Comparison of neonatal MRI examinations with and without an MR-compatible incubator: advantages in examination feasibility and clinical decision-making
| Autor: | Katrin Klebermass, C. Czaba, Francesco Cardona, Arnold Pollak, Daniela Prayer, Peter Brugger, Z. Rona, Manfred Weninger |
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| Rok vydání: | 2008 |
| Předmět: |
Pediatrics
medicine.medical_specialty Incubators Infant Medicine Humans Retrospective Studies Brain Diseases Periventricular leukomalacia medicine.diagnostic_test business.industry Ultrasound Infant Newborn Gestational age Brain Magnetic resonance imaging Arteriovenous malformation Retrospective cohort study General Medicine medicine.disease Magnetic Resonance Imaging Radiological weapon Pediatrics Perinatology and Child Health Angiography Neurology (clinical) business Nuclear medicine |
| Zdroj: | European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society. 14(5) |
| ISSN: | 1532-2130 |
| Popis: | Purpose To assess the utility of an MRI-compatible incubator (INC) by comparing. 1. The frequency of MR examinations done in 18 months periods each in unstable newborns with suspect central-nervous system (CNS) problems, 2. The respective expenditure of time, and 3. The amount of necessary sedatives with and without the INC. Methods In a retrospective study, the clinical and radiological aspects of 129 neonatal MRI examinations during a 3 year period were analyzed. Routine protocols including fast spin-echo T2-weighted (w) sequences, axial T1w, Gradient-echo, diffusion sequences, and 3D T1 gradient-echo sequences were performed routinely, angiography and spectroscopy were added in some cases. Diffusion-tensor imaging was done in 50% of the babies examined in the INC and 26% without INC. Sequences, adapted from fetal MR-protocols were done in infants younger than 32 gestational weeks. Benefit from MR-information with respect to further management was evaluated. Results The number of the examinations increased (30–99), while the mean age (43–38, 8 weeks of gestational age) and weight (3308–2766 g) decreased significantly with the use of the MR-compatible incubator. The mean imaging time (34, 43–30, 29 min) decreased, with a mean of one additionally performed sequence in the INC group. All infants received sedatives according to our anaesthetic protocol preceding imaging, but a repeated dose was never necessary (10% without INC) using the INC. Regarding all cases, MR-based changes in clinical management were initiated in 58%, while in 57% of cases the initial ultrasound diagnosis was changed or further specified. Conclusions The use of the INC enables the MR access of unstable infants with suspect CNS problems to the management, of whom is improved by MR information to significantly higher percentage, than without INC. |
| Databáze: | OpenAIRE |
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