particular, di;usion-weighted imaging
is capable of reliable assessment of
central nervous system (CNS) injury. 2
The nomag IC increased the availability
of MR for young and unstable patients.
With approximately 25% of patients
weighing less than 2,500 g at the time
of their MR, this solution created new
opportunities to examine the most
vulnerable patients at The Institute of
Mother and Child. As an example, in
one infant scanned at the gestational
age of 26 weeks when his body reached
600 g, the MR images depicted bilateral
intraventricular hemorrhages and
intraparenchymal bleeding both in
the supratentorial and infratentorial
compartment. The just-forming cavity
was also appreciated in his right frontal
lobe (Figure 1A). The outcome at term
equivalent was quite good in this
patient, however, with only depositions
of hemosiderin in subependymal
localization in the ventricular system
and the cavity in the frontal lobe that
was a smaller size than on initial
examination (Figure 1B).
de;ne the extent of the injury and
also, knowing that injury is not static,
what is happening to the brain overall.
This allows us to target therapeutic
interventions to mitigate or minimize
cascading events from the initial injury.”
While Dr. Limperopoulos’ research
has been dedicated to the brain, she
sees potential to also study the heart
and multiple organs. “This technology
is giving us an unprecedented
opportunity to make meaningful strides
in our understanding of the timing and
evolution of injury in high-risk infants.”
The Institute of Mother and Child is a
tertiary referral neonatology center in
Warsaw, Poland, with a SIGNA™ HDxt
1.5T that was last upgraded in 2011.
According to Monika Bekiesi;ska-
Figatowska, MD, Head of Diagnostic
Imaging, prior to implementing the
nomag IC, the hospital would perform
neonatal MR examinations using an
adult head coil in conjunction with
a phantom. However, it limited the
hospital to brain-only exams on stable,
mainly term, neonates.
In 2013, thanks to a donation from one
of the largest non-pro;t organizations
in Poland, the Institute acquired the
nomag IC, suitable for scanning infants
with a body weight up to 4. 5 kg and
body length of 55 cm. “With the nomag
IC, newborns, including premature
ones, can be wheeled directly into the
scanner and they lie protected inside
it throughout the entire examination.
According to Dr. Bekiesi;ska-Figatowska, the nomag IC is equipped
with an 8-channel, phase-array head
coil and a whole-body 12-channel,
phase-array coil consisting of two
elements: an 8-channel part integrated
with the incubator bed and a separate
4-channel surface coil.
“We have always seen the superiority
of MR over transfontanelle
ultrasonography (US) in the evaluation
of the brain and the cerebellum,” Dr.
Bekiesi;ska-Figatowska says. In
Figure 1. The youngest neonate examined at the Institute of Mother and Child was at the age of 26 gestational weeks.
(A) Depicts the smooth brain and a cavity forming close to the right frontal horn. (B) At term equivalent: with gyration
appropriate for the corrected age and the small porencephalic cyst on the right.