Magnetic Resonance Imaging - Research Paper Example

Magnetic Resonance Imaging (MRI) on prematurely born babies: Can it really predict the babies’ future neurodevelopmental outcomes? CET 116 Computer Applications for Technology Abstract Premature birth is a leading public-health concern due to its growing prevalence in conjunction with the numerous occurrences of consequent risks in the behavior and mental development confronted by surviving newborns. Magnetic Resonance Imaging is becoming extensively accessible and gradually vital for producing images of the brain of prematurely born babies. It is successful in the assessment of the brain development in these infants (“Neurobiological Determinants of Human Communication: Prematurity and Early Childhood”).This paper will address the natural susceptibility of the developing neonatal brain in preterm infants, the function of magnetic resonance imaging (MRI) as an instrument in the detection of atypical growth and brain damage in premature babies, and the possible role for new MR imaging techniques as biological indicators for intellectual progress and damage in preterm infants. Introduction Magnetic resonance imaging (MRI) is a noninvasive health procedure that assists physicians in the detection and treatment of medical conditions. MR imaging applies controlling magnets, radio rhythms and a computer to create detailed images of internal structure and specific function of the body. These representations can subsequently be observed on a computer screen, and reproduced to a compact disc. Unlike computed tomography (CT), x-ray and ultrasound, detailed MRI uses no ionizing radiation for improved assessment of certain parts of the body and specific maladies (“Functional MRI (fMRI) – Brain”). Premature birth causes an increase in the number of children with neurodevelopmental sequences, with an occurrence of limiting physical and mental conditions varying from 20% to 50% (Bhutta et al). The increasing number of majority of babies who survived premature birth and low-birth weight may have augmented the possibility of unfavorable lasting results, particularly in the cognition and behavior delays, even though some major injuries of the brain are not as prevalent as compared to its incidence a few years back (Hamrick et al). The use of a more effective and accurate neuroimaging method, such as magnetic resonance imaging (MRI), is now widely preferred in the detection of slight to severe injuries of the infant’s brain (Woodward et al). Is MRI on prematurely born babies predictive of neurodevelopmental outcomes? There is a high possibility of neurodevelopmental harms in infants born prematurely, which may lead to consequential long-term impairments. Damage to the white brain matter, irregular brain growth and general illness are interconnected defects that usually result from premature birth or heart birth abnormalities, with reduced white matter volume being the distinguishing pattern of brain damage. It is still unidentified as to why central non-cystic damage in white matter is coupled with distributed irregularities of fine and gross motor function and cognitive ability. Steroidal therapies and general illness such as infection may possibly be connected with distributed irregularities of the functions of motor movements and cognition (Miller). Technological progress in magnetic resonance (MR) permits the careful study of brain growth and brain damage in seriously unwell babies. MRI is a responsive means to determine brain composition and lesions. Specifically, “deformation morphometry”, “diffusion tensor imaging”, and “magnetic resonance spectroscopic imaging”, may be used to measure brain composition, micro-organization and metabolic process. With the use of more sophisticated magnetic resonance imaging methods, in addition to amplitude incorporated EEG and infra-red radiation, physicians are able to study brain growth and lesions in susceptible populace of infants (Miller). Seven years ago, studies showed that over 5% of all British Columbian births were preterm. Prematurely born offsprings are at very elevated possibility for developmental impairments. A margin of 5-10% of low birth-weight children shows considerable delays in motor functions. Almost half of these children were found to demonstrate severe behavioral, developmental and physical insufficiencies. The biggest significant brain pathology connected with these delays is damage to the white matter of the brain. Research was done by the University of British Columbia Professor Steven Miller on the Developmental Neurosciences & Child Health, typifying the outcomes of irregular brain growth and white matter harm in prematurely born infants and comprising brain development impairments in motor and cognition. Miller’s study backs up evidences that (1) brain lesions in preterm babies is carefully discovered with magnetic resonance imaging prior to “term-equivalent age”; (2) the brain’s central non-cystic white matter damage is the distinctive prototype of harm in the prematurely born infants; (3) early brain lesions is coupled with unfavorable early neurodevelopmental effects; and (4) brain damage in the undeveloped brain hinders later brain developmental functions (Miller). In a study made by Pediatrics Professor Inder of Radiology and Neurology at the Washington University School of Medicine, and some pediatric examiners in New Zealand and Australia, it was discovered that magnetic resonance imaging examinations were capable of verifying aberrations in the white and gray matter volumes of premature newborns. Observing these infants from birth to 2 years of age, the researchers were able to mark the discovered irregularities to foresee the possibility of major postponements in motor and cognitive functions, cerebral palsy, or visual and auditory disabilities that may perhaps be noticeable by age 2 (Woodward et al). According to a study performed on 167 preterm babies