Introduction
Newborns and infants are highly prone to infectious and noninfectious diseases. The immune system in infants is not well developed and should be quickly diagnosed and treated. Their immune systems are still in the maturation process and are transforming. In cases of children representing neonatal encephalopathy, metabolic disorders, and brain abnormalities, the important part is correct and timely diagnosis. A wide range of diagnostic imaging, such as fetal brain MRI. MRI, CT scan, and ultrasound are the most common methods. The best technique for a particular child, cost-effective and with less radiation, is chosen by the physician. Understanding the disruption of normal brain development is important to diagnose the abnormality. It is essential to link the brain and the behavioral changes to understand the abnormality and its relation to the function of the brain. Neuroimaging techniques such as MRI have improved the brain's understanding.
What Is the Difference Between Traditional and Advanced MRI?
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Current studies have shown no adverse effects in advanced MRI imaging.
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Earlier MRIs were challenging to perform and also required respiratory support.
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There are no known health risks associated with advanced MRI imaging.
What Are the Benefits of Advanced MRI?
It is a valuable tool for assessing the brain's development and diagnosing abnormalities. This can be helpful in newborns as well as neonates. Other imaging techniques are CT scans and ultrasounds that are still being performed in some radiology departments. MRI advancements are beneficial in pediatrics because of the difference in the brains of adults and neonates. It differs from the adult brain in size, shape, and also the overall maturation of brain tissue.
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Higher resolution is a must to understand neonates' brains, and this can be done with the help of stronger magnets and advancement in the receiver coil. This helps MRI to be better than any other imaging technique.
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The challenge of having the patient still for longer is made more accessible by developing advanced techniques and tools, such as MRI-compatible cradles and incubators for children.
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The sedative option with MRI is another advancement that benefits the professional in MRI. No potentially dangerous sedative is required.
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Advanced MRIs are superior in detecting white matter, are essential in cerebellar abnormality diagnosis, and are becoming popular among professionals.
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There is a lack of ionizing radiation in the MRI, which is a benefit.
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It has high resolution and improved safety for children.
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It is cost-effective, noninvasive, and readily available.
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It can process the radiograph image with less disruption of the structures, even in infants.
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Images can be taken of children on ventilators.
What Are the Issues Related to MRI in Pediatrics?
Although the technique of MRI is helpful in brain study, this procedure has certain limitations.
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The MRI procedure takes a longer time as compared to traditional CT scans and ultrasounds.
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An adult can stay immobile longer during imaging, but it is difficult for children to stay still.
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Infants and children may get uncomfortable or scared of loud noises and can’t stay still to prevent any artifact.
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The equipment is expensive for most of the clinics to afford. The handling and operation also require experts.
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They can be developmental concerns when imaging neonate’s brains.
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The sedative used may have risks associated with its excessive use. Excessive use in pediatric patients can lead to risks, requiring continuous monitoring under specialist care.
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Some patients may experience claustrophobia.
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Medical implants may malfunction, causing problems in the working. The magnetic field in the scans can interfere with the working of medical implants containing metal.
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There can be allergic reactions associated with the materials used.
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Patients with impaired kidney functions are prone to develop nephrogenic fibrosis of the kidneys.
What Are Other MRI Advances in Pediatrics?
Apart from traditional MRI, other MRI methods are developed for efficient and better imaging in newborns and infants. They require greater knowledge and skill and have their benefits and limitations.
Magnetization Transfer MRI
This technique is a structural imaging modality measuring the difference in frequency in free-water proton. This technique is rare because of the limitation in time and energy required. It reflects the amount of myelin that increases from birth to the second year of life. This technique is very sensitive as in preterm babies, it shows more increase in MTR than others. This is very sensitive to macromolecules that are myelin-associated as well as the skeleton component-associated macromolecules.
Susceptibility Weighted MRI
This emerging technique is used to measure the magnetic susceptibility of a particular tissue. The multigradient sequence is required for acquiring images. Background frequency is removed from the map, and images are computed. This is based on the accumulation of ferritin after hemoglobin diffusion from ventricles.
Perfusion MRI
This technique involves the evaluation of hemp dynamics of the brain in the developing brain vulnerability of blood flow and oxygen supply. The advantage of this imaging is reduced time off imaging that is less than one minute. It measures the flow of blood. Although it lacks providing spatial information and images of anatomical structure, segmentation is necessary.
Spectroscopy Imaging
Proton spectroscopy provides the information of quantification of metabolite or chemical shift. The metabolite changes depend on the location of the brain. A higher strength of the field provides less overlap of the spectrum and a small voxel size. In premature infants, the metabolite is in higher concentration than the fetus of the same age. Measuring the change in metabolite concentration is important, especially during the first year of life.
Conclusion
A wide variety of technologies have been applied for better MRI scans of the brain in infants and newborns. This has allowed increased exploration of brain development. Quality control procedures are necessary for better MRI observation. High-field MRIs are essential for better mapping and developing high-resolution images of fine structures or microlesions.
