Organ motion can cause artefacts in abdominal imaging particularly with magnetic resonance imaging (MRI), and may often limit the diagnostic quality of an image. If spatial resolution and image quality are to improve in MRI and other imaging techniques, a more detailed understanding of organ motion is required. Despite the importance of organ motion little quantitative information is available to date. This study was the continuation of work instigated to investigate and quantify respiratory movements of upper abdominal organs for a group of healthy volunteers in order to provide the design criteria for a motion test object for use in MRI. A previous phase of the project allowed construction of a test object but refinements were needed to represent respiratory motion more closely as a consequence of the data presented in this paper. Improvements in the scanning technique and the recording procedure have revealed that, contrary to our initial findings, motion of the diaphragm and liver is predominantly in the superior-inferior (SI) direction with an average displacement (+/- SD) (quiet respiration) of 12 +/- 7 mm (range 7-28 mm) and 10 +/- 8 mm (range 5-17 mm), respectively. For some volunteers, motion of the kidneys can be complex, especially during deep inspiration. New data have been provided by this phase of the motion study on the displacement, velocity and acceleration of abdominal organs as a function of time. These data show that MRI motion artefact reduction techniques which assume that either organ displacement, velocity or acceleration are constant are only applicable during certain phases of the respiratory cycle.

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BackgroundExtravasation injury remains an important cause of iatrogenic injury in neonatal intensive care. This study aims to describe the current approach to extravasation injury (EI) prevention and management in Neonatal Intensive Care Units (NICUs) in Australia and New Zealand.MethodsA literature review regarding extravasation injury in the newborn was carried out to inform questionnaire design. An internet-based survey was then conducted with the clinical directors of the 27 tertiary NICUs in Australia and New Zealand.ResultsThe survey received a 96% response rate. Approximately two thirds of Australian and New Zealand NICUs have written protocols for prevention and management of extravasation injury. Considerable practice variation was seen for both prevention and treatment of EI. 92% of units had experienced cases of significant EI.ConclusionsAustralian and New Zealand tertiary neonatal units clearly recognise EI as an important cause of iatrogenic morbidity and mortality. Significant variation still exists among units with regards to guidelines for both prevention and management of EI. We recommend that neonatal staff should remain vigilant, ensuring that guidelines for the prevention and treatment of EI are available, and rigorously followed.