Overview of Imaging Types for Neonatal Encephalopathy

Neonatal imaging is a process used to produce images of a newborn baby’s internal systems. Medical professionals highly recommended neonatal imaging to check for potential abnormalities in structure and function while a preterm infant is in the NICU. There are a few different forms of neonatal imaging, each with their own set of benefits, limitations, and indications. This page will cover some of the neonatal imaging techniques you may encounter after your baby is born, especially if your child has suspected neurological dysfunction such as hypoxic-ischemic encephalopathy (HIE), cerebral palsy, or seizure disorders/epilepsy.


Neonatal Imaging Techniques

Magnetic Resonance Imaging (MRI)

An MRI is a form of non-invasive scanning technology that takes three-dimensional images of the body, without using radiation. Due to the highly-detailed images produced, this method is most highly recommended for neonatal imaging. MRIs are useful for imaging non-bony parts of the body, including the brain. These scans can be used to help diagnose neonatal injuries such as hypoxic ischemic encephalopathy (HIE), intracranial hemorrhages, hydrocephalus, white matter brain damage, and cerebral palsy.

Benefits of Magnetic Resonance Imaging

  • No radiation
  • Presents a very clear and complete image
  • Suitable for many scans in a row
  • Can be used in conjunction with magnetic resonance spectroscopy to understand biochemical and physiological changes, in addition to structural imaging

Limitations of Magnetic Resonance Imaging

  • Must be completed in a separate room, often quite a distance from the NICU
  • Expensive

Computed Tomography (CT)

A CT scan uses a computerized x-ray machine to collect a series of images from a patient.  These images are put together to create a three-dimensional picture of the area of interest. CT scans are useful for locating injuries, tumors, clots, and hemorrhages and can be used to image the brain.

Benefits of Computed Tomography

  • Available in many hospitals
  • Relatively cheap
  • Images can be stacked for complete three-dimensional picture

Limitations of Computed Tomography

  • Use of ionizing radiation
  • Must be completed in a separate room, often quite a distance from the NICU
  • Not suitable for many scans in a row

Ultrasound

An ultrasound is a non-invasive imaging technique that scans the inside of the body using ultrasound probes or cell transducers. Cranial ultrasounds are often performed on newborns in the NICU to produce useful images of the brain and surrounding areas. Ultrasounds are valuable for identifying cerebral edema and parenchymal or intraventricular hemorrhage, though this imaging modalities is the least detailed of the three types mentioned.


Benefits of Ultrasound

  • No radiation
  • Mobile, easily used within the NICU
  • Suitable for 1 to 2 scans per day

Limitations of Ultrasound

  • Produces a less clear and complete picture than other available technologies
  • Difficult to pinpoint exact location of certain injuries
  • Requires absolute expertise of the ultrasound administrator and interpreter

**Often cranial ultrasounds and MRIs are used together to produce complete and progressive images of newborns in the NICU.

It is also worthwhile to note that oftentimes newborns will require an anesthetic before the administration of imaging procedures.  Neonatal anesthesia comes with its own set of limitations which physicians will often counsel parents on before anesthesia administration. These limitations may include:

  • A drug-induced depression of consciousness, with potential for loss of protective reflexes.
  • Cardiorespiratory depression, which can include hypoventilation, hypoxia, and hypotension.
  • Post-sedation side effects such as nausea, vomiting, disorientation, or sleep disturbances.

Overall Takeaways

While the MRI is more expensive, it is most highly recommended due to its ability to produce a clear image and its lack of ionizing radiation. Your physician will provide you with information on the appropriate or suggested imaging procedures, and from here a decision can be made.  Remember, if you desire more information on any imaging technique or decision, don’t hesitate to ask your physician. A quick note, however – frequently, after a baby comes back from the NICU, follow-up imaging isn’t done, unless the parent insists on it. Don’t be afraid to insist on getting follow-up imaging done, as this test can provide highly valuable information regarding your child’s development.

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