrossRefGoogle Scholar
  7. 7.
    Childs AM, Cornette L, Ramenghi LA, Tanner SF, Arthur RJ, Martinez D, Levene MI (2001) Magnetic resonance and cranial ultrasound characteristics of periventricular white matter abnormalities in newborn infants. Clin Radiol 56:647–655PubMedCrossRefGoogle Scholar
  8. 8.
    Roelants-van Rijn AM, Groenendaal F, Beek FJ, Eken P, van Haastert IC, de Vries LS (2001) Parenchymal brain injury in the preterm infant: comparison of cranial ultrasound, MRI and neurodevelopmental outcome. Neuropediatrics 32:80–89PubMedCrossRefGoogle Scholar
  9. 9.
    Miller SP, Cozzio CC, Goldstein RB, Ferriero DM, Partridge JC, Vigneron DB, Barkovich AJ (2003) Comparing the diagnosis of white matter injury in premature newborns with serial MR imaging and transfontanel ultrasonography findings. AJNR 24:1661–1669PubMedGoogle Scholar
  10. 10.
    Inder TE, Anderson NJ, Spencer C, Wells S, Volpe JJ (2003) White matter injury in the premature infant: a comparison between serial cranial sonographic and MR findings at term. AJNR 24:805–809PubMedGoogle Scholar
  11. 11.
    Rademaker KJ, Uiterwaal CS, Beek FJ, van Haastert IC, Lieftink AF, Groenendaal F, Grobbee DE, de Vries LS (2005) Neonatal cranial ultrasound versus MRI and neurodevelopmental outcome at school age in children born preterm. Arch Dis Child Fetal Neonatal Ed 90:F489–F493PubMedCrossRefGoogle Scholar
  12. 12.
    Steggerda SJ, Leijser LM, Wiggers-de Bruine FT, van der Grond J, Walther FJ, van Wezel-Meijler G (2009) Cerebellar injury in preterm infants: incidence and findings on US and MR images. Radiology 252:190–199PubMedCrossRefGoogle Scholar
  13. 13.
    Leijser LM, de Bruine FT, van der Grond J, Steggerda SJ, Walther FJ, van Wezel-Meijler G (2010) Is sequential cranial ultrasound reliable for detection of white matter injury in very preterm infants? Neuroradiology 52:397–406PubMedCrossRefGoogle Scholar
  14. 14.
    Woodward LJ, Anderson PJ, Austin NC, Howard K, Inder TE (2006) Neonatal MRI to predict neurodevelopmental outcomes in preterm infants. N Engl J Med 355:685–694PubMedCrossRefGoogle Scholar
  15. 15.
    Krishnan ML, Dyet LE, Boardman JP, Kapellou O, Allsop JM, Cowan F, Edwards AD, Rutherford MA, Counsell SJ (2007) Relationship between white matter apparent diffusion coefficients in preterm infants at term-equivalent age and developmental outcome at 2 years. Pediatrics 120:e604–e609PubMedCrossRefGoogle Scholar
  16. 16.
    Martinez-Biarge M, Diez-Sebastian J, Kapellou O, Gindner D, Allsop JM, Rutherford MA, Cowan FM (2011) Predicting motor outcome and death in term hypoxic-ischemic encephalopathy. Neurology 76:2055–2061PubMedCrossRefGoogle Scholar
  17. 17.
    Rona Z, Klebermass K, Cardona F, Czaba CD, Brugger PC, Weninger M, Pollak A, Prayer D (2010) Comparison of neonatal MRI examinations with and without an MR-compatible incubator: advantages in examination feasibility and clinical decision-making. Eur J Paediatr Neurol 14:410–417PubMedCrossRefGoogle Scholar
  18. 18.
    Bluml S, Friedlich P, Erberich S, Wood JC, Seri I, Nelson MD Jr (2004) MR imaging of newborns by using an MR-compatible incubator with integrated radiofrequency coils: initial experience. Radiology 231:594–601PubMedCrossRefGoogle Scholar
  19. 19.
    Erberich SG, Friedlich P, Seri I, Nelson MD Jr, Bluml S (2003) Functional MRI in neonates using neonatal head coil and MR compatible incubator. NeuroImage 20:683–692PubMedCrossRefGoogle Scholar
  20. 20.
    Whitby EH, Griffiths PD, Lonneker-Lammers T, Srinivasan R, Connolly DJ, Capener D, Paley MN (2004) Ultrafast magnetic resonance imaging of the neonate in a magnetic resonance-compatible incubator with a built-in coil. Pediatrics 113:e150–e152PubMedCrossRefGoogle Scholar
  21. 21.
    O'Regan K, Filan P, Pandit N, Maher M, Fanning N (2012) Image quality associated with the use of an MR-compatible incubator in neonatal neuroimaging. Br J Radiol 85:363–367PubMedCrossRefGoogle Scholar
  22. 22.
    Merchant N, Groves A, Larkman DJ et al (2009) A patient care system for early 3.0 Tesla magnetic resonance imaging of very low birth weight infants. Early Hum Dev 85:779–783PubMedCrossRefGoogle Scholar
  23. 23.
    Born M, Scheef L, Boecker H, Heep A (2010) Cerebral MRI of preterm neonates at term equivalent age at 3 Tesla: hints at white matter damage on T2- and diffusion weighted images. Klin Padiatr 222:443–448PubMedCrossRefGoogle Scholar
  24. 24.
    Roze E, Meijer L, Van Braeckel KN, Ruiter SA, Bruggink JL, Bos AF (2010) Developmental trajectories from birth to school age in healthy term-born children. Pediatrics 126:e1134–e1142PubMedCrossRefGoogle Scholar
  25. 25.
    De Sanctis Briggs V (2005) Magnetic resonance imaging under sedation in newborns and infants: a study of 640 cases using sevoflurane. Paediatr Anaesth 15:9–15PubMedCrossRefGoogle Scholar
  26. 26.
    Pennock JM (2002) Patient preparation, safety and hazards in imaging infants and children. In: Rutherford MA (ed) MRI of the neonatal brain, 4th edn. Saunders, London, pp 3–17Google Scholar
  27. 27.
    Mathur AM, Neil JJ, McKinstry RC, Inder TE (2008) Transport, monitoring, and successful brain MR imaging in unsedated neonates. Pediatr Radiol 38:260–264PubMedCrossRefGoogle Scholar
  28. 28.
    Neubauer V, Griesmaier E, Baumgartner K, Mallouhi A, Keller M, Kiechl-Kohlendorfer U (2011) Feasibility of cerebral MRI in non-sedated preterm-born infants at term-equivalent age: report of a single centre. Acta Paediatr 100:1544–1547PubMedCrossRefGoogle Scholar
  29. 29.
    Windram J, Grosse-Wortmann L, Shariat M, Greer ML, Crawford MW, Yoo SJ (2012) Cardiovascular MRI without sedation or general anesthesia using a feed-and-sleep technique in neonates and infants. Pediatr Radiol 42:183–187PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Selma Sirin
    • 1
    Email author
  • Sophia L. Goericke
    • 1
  • Britta M. Huening
    • 2
  • Anja Stein
    • 2
  • Sonja Kinner
    • 1
  • Ursula Felderhoff-Mueser
    • 2
  • Bernd Schweiger
    • 1
  1. 1.Institute of Diagnostic and Interventional Radiology and NeuroradiologyUniversity Hospital EssenEssenGermany
  2. 2.Department of Neonatology, Division of Pediatrics IUniversity Hospital EssenEssenGermany

Personalised recommendations