Synopsis

Keywords: Cross-organ: Neonatal, Image acquisition: Motion Correction, Cross-organ: Pediatric

It is important to maintain their vitals like body temperature, heart rate, blood pressure and oxygen saturation during the transportation and in the MRI scanner. Usually, light sedation from midazolam works well for NICU babies while feed-and-swaddle technique works well for non-NICU babies. Protocol should balance quality of imaging and time with most important sequences performed earlier, in case the baby wakes up. Most currently available sequences can be optimized to obtain diagnostic quality MR exam in neonates. There is limited data on use of gadolinium-based contrast media in neonates but are in general considered safe for use in neonates.

Abstract

MR imaging of neonatal body is uncommonly performed and usually includes chest, abdomen and musculoskeletal examinations. Neonates are most delicate patients and are susceptible to physiologic stress and instability. MR compatible incubator is essential to maintain these parameters and minimize time away from NICU. Most babies do not require general anesthetic or deep sedation for MRI. Usually, light sedation from midazolam works well for NICU babies while feed-and-swaddle technique works well for non-NICU babies. Neonates can be scanned on both 1.5T and 3T scanners but 3T provides better SNR and may reduce exam length. Due to in general poor signal in babies, RF coils are more important determinant of SNR in neonates. Dedicated neonatal body coils provide better SNR. Small part coils and head coils used for older children and adults can also be effectively used. Protocol should balance quality of imaging and time with most important sequences performed earlier, in case the baby wakes up. Free breathing radial and compressed sensing based sequences can be used for dynamic imaging but not widely available currently. In such situations, regular VIBE/THRIVE/LAVA sequences can be used with 2 number of signal averages. There is no need for anesthetist-assisted apnea with intubation for dynamic imaging in neonates and children. The images may not be crisp due to free breathing but do provide clear information about pattern of enhancement in majority of cases. Stack of star T1-weighted images are able to eliminate movement artifacts but in current state cannot be used for dynamic imaging. They can be used for delayed post-contrast imaging but do not provide contrast similar to usual T1-fast spin echo sequences and usually take similar time to them. There is limited data on use of gadolinium-based contrast media in neonates but are in general considered safe for use in neonates. Cautious approach needs to be taken with case by case basis analysis while using GBCA in neonates.

Acknowledgements

No acknowledgement found.