TY - JOUR
T1 - Quantitative cranial magnetic resonance imaging in neonatal hypoxic-ischemic encephalopathy
AU - Mulkey, Sarah B.
AU - Yap, Vivien L.
AU - Swearingen, Christopher J.
AU - Riggins, Melissa S.
AU - Kaiser, Jeffrey
AU - Schaefer, G. Bradley
N1 - Funding Information:
S.B.M. thanks the Arkansas Children's Hospital Research Institute for generous support with research time, the Arkansas Biosciences Institute, and the support of grant P20 GM103425 from the National Institutes of Health. The authors also thank Crystal Bland for assisting with magnetic resonance imaging measurements.
PY - 2012/8
Y1 - 2012/8
N2 - The volume of acute injury detected by diffusion-weighted imaging and quantitative brain growth on serial cranial magnetic resonance imaging was not previously used to predict neurodevelopmental outcomes in infants with neonatal hypoxic-ischemic encephalopathy treated with head cooling. Our longitudinal study involved 16 head-cooled term infants with hypoxic-ischemic encephalopathy who underwent early and follow-up cranial magnetic resonance imaging and follow-up neurologic evaluations, out of 105 infants who received therapeutic hypothermia. The volume of acute injury was measured on initial cranial magnetic resonance imaging, using diffusion-weighted images. Total brain volumes were measured in both early and follow-up magnetic resonance imaging studies. Acute injury volume in the corpus callosum >0.5 cm3 was associated with developing epilepsy (odds ratio, 20; 95% confidence interval, 1.01-1059.6; P = 0.013). Follow-up whole brain volume was reduced in those with unfavorable outcomes (i.e., epilepsy, cerebral palsy, and delayed developmental milestones), compared with infants without all three outcomes. Although acute brain injury volume and brain growth measurements may be useful predictors of outcomes in neonatal hypoxic-ischemic encephalopathy, the evolution of brain injury in these infants has yet to be fully understood and should be studied prospectively.
AB - The volume of acute injury detected by diffusion-weighted imaging and quantitative brain growth on serial cranial magnetic resonance imaging was not previously used to predict neurodevelopmental outcomes in infants with neonatal hypoxic-ischemic encephalopathy treated with head cooling. Our longitudinal study involved 16 head-cooled term infants with hypoxic-ischemic encephalopathy who underwent early and follow-up cranial magnetic resonance imaging and follow-up neurologic evaluations, out of 105 infants who received therapeutic hypothermia. The volume of acute injury was measured on initial cranial magnetic resonance imaging, using diffusion-weighted images. Total brain volumes were measured in both early and follow-up magnetic resonance imaging studies. Acute injury volume in the corpus callosum >0.5 cm3 was associated with developing epilepsy (odds ratio, 20; 95% confidence interval, 1.01-1059.6; P = 0.013). Follow-up whole brain volume was reduced in those with unfavorable outcomes (i.e., epilepsy, cerebral palsy, and delayed developmental milestones), compared with infants without all three outcomes. Although acute brain injury volume and brain growth measurements may be useful predictors of outcomes in neonatal hypoxic-ischemic encephalopathy, the evolution of brain injury in these infants has yet to be fully understood and should be studied prospectively.
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U2 - 10.1016/j.pediatrneurol.2012.05.009
DO - 10.1016/j.pediatrneurol.2012.05.009
M3 - Article
C2 - 22759685
AN - SCOPUS:84863309102
SN - 0887-8994
VL - 47
SP - 101
EP - 108
JO - Pediatric Neurology
JF - Pediatric Neurology
IS - 2
ER -