New neonatal 3-Tesla MRI transporter now at UT Medical School at Houston
Device is one of only two in the country
HOUSTON - (Nov. 10, 2009) - Researchers at The University of Texas Medical School at Houston are using a neonatal transporter that can go directly into a magnetic resonance imaging (MRI) scanner as part of a novel study to identify acute brain injury in extremely premature infants.
"One of the many challenges in comprehensively evaluating acute brain injury in these infants is the risk of removing them from the neonatal intensive care unit (NICU) for even a standard MRI. It could compromise their health. These babies are very susceptible to temperature change and a host of other difficulties," said Nehal A. Parikh, D.O., principal investigator of the study and assistant professor of pediatrics at the UT Medical School at Houston. "This pilot study will help us establish the safety of this MRI transporter and explore new measures of detecting brain injury by using blood work, or proteomics, and multichannel electroencephalography (EEG).
Extremely premature babies are susceptible to damage of the communication channels in their brain called white matter. In most cases, the injury is not detected within days, making it difficult, if not impossible to treat, said Parikh, a neonatologist at Children's Memorial Hermann Hospital. "This type of injury cannot be diagnosed without using a MRI."
According to Parikh, survival rates for preterm infants have improved dramatically while the incidence of neurological impairment remains unchanged. Therefore, the overall number of children with disabilities is increasing; half of all neurologic disabilities in children are related to preterm births, according to a 2005 March of Dimes report.
One of only two in the country, the transporter provides everything the infant can receive while being cared for in an NICU incubator. The transporter keeps the baby warm, provides humidity needed for the first 10 days of life, contains an intravenous (IV) pole with pumps that are shielded from the MRI magnet and includes an MRI-compatible ventilator. "Without that, you couldn't scan a baby who was on a ventilator. The transporter also has a built-in MRI head coil, a heart rate monitor and pulse oximeter that detects the level of oxygen in the blood," Parikh said.
The transporter is housed at the UT Medical School. When needed, it can be taken to the Children's Memorial Hermann Hospital's NICU where an infant will be removed from the incubator and placed inside the transporter's incubator. The transporter and the infant, while remaining in the controlled environment of the MRI transporter, can then be scanned in a high-powered 3-Tesla MRI at Memorial Hermann-Texas Medical Center or the medical school. A 3-Tesla scanner has a stronger magnet and produces high quality images.
Also to be utilized are advanced MRI techniques including diffusion weighted imaging and magnetic resonance spectroscopy that are highly sensitive to detecting damage to white matter in the brain.
UT researchers will recruit 15 hospitalized mothers at Children's Memorial Hermann who deliver between 23 and 29 weeks gestation and ten healthy full-term newborns.
The study will include a research team examining the infant's blood, urine, placenta and cord blood. Researchers will be looking for a correlation among those test results, EEG and the MRI. "If a connection is made and validated in a larger study, it should allow us to select high risk infants for randomized trials on how to protect the brain," Parikh said. "This has been one of the big hurdles contributing to the lack of effective therapies for extremely preterm infants."
"Dr. Parikh is among few investigators in the world capable of doing very sophisticated brain imaging in small infants. This work complements our National Institutes of Health (NIH) Neonatal Network by performing innovative imaging and builds upon the Medical School's continuum of brain research," said Giuseppe Colasurdo, M.D., dean of the UT Medical School and professor and chair of the Department of Pediatrics.
The study was funded by a UT Pilot Grant and Dean's Research Award through the UT Medical School and a K23 Career Development grant from the National Institute of Neurological Disorders and Strokes at the NIH.
UT co-investigators include Sean C. Blackwell, M.D., associate professor of obstetrics, gynecology and reproductive sciences; William P. Dubinsky, Jr., Ph.D., professor of diagnostic sciences; Nina Tatevian, M.D., associate professor of pathology; Katrina Burson, R.N., research coordinator; Robert E. Lasky, Ph.D., professor of pediatrics and Ponnada A. Narayana, Ph.D, professor of radiology.
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