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13 - Imaging the neonatal brain

from Section 3 - Radiological and neurophysiological investigations

Published online by Cambridge University Press:  01 March 2011

By
Mary A. Rutherford
Edited by
Hugo Lagercrantz ,
M. A. Hanson ,
Laura R. Ment  and
Donald M. Peebles
Hugo Lagercrantz
Affiliation:
Karolinska Institutet, Stockholm
M. A. Hanson
Affiliation:
Southampton General Hospital
Laura R. Ment
Affiliation:
Yale University, Connecticut
Donald M. Peebles
Affiliation:
University College London
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Summary

Introduction

Ultrasound is the routine imaging tool for assessing and monitoring the neonatal brain. It is cheap, mobile, and easy to use, and in experienced hands serial examination provides valuable information about the normal and abnormal brain. Computed tomography exposes the already sick neonate to unacceptable radiation and may miss clinically important pathology. Magnetic resonance imaging (MRI) has become an invaluable adjunct to ultrasound: the two techniques have complementary roles with ultrasound providing an ideal screening tool. MRI is safe and can therefore be used serially; in addition, unlike ultrasound, it may be used when the anterior fontanelle has closed. Unfortunately MRI of the sick or very preterm neonate is not easy and experience is limited to relatively few centers, both in the practicalities of performing a successful examination and in the interpretation of the results.

The increasing literature on advanced postacquisition analysis of MR images is evidence of the power of this tool to investigate the normal and abnormal developing brain but these techniques depend on high-quality imaging datasets, which may be difficult to acquire. The aim of any neonatal MR examination, whether performed for clinical or research studies, is to produce high-quality datasets, safely and in an acceptable acquisition time.

Practical issues

Sedation

Successful imaging of the neonatal brain requires careful preparation of the infant and close cooperation between radiologist, radiographer, and neonatologist. Neonates may be successfully imaged during natural sleep, following a feed, or under light sedation (Rutherford, 2002).

Type
Chapter
Information
The Newborn Brain
Neuroscience and Clinical Applications
 , pp. 199 - 210
Publisher: Cambridge University Press
Print publication year: 2010

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