Grace Centre MRI information sheet
Contact details
Newborn Intensive Care (Grace Centre), The Children's Hospital at Westmead
- Telephone: 02 7825 2715
Introduction
Grace Centre for Newborn Care is a specialised newborn nursery which provides intensive care and special care treatment.
About the scan
An MRI stands for Magnetic Resonance Imaging. It is a procedure that uses a strong magnetic field to create detailed images of the body. An MRI generally gives detailed images /pictures than any other imaging scans like X-ray and Ultrasound. They are safe, painless and do not involve radiation exposure.
The scan is generally requested by your baby’s doctor to help diagnose your baby’s condition.
MRI scans can be used to investigate variety of areas such as brain, spine, eyes, ears, heart, chest, lungs, abdomen and bones.
Why babies need anaesthesia for MRI scans
MRI is a painless procedure, but it may take up to two hours during which one is required to stay still. Babies often have difficulty staying still for the whole duration of this procedure. In addition to that, MRI requires your baby to remain perfectly still for good quality, clear pictures. General anaesthesia helps keeping the babies still and minimise movement.
During the scan, your baby will be on a sliding bed which can go inside the MRI scan machine which is shaped like a tunnel. It can be very noisy inside this scan machine.
Preparing for the scan
Fasting
For MRI under general anaesthesia, your baby needs to fast before the scan, usually 2-4 hours. This reduces the risk of aspiration (stomach contents entering lungs) during the procedure.
IV Access
A small Intravenous cannula may be placed on your baby’s hand for administering any anaesthetic medication by the baby doctor or by the paediatric anaesthetist.
Medications - Some medications may need to be withheld depending on specific instructions by medical team.
Consent and Pre-Scan Questionnaire
You will be contacted by the medical team to sign a consent form for the procedure along with filling up a Pre-Scan Questionnaire (which involves questions regarding current allergies, any cold flu symptoms, past general anaesthesia history of your baby to ensure safe administration of anaesthesia).
Babies nurse will also make sure that anything containing metal is removed from your baby or otherwise reported. This is because MRI uses magnets which attract metals. This can be dangerous and affect the quality of the scan. Speak to your baby’s doctor if you are unsure about medical devices or implants. An anaesthetist will also come to assess your baby to make sure that they are fit for anaesthesia.
During the procedure
Usually, you can accompany your baby to MRI but due to limited space in MRI, you will have to wait in the waiting area. Your child will be closely monitored by the paediatric anaesthetist and your baby’s nurse during the procedure for the vital signs including heart rate, respiratory rate, blood pressure, oxygen saturation and breathing.
Your baby will need a breathing tube under general anaesthesia and will be supported by the ventilator for the breathing. Also, your baby will be swaddled and will have earmuffs on ears to reduce noise of the scanner interrupting their sleep status.
Feed and Wrap Procedure
The babies who are not on any respiratory support, or not critically unwell, and are on full oral feeds are sometimes considered the candidates for feed and wrap MRI scan. To minimise movements by your baby, they are swaddled for the scan after being fed. However, a mild oral sedative dosage, which is not as strong as anaesthesia, may still be required if your baby does not remain still.
Common questions
What does general anaesthesia involve?
Anaesthetic drugs may be used to keep your baby still and avoid movement during MRI scan. Frequently, these medications will be anaesthetic gases that are inhaled through an anaesthetic machine and circuit. This is a particularly common technique for babies who are already having a breathing tube in place. Other drugs may include medications that are injected into an intravenous cannula.
Your baby’s vital signs will be monitored continuously throughout the procedure.
Depending on what anaesthetic drugs were used it is possible that these medications may still have an effect (baby staying still with minimal movement, eye lids closed) for some time after your baby returns to the NICU from the MRI scan.
Are there any complications related to MRI under general anaesthesia?
MRI scans are usually safe with no adverse effects expected in babies. However, there may be some common side effects related to anaesthesia which is extremely rare and are not long-lasting. These may involve altered blood pressure, temperature, increased requirement for oxygen. You will be explained about the risks by your paediatric anaesthetist. Nevertheless, your baby will be closely monitored and assessed prior to the procedure and during and post procedure to avoid this.
Who can I talk to?
Your child’s medical team will be able to talk to you about why they believe an MRI scan may be beneficial for your baby’s care.
If you have any specific questions about the anaesthesia required for the MRI scan, the NICU doctor/ nurse will be able to put you in touch with one of the paediatric anaesthetists.
If you have additional questions or concerns, please feel free to talk to your baby’s nurse or doctor.
After the scan
After making sure that your baby’s vital signs are stable, your baby will be transported back to Grace NICU for further monitoring. Although, your baby will be closely monitored for all the vital signs (heart rate, respiratory rate, oxygen saturation) inside scanner room, but due to non-availability of MRI compatible temperature monitor and blood pressure monitor, blood pressure and temperature cannot be monitored continuously.
After you baby comes out of the scanner room, his/her temperature and blood pressure will be assessed. In case they are cold (temperature less than 36.5 degree celsius), they will be warmed for 15 minutes under overhead warmer before being transferred to Grace.
Any medical intervention for blood pressure if needed will be attended by the anaesthetist team. The waking time for each baby varies after MRI, most babies usually wake up in 4-8 hours. It will be decided by your baby’s medical team to take out the breathing tube as per your baby’s condition and vital signs.
The results for MRI scan are usually not reported immediately. This is because MRI scan involves lot of images which may take longer (about a day or two) for a radiologist to report in detail. If you have any questions and concerns regarding this, please don’t hesitate to talk to your baby’s doctor.