December 1, 2005 Designed by a team of doctors, nurses, and engineers, a specially designed incubator allows premature babies to receive MRI scans to assess their health. The scans can measure many indicators, such as the levels of various metabolic substances in the body, to reveal whether or not a baby may have developmental problems, enabling parents to take therapeutic steps sooner for their children.
SAN FRANCISCO--Babies born prematurely face a host of health concerns, including future developmental problems. Now, a new kind of incubator helps doctors get a better look inside premature babies' brains.
MRI images can help doctors determine which babies will have these problems, but getting those images can be dangerous. Now, new technology solves the problem and keeps the babies safe.
When it comes to preemies -- everything is little -- including their brains. Imaging a premature baby's brain can be tricky. For years, doctors only used ultrasounds because transporting a baby to an MRI unit is dangerous.
Jim Barkovich, a pediatric neuro-radiologist at UCSF Children's Hospital in San Francisco, says, "You really worry about their blood pressure because their blood pressure can drop just from moving them too much."
Dr. Barkovich is using this specially designed incubator conceived by a team of doctors, nurses and engineers. It rolls right up to the MRI machine and allows doctors to get a clearer picture. "You can look at it to see the metabolites of the brain and whether the metabolites are normal or abnormal," he says.
The metabolites are just one of many indicators that reveal whether a baby may have developmental problems. The incubator provides constant heat and has built-in oxygen tanks. A strap keeps the baby's head in place. Special cables allow nurses to monitor heart rate and blood pressure, and a camera lets them see the baby.
After 106 days in the hospital, Kathy Ramsey and Andrew Ramsey now have baby Martha home. Martha was born prematurely and as all premature babies do, needed hospital care for many weeks following her birth. "It was a day we were looking forward to for a long time," Kathy says.
As part of the study, Martha used the MRI incubator two times and didn't seem to mind it. Andrew says, "She slept through both of them." Luckily, Martha's scans came back normal. Now, everyone can rest a little easier.
The special unit is now used at a handful of hospitals across the country.
BACKGROUND: Scientists at the University of California, San Francisco, are making MRI safer for premature babies by using a transportable incubator that is compatible with MRI machines. This will enable doctors to peer into the brain of such infants to determine which areas are most affected by the stress of premature birth.
THE PROBLEM: There is no inherent health risk with using MRI on a premature baby, but getting the infant in and out of the scanner is time-intensive process that involves great risk. Too much handling, or even a loud noise, can cause life-threatening complications in a premature baby, most commonly irregular heart rate and breathing patterns.
THE SOLUTION: The UCSF scientists collaborated with General Electric to design the MRI-compatible incubator -- currently the only one of its kind. It has already vastly improved the screening of premature babies. The incubator is made entirely of plastic, aluminum or brass, since anything magnetic would be attracted to the powerful magnets used in the MRI machine. It is essentially a capsule of double-paned Plexiglass that holds in heat. The infant can breath fresh warmed air piped in from the outside. Often a sedative is used so that the baby falls asleep, since an MRI scan is slow and can take as long as an hour.
ABOUT PREEMIE BRAIN DAMAGE: Roughly half of early premature births show subtle abnormalities in the brain that may be linked to later developmental problems. Yet it is often difficult to spot this damage early with traditional ultrasound; problems often don't become apparent until around 10 months of age. An early MRI scan can help doctors detect brain damage early enough so that therapy can improve the infant's chances of developing normally. The possible causes of brain damage in premature infants are not fully established, but include infection stemming from the wall of the uterus or placenta; the inability of an immature cardiovascular system to pump enough oxygen-rich blood to the brain; and an inflammatory response at birth.
Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.