A Practical approach Dr Dr. Khorshid Moh ohammad, MD, MSc(Pedia - - PowerPoint PPT Presentation

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A Practical approach Dr Dr. Khorshid Moh ohammad, MD, MSc(Pedia - - PowerPoint PPT Presentation

Jul 27, 2023 160 likes •870 views

Neonatal Brain MRI: A Practical approach Dr Dr. Khorshid Moh ohammad, MD, MSc(Pedia iatrics), FABP, FR FRCP(Edin in) NIC ICU le lead ad, Neuro-Crit itical l Car are Program , , Univ iversity of of Calg algary ry Disclosure I

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Neonatal Brain MRI: A Practical approach

Dr

  • Dr. Khorshid Moh
  • hammad, MD, MSc(Pedia

iatrics), FABP, FR FRCP(Edin in) NIC ICU le lead ad, Neuro-Crit itical l Car are Program , , Univ iversity of

  • f Calg

algary ry

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SLIDE 2

Disclosure

  • I have no conflict of interest to disclose
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SLIDE 3

Objectives

  • MRI sequences
  • Brain MRI in HIE
  • MRI approach to large ventricles
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Orientation

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Sagittal

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Axial

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Coronal

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Sequences

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T1

  • Chronic ischemic changes
  • Hemorrhage
  • Myelination
  • Brain malformation
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Chronic ischemia

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Hemorrhage

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Myelination

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Myelination

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T2

  • Myelination
  • Brain malformation
  • Hemorrhage
  • Chronic ischemic changes
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Myelination

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Myelination

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Hemorrhage

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Chronic ischemia

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DWI/ADC

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MRS

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MRS

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GRE/SWI

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Brain MRI in HIE

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MRI windows

Post cooli ling (day 4-5) 5)

  • DWI
  • ADC
  • MRS

Day 10-14 14

  • T1

T1

  • T2

T2

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HIE IE brain in in inju jury ry patterns on MRI

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MRS

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b f h

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Hypoglycemia

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Big ventricles Normal or small head Big head Hydrocephalus Brain atrophy or malformation

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Big ventricles and small/normal HC= Atrophy

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Big ventricles and small/normal HC= Malformation

  • 1)

Ventriculomegaly dysmorphic

  • 2)

Sylvian Fissures simple, vertically oriented

  • 3)

G/W interface normal vs. too simple

  • 4)

Cortical thickness: too thick > 3mm

  • 5)

# Sulci/Gyri too many or too few

  • 6)

Heterotopias radial review of images

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1.Ventricles

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Ventricles

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Lateral ventricles

corpus callosum Anterior horn of the lateral ventricles Head of caudate Fornix Septum pellucidum

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Third ventricle

Third Ventricle Thalamus Midbrain Fornix Thalamus

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Fourth ventricle

Fourth ventricle Cerebellar peduncle Pons Cerebellar peduncle Vermis

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CC Agenesis

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Vermis agenesis

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2.Sylvian fissure

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Sylvian fissure

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Sylvian fissure

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  • 3. G/W interface
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G/W interface

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4.Cortical thickness

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Cortical thickness

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  • 5. Number of Sulci/Gyri
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Lissencephaly Polymicrogyria

pachygyria

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Lissencephaly

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Hemimegalencephaly

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Polymicrogyria

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Polymicrogyria

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6.Heterotopias

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CSF-WM-GM

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Heterotopia

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subependymal heterotopia

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Large ventricles with macrocephaly =Hydrocephalus

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CSF flow

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Aqueductal stenosis

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PHVD

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PHVD

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PHVD

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ACKNOWLEDGEMENTS

NICU-NCC

  • Alixe Howlett
  • Hussein Zein
  • Prashanth Murthy
  • Thierry Lacaze
  • Leonora Hendson
  • Elsa Fiedrich
  • Ayman Abou Mehrem
  • Ipsita Goswami
  • Jan Lind
  • Cathy Metcalf
  • Leigh Irvine
  • Norma Oliver

SANTS outreach program team

  • Sumesh Thomas
  • Renee Paul
  • NTNs and TRTs

Pediatric-NCC

  • Michael Esser
  • Luis Bello-Espinoza
  • Jeffrey Buchhalter
  • JP Appendino
  • Aleksandra Mineyko
  • Jong Rho
  • Adam Kirton
  • Harvey Sarnat
  • Alice Ho
  • Kim Smyth
  • Xing-Chang Wei
  • James Scott
  • Megan Crone
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THANK YOU!