title: Pulmonary MRI of neonates in the intensive care unit using 3D ultrashort echo time and a small footprint MRI system.
abstract: To determine the feasibility of pulmonary magnetic resonance imaging (MRI) of neonatal lung structures enabled by combining two novel technologies: first, a 3D radial ultrashort echo time (UTE) pulse sequence capable of high spatial resolution full-chest imaging in nonsedated quiet-breathing neonates; and second, a unique, small-footprint 1.5T MRI scanner design adapted for neonatal imaging and installed within the neonatal intensive care unit (NICU).
  
  
  
  Ten patients underwent MRI within the NICU, in accordance with an approved Institutional Review Board protocol. Five had clinical diagnoses of bronchopulmonary dysplasia (BPD), and five had putatively normal lung function. Pulmonary imaging was performed at 1.5T using 3D radial UTE and standard 3D fast gradient recalled echo (FGRE). Diagnostic quality, presence of motion artifacts, and apparent severity of lung pathology were evaluated by two radiologists. Quantitative metrics were additionally used to evaluate lung parenchymal signal.
  
  
  
  UTE images showed significantly higher signal in lung parenchyma (P < 0.0001) and fewer apparent motion artifacts compared to FGRE (P = 0.046). Pulmonary pathology was more severe in patients diagnosed with BPD relative to controls (P = 0.001). Infants diagnosed with BPD also had significantly higher signal in lung parenchyma, measured using UTE, relative to controls (P = 0.002).
  
  
  
  These results demonstrate the technical feasibility of pulmonary MRI in free-breathing, nonsedated infants in the NICU at high, isotropic resolutions approaching that achievable with computed tomography (CT). There is potential for pulmonary MRI to play a role in improving how clinicians understand and manage care of neonatal and pediatric pulmonary diseases. J. Magn. Reson. Imaging 2016.
  
  
  
  2 J. Magn. Reson. Imaging 2017;45:463-471.
authors.affiliation: Department of Medical Physics, University of Wisconsin, Madison, WI.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Hahn
authors.affiliation: Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.|Department of Physics, Washington University in St. Louis, St. Louis, MO.
authors.forename: Nara S
authors.initials: NS
authors.lastname: Higano
authors.affiliation: Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Laura L
authors.initials: LL
authors.lastname: Walkup
authors.affiliation: Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.|Department of Physics, Washington University in St. Louis, St. Louis, MO.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Thomen
authors.affiliation: Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.|Department of Physics, University of Cincinnati, Cincinnati, OH.
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Cao
authors.affiliation: Perinatal Institute, Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Merhar
authors.affiliation: Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Jean A
authors.initials: JA
authors.lastname: Tkach
authors.affiliation: Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.|Department of Physics, Washington University in St. Louis, St. Louis, MO.
authors.forename: Jason C
authors.initials: JC
authors.lastname: Woods
authors.affiliation: Department of Medical Physics, University of Wisconsin, Madison, WI.
authors.forename: Sean B
authors.initials: SB
authors.lastname: Fain
mesh_terms: D004867:Equipment Design; D019544:Equipment Failure Analysis; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation; D021621:Imaging, Three-Dimensional / Q000295:instrumentation*; D007363:Intensive Care Units, Neonatal; D008168:Lung / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D008297:Male; D008904:Miniaturization; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: 3D radial; UTE; bronchopulmonary dysplasia; lung; neonates; pulmonary MRI