Image quality associated with the use of an MR-compatible incubator in neonatal neuroimaging

Objectives: MRI in the neonate poses significant challenges associated with patient transport and monitoring, and the potential for diminished image quality owing to patient motion. The objective of this study was to evaluate the usefulness of a dedicated MR-compatible incubator with integrated radiofrequency coils in improving image quality of MRI studies of the brain acquired in term and preterm neonates using standard MRI equipment. Methods: Subjective and objective analyses of image quality of neonatal brain MR examinations were performed before and after the introduction of an MR-compatible incubator. For all studies, the signal-to-noise ratio (SNR) was calculated, image quality was graded (1-3) and each was assessed for image artefact (e.g. motion). Student's t-test and the Mann-Whitney U-test were used to compare mean SNR values. Results: 39 patients were included [mean gestational age 39weeks (range 30-42 weeks); mean postnatal age 13 days (range 1-56 days); mean weight 3.5 kg (range 1.4-4.5 kg)]. Following the introduction of the MR-compatible incubator, diagnostic quality scans increased from50 to 89%and motion artefact decreased from73 to 44%of studies. SNR did not increase initially, but, when using MR sequences and parameters specifically tailored for neonatal brain imaging, SNR increased from 70 to 213 (p=0.001). Conclusion: Use of an MR-compatible incubator in neonatal neuroimaging provides a safe environment for MRI of the neonate and also facilitates patient monitoring and transport. When specifically tailored MR protocols are used, this results in improved image quality.