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. 2004 May;89(3):F193-7.
doi: 10.1136/adc.2003.027334.

The magnetic resonance revolution in brain imaging: impact on neonatal intensive care

N J Robertson  1 , J S Wyatt
Affiliations

The magnetic resonance revolution in brain imaging: impact on neonatal intensive care

N J Robertson et al. Arch Dis Child Fetal Neonatal Ed. 2004 May.
No abstract available

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Figures

Figure 1
Figure 1
(A) Representative T2 weighted magnetic resonance (MR) images, (B) 1H MR spectra, and (C) 31P MR spectra from healthy infants at 30 weeks gestation, term, 6 months, and 1 year of age. (A) The MR images show an increase in volume, surface area, and sulcation of cerebral cortex and in volume and microstructural organisation of cerebral white matter with development. (B) The series of 1H MR spectra show a steady increase in N-acetyl aspartate (NAA; a marker of neuronal and axonal density and viability) and a decrease in brain lactate with maturation. (C) The series of 31P MR spectra show changing ratios of brain phospholipids and increasing energy state with maturation. PME, Phosphomonoesters; Pi, inorganic phosphate; PDE, phosphodiesters; PCr, phosphocreatine; ATP, adenosine triphosphate; Cho, choline; Cr, creatine; lac, lactate.
Figure 2
Figure 2
T1 weighted magnetic resonance images of (A) focal injury in an infant with Sarnat stage II neonatal encephalopathy (NE) aged 11 days and (B) global injury in an infant with Sarnat stage III NE aged 12 days. (A) Focal high signal intensity lesions are visible in the lentiform nuclei and thalami, and there is loss of the normal high signal intensity from myelin in the posterior limb of the internal capsule. (B) There are extensive high signal intensity lesions in the lentiform nuclei and thalami, loss of the normal high signal intensity from myelin in the posterior limb of the internal capsule, and abnormal low signal intensity in the white matter with loss of the normal grey/white matter differentiation.
Figure 3
Figure 3
(A) 1H MR spectrum from left basal ganglia showing appreciably raised lactate and reduced N-acetyl aspartate (NAA). (B) 31P MR spectrum from the whole brain showing severe secondary energy failure with phosphocreatine (PCr) and ATP depletion and increased inorganic phosphate (Pi). The brain pHi was alkaline (7.18). PME, Phosphomonoesters; PDE, phosphodiesters; Cho, choline; Cr, creatine; mI, myo-inositol; lac, lactate.
Figure 4
Figure 4
Fibre tracking which in the future may be possible using diffusion tensor imaging. If successful, this technique has huge potential in furthering our understanding of preterm white matter damage.
See this image and copyright information in PMC

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