Pontine and cerebellar injury in neonatal hypoxic-ischemic encephalopathy: MRI features and clinical outcomes
| Autor: | Koichi Tanda, Zenro Kizaki, Sachiko Koshino, Akira Nishimura, Koji Ohno, Katsumi Hayakawa |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Encephalopathy 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Cerebellum Pons Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Cause of death Radiological and Ultrasound Technology medicine.diagnostic_test business.industry Infant Newborn Magnetic resonance imaging General Medicine medicine.disease Magnetic Resonance Imaging Neonatal Hypoxic Ischemic Encephalopathy Diffusion Magnetic Resonance Imaging Hypoxia-Ischemia Brain Cardiology Female business 030217 neurology & neurosurgery |
| Zdroj: | Acta Radiologica. 61:1398-1405 |
| ISSN: | 1600-0455 0284-1851 |
| DOI: | 10.1177/0284185119900442 |
| Popis: | Background Perinatal hypoxic-ischemic encephalopathy (HIE) is a major cause of death and disability in infants. Magnetic resonance imaging (MRI) is valuable for predicting the outcome in high-risk neonates. The relationship of pontine and cerebellar injury to outcome has not been explored sufficiently. Purpose To characterize MRI features of pontine and cerebellar injury and to assess the clinical outcomes of these neonates. Material and Methods The retrospective study included 59 term neonates (25 girls) examined by MRI using 1.5-T scanner in the first two weeks of life between 2008 and 2017. Involvement of the pons and cerebellum was judged as a high signal intensity on diffusion-weighted image (DWI) and a restricted diffusion on an apparent diffusion coefficient (ADC) map. