Final Pr. ID: Poster #: SCI-030
Hypoxic Ischemic Encephalopathy (HIE) is a brain injury caused by a lack of blood and oxygen supply to the brain. HIE affects 4,000,000 term-born neonates per year worldwide, with an estimated 2 billion/year cost in the US, let alone family burdens. Therefore, reducing mortality and morbidity for HIE patients remains an important public health concern. Therapeutic hypothermia (TH) was established in 2005 as a standard therapy by cooling patients to 33-34°C in the first six postnatal hours for 72 hours. However, 35–50% of the patients still experience adverse outcomes, defined as death or cognitive Bayley Scales of Infant Development by age two years. Ongoing HIE-related trials worldwide are testing whether new therapies can supplement TH and further reduce adverse outcomes. However, therapeutic innovation is slow and inconclusive, for 1) before therapy, patients at high risk of developing adverse outcomes cannot be identified; 2) after therapy, outcomes cannot be measured until age two years. Besides, public MRI data exists for hundreds of patients with brain tumors, Alzheimer’s Disease, and other diseases, fueling AI’s success in MRI-based diagnosis and prognosis of brain tumor, Alzheimer’s Disease, and other disorders. In contrast, annotated MRIs with linked clinical and bio-marker data do not exist publicly for HIE. Our previous work has collected multi-site HIE MRI data. Therefore, to fill the gap in HIE diagnosis with MRI data, target high-risk patients, increase efficiency, evaluate therapeutic effects early, and expedite therapeutic innovations, in this work, we propose to predict 2-year neurocognitive outcomes in neonates using brain MRIs by deep learning methods. Read More
Final Pr. ID: Poster #: CR-029
A novel 1T MRI scanner, previously compared to a 1.5T Siemens scanner, was placed in our NICU. The 5-gauss safety line is inside the magnet, rendering standard magnetic safety precautions unnecessary and allowing maintaining ongoing critical care. Scans included near-term equivalent stable neonates and neonates in an acute / sub-acute setting of disease. Through the following cases we present the capabilities of the 1T in-NICU scanner to evaluate the neonatal brain throughout different phases of injury.
Case 1–Chronic. A 28 5/7 week infant born to mother with chorioamnionitis, developed sepsis. Cranial US showed bilateral IVH Grade III (L) / IV (R) on DOL 2. At DOL 49, ventriculomegaly and porencephalic cysts were detected on US. MRI at term equivalent age demonstrated the post hemorrhagic cystic degeneration and ventriculomegaly. Follow up MRI was performed at 4 months of age due to increasing head circumference. Presence of prior MRI images increased diagnostic confidence.
Case 2–Sub-acute. A term infant with moderate encephalopathy treated with therapeutic hypothermia, after absent fetal movements for two days. Complicated NICU course, with multi-system organ failure, seizures and severe hypoglycemia. MRI scan on DOL 14 showed punctate rim-T1 hyperintense foci with a hypointense center, opposite T2 signal and restricted diffusion, in the centrum semi-ovale and periventricular white matter. Sub-acute hemorrhage with suspected ischemic etiology was the working diagnosis.
Case 3–Acute. A term infant delivered by stat C-section for non-reassuring fetal heart rate and low Apgar scores. Complicated NICU course, including multisystem organ failure, seizures, and burst suppression on cerebral monitoring. MRI scan on DOL 6 showed diffuse abnormal cortical T1 and white-matter T2 signal. Restricted diffusion was seen diffusely in a posterior distribution. Diffuse hypoxic ischemic injury was diagnosed.
