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MR Imaging of Newborns by Using an MR-compatible Incubator with Integrated Radiofrequency Coils: Initial Experience¹

¹ From the Department of Radiology (S.B., S.E., M.D.N.) and Divisions of Neonatal Medicine (P.F., I.S.) and Cardiology (J.C.W.), Children’s Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027; and Rudi Schulte Research Institute, Santa Barbara, Calif (S.B.). Received January 31, 2003; revision requested April 21; final revision received September 17; accepted September 18. Supported by the Rudi Schulte Research Institute, Santa Barbara, Calif. Address correspondence to S.B. (e-mail: sbluml@chla.usc.edu).

View larger version (129K): [in a new window]   Figure 1. Preparation of neonatal patient for MR imaging examination. The MR-compatible incubator with the integrated neonatal RF head coil, set on a standard patient bed is shown with a patient inside and prepared for a brain examination.

View larger version (30K): [in a new window]   Figure 2. Graph of skin temperature measurements. The main purpose of the MR-compatible incubator is to maintain the neonate’s core body temperature. Skin temperature measurements versus time spent in the incubator for subjects are shown. These measurements demonstrate that the neonates were able to maintain their skin temperatures. The sudden decrease in temperature in one patient was due to a loose temperature sensor.

View larger version (134K): [in a new window]   Figure 3. MR images of the brain obtained in two 2-month-old babies: one evaluated for intracranial hemorrhage after extracorporeal membrane oxygenation (A-C) and the other examined because of increased seizure activity (D-F). A, Sagittal T1-weighted fluid-attenuated inversion-recovery (2,000/7/750 [repetition time msec/echo time msec/inversion time msec], 256 x 256 matrix, one signal acquired, echo train length of six, acquisition time of 2 minutes 8 seconds); B, transverse T2-weighted fast spin-echo (3,500/85 [repetition time msec/echo time msec], 256 x 192 matrix, two signals acquired, echo train length of 16, acquisition time of 2 minutes 48 seconds); and C, transverse fluid-attenuated inversion-recovery (9,000/120/2,200, 256 x 192 matrix, one signal acquired, acquisition time of 4 minutes 48 seconds) MR images acquired with the MR-compatible incubator (180-mm field of view, 3-mm section thickness) are shown. D, Sagittal T1-weighted fluid-attenuated inversion-recovery (2,000/7/750, 256 x 256 matrix, two signals acquired, echo train length of six, acquisition time of 4 minutes 16 seconds); E, transverse T2-weighted fast spin-echo (3,500/85, 256 x 192 matrix, three signals acquired, echo train length of 16, acquisition time of 3 minutes 12 seconds); and F, transverse fluid-attenuated inversion-recovery (9,000/120/2,200, 256 x 192 matrix, one signal acquired, acquisition time of 4 minutes 48 seconds) MR images acquired with the standard MR imaging equipment (220-mm field of view, 3-mm section thickness) also are shown. The images acquired with the MR-compatible incubator (A-C) have two times higher spatial resolution than the corresponding images acquired with the standard head coil (D-F). Note the superior delineation of the gray and white matter (arrows in A and B) on the images acquired with the MR-compatible incubator compared with the delineation of the gray and white matter (arrows in D and E) on the images acquired by using regular equipment. The improved SNR of images acquired by using the MR-compatible incubator can be used to generate diagnostic images with improved spatial resolution and thus better definition of anatomic structures within equal or shorter imaging times.

View larger version (129K): [in a new window]   Figure 4. A, Fast spin-echo (3,500/85, 180-mm field of view, 3-mm section thickness, 256 x 192 matrix, one signal acquired, acquisition time of 2 minutes 48 seconds), and, B, fluid-attenuated inversion-recovery (9,000/120/2,200, 180-mm field of view, 3-mm section thickness, 256 x 192 matrix, one signal acquired, acquisition time of 4 minutes 48 seconds) MR images of the brain acquired with the MR-compatible incubator in a preterm (born at 32 weeks) 2-month-old baby with hemorrhagic hydrocephalus. Hemosiderin lining the ventricles, especially the frontal horns (arrow in ii), and old red blood cell debris (arrow in v) in the posterior horns of the lateral ventricles are seen. Bilateral extraaxial fluid collections (arrows in iv) are also seen.

View larger version (27K): [in a new window]   Figure 5. 1H MR spectra obtained A, with the MR-compatible incubator in a 2-month-old baby after extracorporeal membrane oxygenation, and, B, with the standard head coil in a 2-month-old term baby examined because of increased seizure activity. (The MR images obtained in these two patients are shown in Fig 3.) The spectra acquired with the RF coils optimized for use in newborns and integrated with the MR-compatible incubator showed a three times higher SNR. The spectra for both patients were acquired by using single-voxel point-resolved MR spectroscopy (1,500/35, 128 signals acquired from a 4.2-mL region of interest in occipital gray matter). a.u. = arbitrary units, Cho = choline-containing compounds, Cr = creatine plus phosphocreatine, Glx = glutamate and glutamine, mI = myo-inositol, NAA = N-acetylaspartate.

View larger version (194K): [in a new window]   Figure 6. A, Coronal black-blood spin-echo (870/14, 180-mm field of view, 256 x 192 matrix, four signals acquired, 2-mm section thickness), and, B, coronal white-blood cine spoiled gradient-echo (11.5/5.1, 200 x 150-mm field of view, 20° flip angle, 256 x 160 matrix, 3-mm section thickness, two signals acquired) MR images of the heart acquired with the MR-compatible incubator and the integrated body coil in a 1-week-old neonate examined for assessment of vessel branching. For comparison, C, coronal black blood spin-echo (1,081/14, 180-mm field of view, 256 x 160 matrix, 2-mm section thickness, four signals acquired), and, D, coronal white blood cine spoiled gradient-echo (11.5/5.1, 200-mm field of view, 20° flip angle, 256 x 160 matrix, 3-mm section thickness, two signals acquired) MR images were obtained with the standard head coil in a 1-month-old baby examined for assessment of pulmonary and systemic venous drainage. Note the sharp definition of the left ventricular outflow tract and the aorta (arrows in A and C) and the superior blood-myocardial contrast (arrows in B and D) on the images acquired with the MR-compatible incubator.