A 1-Tesla MRI system for dedicated brain imaging in the neonatal intensive care unit

To assess the feasibility of a point-of-care 1-Tesla MRI for identification of intracranial pathologies within neonatal intensive care units (NICUs).

Clinical findings and point-of-care 1-Tesla MRI imaging findings of NICU patients (1/2021 to 6/2022) were evaluated and compared with other imaging modalities when available.

A total of 60 infants had point-of-care 1-Tesla MRI; one scan was incompletely terminated due to motion. The average gestational age at scan time was 38.5 ± 2.3 weeks. Transcranial ultrasound (n = 46), 3-Tesla MRI (n = 3), or both (n = 4) were available for comparison in 53 (88%) infants. The most common indications for point-of-care 1-Tesla MRI were term corrected age scan for extremely preterm neonates (born at greater than 28 weeks gestation age, 42%), intraventricular hemorrhage (IVH) follow-up (33%), and suspected hypoxic injury (18%). The point-of-care 1-Tesla scan could identify ischemic lesions in two infants with suspected hypoxic injury, confirmed by follow-up 3-Tesla MRI. Using 3-Tesla MRI, two lesions were identified that were not visualized on point-of-care 1-Tesla scan: (1) punctate parenchymal injury versus microhemorrhage; and (2) small layering IVH in an incomplete point-of-care 1-Tesla MRI with only DWI/ADC series, but detectable on the follow-up 3-Tesla ADC series. However, point-of-care 1-Tesla MRI could identify parenchymal microhemorrhages, which were not visualized on ultrasound.

Although limited by field strength, pulse sequences, and patient weight (4.5 kg)/head circumference (38 cm) restrictions, the Embrace^® point-of-care 1-Tesla MRI can identify clinically relevant intracranial pathologies in infants within a NICU setting.