Case 4–Hyper-Acute. A 31 week infant was delivered by stat C-section after major maternal trauma, with extremely severe hypovolemic shock. An MRI scan was performed at 8 hours of life, to determine direction of care while intubated and on vasopressor support. Extra-axial and intraventricular hemorrhage were seen, as well as diffuse restricted diffusion. The scan assisted family and physicians to reach a decision regarding discontinuing of care. Read More
Final Pr. ID: Poster #: SCI-006 (S)
Los problemas en el desarrollo del lenguaje se han incrementado en anios recientes, se estima que solo en Mexico el siete por ciento de los ninios presenta alteraciones del lenguaje. La caracterizacion de los valores de ADC y FA asociados al area de Broca y Wernicke propuestas por el modelo clasico pueden permitir en un mediano plazo detectar anomalias en el sistema del lenguaje pudiendose utilizar para un diagnostico temprano. Por esta razon nuestro primer objetivo es caracterizar ambos parametros en pacientes sanos que permita establecer valores de control. Read More
Final Pr. ID: Poster #: SCI-019
Fetal demise (FD) occurs in 1/1000 pregnancies after 20 weeks gestation. MRI is increasingly being used after ultrasound to assess fetal pathology. FD may occur in the interval between ultrasound and MRI, and various organ systems have been described as having changes on fetal MRI. Although ultrasound findings of FD have been well described, criteria for FD on MRI have not. Diffusion MRI evaluates Na+/K+ channel viability and can be used to evaluate tissue death. Flowing blood produces signal loss on MRI, and along with fetal heart activity results in MRI signal loss of the cardiac chambers. FD with no heart motion and increased signal within non-flowing blood in the heart should result in increased signal in the chambers relative to the myocardium. Either of these findings can be seen with different fetal pathology, but the combination of brain and cardiac changes may allow for a diagnosis of FD. We hypothesize that restricted brain diffusion in certain brain lobes along with increased signal within heart chambers is specific for FD. Read More
Final Pr. ID: Poster #: SCI-026
To assess the utility and adaptability of some widely used automated segmentation methods when applied to abnormal pediatric magnetic resonance imaging (MRI) brain scans. Segmentation is an essential component of the workflow when building 3D anatomical models of abnormal pediatric brains to demonstrate surface pathology. Read More
Final Pr. ID: Paper #: 105
Postmortem imaging is increasingly used following stillbirths and neonatal death. Estimating time of death has legal, biological, and ethical implications. This study aims to investigate feasibility of prenatal MRI in estimating time of death in intra-uterine fetal demise (IUFD). Read More
Final Pr. ID: Poster #: SCI-058
Establish and evaluate a process for 3DPrinting (3DP) patient specific functional anatomical models of the brain from multiple MRI sequences in patients with epileptic focal lesions.The second objective was to evaluate the clinical utility of the models. Read More
Final Pr. ID: Poster #: SCI-027
Hypoxic ischemic encephalopathy (HIE) is a brain injury that occurs in 1 ∼ 5/1000 term-born neonates. HIE lesion detection is a crucial step in clinical care of HIE. It could lead to a more accurate estimation of prognosis, a better understanding of neurological symptoms, and a timely prediction of response to therapy in this population. In addition, the rise of Artificial Intelligence (AI) brings hope to objectively and accurately finding HIE lesions. With public MRI data for brain tumors, Alzheimer’s Disease, and other diseases, AI has achieved significant success in MRI-based diagnosis and prognosis of these diseases. To facilitate the early prognosis and diagnosis of HIE, in this work, we focus on HIE lesion detection with MRI data using deep learning methods. Read More
Final Pr. ID: Poster #: SCI-048
Monochorionic multiple gestations are at risk for complications related to a shared placenta. In utero therapies such as fetoscopic laser and radiofrequency ablation (RFA) are used to treat these complications. Previous work at our institution demonstrated a low rate of neuroanatomical abnormalities on post-therapy fetal imaging. The purpose of this study was to evaluate postnatal neurological outcomes within the same cohort.
Final Pr. ID: Poster #: EDU-078
Synthetic magnetic resonance imaging (SyMRI) is a new imaging technique that permits generating multiple contrast-weighted images based on relaxivity measurements of tissue properties in a single acquisition using a multi-echo, multi-delay saturation recovery spin-echo sequence of approximately 6 minutes. Read More
Final Pr. ID: Poster #: SCI-001 (R)
Background: Brain MRI has become an integral tool in the diagnosis and management of neonates with possible brain injury. In a large quaternary care neonatal intensive care unit (NICU), MRIs are routinely performed for the identification of white matter lesions in preterm infants, prognostication in hypoxic ischemic encephalopathy, peri-operative evaluation of patients with meningomyeloceles and hydrocephalus among other indications. Patients are often sedated in order to obtain high quality images, but sedation comes with complications. As these studies become an integral part of our practice in the NICU, we have identified a need to minimize the use of sedation to obtain clinically acceptable neonatal brain MRIs. Read More
Authors: Harris Chris