in New Zealand and Australia and at St. Louis Children's Hospital, Inder said that magnetic resonance imaging is the biggest advancement in technology as cranial ultrasound alone, can not detect brain abnormalities in infants. "With the MRI, now we can understand what's going wrong in the developing brain when the baby is born early. We can use the MRI when the baby reaches full-term (40 weeks) to predict neurodevelopmental outcomes," Inder said. Births prior to 32 gestation weeks are over 2 % of all live deliveries. Consistent to the March of Dimes, premature birth rate generally escalated 13 % between 1992 and 2002. Current records confirm that more than half of prematurely born children are likely to suffer from neurodevelopmental issues of psychomotor abilities and other functions necessary for synchronization and equilibrium. Five to fifteen % of surviving children suffer from cerebral palsy, major visual or auditory malfunctions or both, and those that have deficits on behavioral, social and cognitive functions amount to 25 - 50 percent of surviving children. These children may require special education services (Woodward et al). The magnetic resonance imaging procedure illustrates brain injuries, damaged brain areas, and the degree of potential developmental deficits. Based on which part of the brain is damaged, it would be predictive if the child would later need therapies to correct such injuries. If the brain injury is in the region that is responsible for motor skills, then it would be expected that the child may have impediments in movement, and would therefore require physical therapy. Likewise, if the part damaged is in the area where cognitive functions are processed, then possible future behavioral therapies would be helpful (Woodward et al). "We can use these results to determine which baby would benefit most from physical, occupational or speech therapy. We can also help prepare the parents for future challenges with learning delays and developmental disabilities,” Inder stated (Woodward et al). David Edwards and associates from Imperial College London made a study on the brain development of 113 preterm infants born 22 to 26 gestation weeks through the use of magnetic resonance imaging techniques. Half of these infants were then evaluated for mental growth from birth up to a period of 2 years. MRI evidences showed that exterior part of the brain matures sooner than the brain capacity, however the slower growth rate of the exterior part in relation to volume may mean a greater risk of the child’s developmental delays. Male preterm infants are more susceptible to slower development of the exterior part of the brain relative to the brain volume. The exterior region develops more than the volume; on the other hand, the discoveries imply that the standard mode of brain development is disturbed in prematurely born infants and the degree of growth interruption may forecast a delay in neurodevelopmental functions two years after. The more premature the birth, the bigger the delay is. Moreover, there are more male children affected than females. If these consequences are verified in more preterm infants then it may be more likely to observe brain growth after birth so as to forecast which children may require neurodevelopmental services in the future. Edwards’ research furthermore proposes probable ways for supplementary effort to comprehend the precise neuroanatomy of disabilities in preterm children (“Abnormal Pattern of Brain Development in Premature Babies”). Conclusion Magnetic resonance imaging scan is effective in forecasting possible developmental results in prematurely born infants. MRI scan exposes irregularities that are not detectable in a cranial ultrasound. It can make predictions of developmental concerns that would later be noticeable when the child reaches the age of two. Although cranial ultrasound is the usual and well-chosen practice for neuroimaging examination and evaluating brain lesions in preterm babies, it was recently discovered to be inadequately responsive to predict the broad spectrum of white matter damages. Magnetic resonance imaging scans are more prognostic of early developmental postponement. MRIs are predictive of the communicative, perceptual, cognitive, and attentional difficulties that may affect the well-being of several exceedingly low birth weight surviving infants. The capacity of sophisticated magnetic resonance imaging procedures in detecting which newborns have brain irregularities or abnormalities may assist parents and medical practitioners for better care of dangerously ill preterm infants. However, with the continuing advancement in technology, magnetic resonance imaging may still be improved for a faster, more effective and concise prognosis of neurodevelopmental abnormalities in preterm infants. Works Cited “Abnormal Pattern of Brain Development in Premature Babies.” Medical News Today. 2006. 14 March 2010. Bhutta, Adnan T. et al. “Cognitive and Behavioral Outcomes of School-aged Children who were Born Preterm: A Meta-analysis.” Journal of the American Medical Association. 2002. 288:728-737. “Fetal MRI.” Magnetic Resonance – Technology Information Portal. 2010. 14 March 2010. “Functional MRI (fMRI) – Brain.” Radiology Information. 2010. 14 March 2010. Hamrick, Shannon E. et al. “Trends in Severe Brain Injury and Neurodevelopmental Outcome in Premature Newborn Infants: The Role of Cystic Periventricular Leukomalacia.” Journal of Pediatrics. 2004. 145:593-599. Miller, Stephen P. “Brain Development and Injury in the Newborn.” Child & Family Research Institute. 1 Sept. 2009. 14 March 2010. “Neurobiological Determinants of Human Communication: Prematurity and Early Childhood.” Journal of Communication Disorders. July – August 2009. 42. 4:248-255. Woodward, Lianne J. et al. “Neonatal MRI to Predict Neurodevelopmental Outcomes in Preterm Infants.” New England Journal of Medicine. 17 Aug. 2006. 355:658-694. Read More