Early MRI in term infants with perinatal hypoxic–ischaemic brain injury: Interobserver agreement and MRI predictors of outcome at 2 years
| Autor: | Stacy Goergen, Graham Whiteley, Rachel Evans, Eldho Paul, Jenni Clark, Margaret Charlton, Flora Y. Wong, Elizabeth Carse, Hazel Ang, Jeanie Ling Yoong Cheong, David Shipp, Damien Jolley |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Magnetic Resonance Spectroscopy Lentiform nucleus Encephalopathy Sensitivity and Specificity Bayley Scales of Infant Development Predictive Value of Tests medicine Humans Effective diffusion coefficient Radiology Nuclear Medicine and imaging cardiovascular diseases Observer Variation Aspartic Acid Univariate analysis medicine.diagnostic_test business.industry Infant Newborn Magnetic resonance imaging General Medicine Prognosis medicine.disease Magnetic Resonance Imaging Diffusion Magnetic Resonance Imaging Predictive value of tests Hypoxia-Ischemia Brain Lactates Female Abnormality business Nuclear medicine |
| Zdroj: | Clinical Radiology. 69:72-81 |
| ISSN: | 0009-9260 |
| DOI: | 10.1016/j.crad.2013.09.001 |
| Popis: | To compare diffusion-weighted imaging (DWI) and non-DWI magnetic resonance imaging (MRI), proton MR spectroscopy (1H-MRS), and clinical biomarkers for prediction of 2 year developmental outcome in term infants with perinatal hypoxic-ischaemic encephalopathy (HIE).Nineteen infants ≥36 weeks gestation with HIE were recruited and MRI performed day 3-7 (mean = 5). MRI was scored independently by three radiologists using a standardized scoring system. Lactate-to-N-acetylaspartate ratio (Lac:NAA) in the lentiform nucleus was calculated. Developmental assessment was performed at 2 years using the Bayley Scales of Infant and Toddler Development (BSID-III). Interobserver agreement about abnormality in 10 brain regions was measured. Univariate analysis was performed to determine variables associated with adverse outcome (i.e., death or Bayley score for any domain70).Good interobserver agreement (kappa = 0.61-0.69) on scores for DWI was obtained for the cortex, putamen, and brainstem, but not for any region on non-DWI. A significant association was found between outcome and Lac:NAA (p0.003) and DWI scores for lentiform nucleus, thalamus, cortex, posterior limb of the internal capsule (PLIC), and paracentral white matter (p = 0.001-0.013), but for non-DWI score only in the vermis or brainstem. A combination of Lac:NAA ≥0.25 or DWI/apparent diffusion coefficient (ADC) signal abnormality in the PLIC had 100% specificity and sensitivity for poor outcome.Interobserver agreement for non-DWI performed during the first week is poor. Agreement by three radiologists about the presence of abnormal signal within the PLIC on ADC/DWI images or elevation of Lac:NAA above 0.25 improved sensitivity without reducing the prognostic specificity of MRS in the 19 patients, but this requires validation in a larger group of infants with HIE who have been treated with hypothermia. |
| Databáze: | OpenAIRE |
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