Prognostic value of brain proton MR spectroscopy and diffusion tensor imaging in newborns with hypoxic-ischemic encephalopathy treated by brain cooling
| Autor: | Francesca Sbravati, Sara Grandi, Emil Malucelli, David Neil Manners, Caterina Tonon, Gina Ancora, Claudia Testa, Luigi Corvaglia, Silvia Savini, Laura Ludovica Gramegna, Raffaele Lodi, Giovanni Tani, Giacomo Faldella |
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| Přispěvatelé: | G. Ancora, C. Testa, S. Grandi, C. Tonon, F. Sbravati, S. Savini, D. N. Manner, L. L. Gramegna, G. Tani, E. Malucelli, L. T. Corvaglia, G. Faldella, R. Lodi |
| Rok vydání: | 2013 |
| Předmět: |
Male
MRS medicine.medical_specialty Neurology Encephalopathy Corpus callosum Sensitivity and Specificity Hypoxic Ischemic Encephalopathy White matter Nuclear magnetic resonance Fractional anisotropy medicine Humans Radiology Nuclear Medicine and imaging Neuroradiology HYPOTHERMIA Hypoxic-ischemicencephalopathy business.industry Infant Newborn Brain Reproducibility of Results medicine.disease Prognosis Magnetic Resonance Imaging medicine.anatomical_structure Diffusion Tensor Imaging Treatment Outcome nervous system DTI Cryotherapy Hypoxia-Ischemia Brain Female Neurology (clinical) Protons Cardiology and Cardiovascular Medicine Nuclear medicine business Biomarkers Diffusion MRI |
| Zdroj: | Neuroradiology. 55(8) |
| ISSN: | 1432-1920 |
| Popis: | INTRODUCTION: MRI, proton magnetic resonance spectroscopy (¹H-MRS), and diffusion tensor imaging (DTI) have been shown to be of great prognostic value in term newborns with moderate-severe hypoxic-ischemic encephalopathy (HIE). Currently, no data are available on ¹H-MRS and DTI performed in the subacute phase after hypothermic treatment. The aim of the present study was to assess their prognostic value in newborns affected by moderate-severe HIE and treated with selective brain cooling (BC). METHODS: Twenty infants treated with BC underwent conventional MRI and (1)H-MRS at a mean (SD) age of 8.3 (2.8) days; 15 also underwent DTI. Peak area ratios of metabolites and DTI variables, namely mean diffusivity (MD), axial and radial diffusivity, and fractional anisotropy (FA), were calculated. Clinical outcome was monitored until 2 years of age. RESULTS: Adverse outcome was observed in 6/20 newborns. Both ¹H-MRS and DTI variables showed higher prognostic accuracy than conventional MRI. N-acetylaspartate/creatine at a basal ganglia localisation showed 100% PPV and 93% NPV for outcome. MD showed significantly decreased values in many regions of white and gray matter, axial diffusivity showed the best predictive value (PPV and NPV) in the genu of corpus callosum (100 and 91%, respectively), and radial diffusivity was significantly decreased in fronto white matter (FWM) and fronto parietal (FP) WM. The decrement of FA showed the best AUC (0.94) in the FPWM. CONCLUSION: Selective BC in HIE neonates does not affect the early and accurate prognostic value of ¹H-MRS and DTI, which outperform conventional MRI. |
| Databáze: | OpenAIRE |
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