Synopsis
Term newborns are
at risk to develop brain injury. Magnetic resonance imaging has permitted to better
understand how brain injury develops despite standard available treatments. The
use of magnetic resonance imaging has also given clues of which newborns would
benefit from additional treatments, and indications for possible alternative
treatments. However, magnetic resonance imaging in these newborns remains
challenging, and must imperatively be improved to allow further detection and
treatment. This education session will cover the advantages and limitations of
magnetic resonance imaging in term newborns.Target audience
Scientists and
clinicians interested in learning what can be learnt from imaging in term
newborns and how those methods can be applied in their daily practice for
research and clinical applications
Objectives
Upon completion of
this lecture, the participants should be able to:
- Have an overview
of the specifics of the term neonatal brain
- Improve the
understanding of what imaging brings to the understanding of the development of
brain injury in term newborns
- Learn how imaging
in these newborns may permit to develop new treatments
Purpose
Term newborns can
be critically ill and are thus at risk to develop brain injury. At that age,
the brain is still maturating and injury will still impact the normal brain
development. Brain injury most often develops in these newborns following birth
asphyxia. Hypothermia treatment has been introduced now as standard of care for
these newborns. However, some asphyxiated newborns treated with hypothermia
still develop brain injury.
Methods
The different
imaging techniques available in term newborns will be reviewed, as well as the
results obtained so far in asphyxiated newborns treated with hypothermia. More
specifically, diffusion-weighted imaging, diffusion-tensor imaging,
spectroscopy and arterial spin labeling results will be outlined. Their potential
use and their limitations will be discussed in more details.
Discussion
Magnetic resonance
imaging in term newborns has permitted to understand why asphyxiated newborns
develop brain injury despite hypothermia treatment, has started to give
clues how treatments may need to be adjusted to prevent or repair these brain
injuries, and has allowed to identify which newborns should be targeted with these new treatments.
Conclusions
This education
session will cover the challenges of imaging term newborns, but also the
possibilities of these imaging techniques to better detect brain injury and to help
in developing improved treatments for these newborns.
Acknowledgements
Pia Wintermark receives research grant funding from
the FRSQ Clinical Research Scholar Career Award Junior 1, and the New
Investigator Research Grant from the SickKids Foundation and the CIHR
Institute of Human Development, Child and Youth Health (IHDCYH).References
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