A validated clinical MRI injury scoring system in neonatal hypoxic-ischemic encephalopathy
| Autor: | Rakesh Rao, Zachary A. Vesoulis, Amit M. Mathur, Robert C. McKinstry, Steve M. Liao, Shamik Trivedi, Joshua S. Shimony |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Internal capsule Encephalopathy Severity of Illness Index Bayley Scales of Infant Development Article Hypoxic Ischemic Encephalopathy White matter 03 medical and health sciences 0302 clinical medicine Hypothermia Induced 030225 pediatrics medicine Humans Radiology Nuclear Medicine and imaging Neuroradiology medicine.diagnostic_test business.industry Putamen Infant Newborn Reproducibility of Results Magnetic resonance imaging medicine.disease Magnetic Resonance Imaging Diffusion Magnetic Resonance Imaging Treatment Outcome medicine.anatomical_structure Anesthesia Hypoxia-Ischemia Brain Pediatrics Perinatology and Child Health Female Radiology business 030217 neurology & neurosurgery |
| Zdroj: | Pediatric Radiology. 47:1491-1499 |
| ISSN: | 1432-1998 0301-0449 |
| DOI: | 10.1007/s00247-017-3893-y |
| Popis: | Deep nuclear gray matter injury in neonatal hypoxic-ischemic encephalopathy (HIE) is associated with worse neurodevelopmental outcomes. We previously published a qualitative MRI injury scoring system utilizing serial T1-weighted, T2-weighted and diffusion-weighted imaging (DWI), weighted for deep nuclear gray matter injury. To establish the validity of the MRI scoring system with neurodevelopmental outcome at 18-24 months. MRI scans from neonates with moderate to severe HIE treated with therapeutic hypothermia were evaluated. Signal abnormality was scored on T1-weighted, T2-weighted and DWI sequences and assessed using an established system in five regions: (a) subcortical: caudate nucleus, globus pallidus and putamen, thalamus and the posterior limb of the internal capsule; (b) white matter; (c) cortex, (d) cerebellum and (e) brainstem. MRI injury was graded as none, mild, moderate or severe. Inter-rater reliability was tested on a subset of scans by two independent and blinded neuroradiologists. Surviving infants underwent the Bayley Scales of Infant and Toddler Development-III (Bayley-III) at 18-24 months. Data were analyzed using univariate and multivariate linear and logistic regression. Fifty-seven eligible neonates underwent at least one MRI scan in the first 2 weeks of life. Mean postnatal age at scan 1 was 4±2 days in 50/57 (88%) neonates and 48/54 (89%) surviving infants underwent scan 2 at 10±2 days. In 54/57 (95%) survivors, higher MRI injury grades were significantly associated with worse outcomes in the cognitive, motor and language domains of the Bayley-III. A qualitative MRI injury scoring system weighted for deep nuclear gray matter injury is a significant predictor of neurodevelopmental outcome at 18–24 months in neonates with HIE. |
| Databáze: | OpenAIRE |
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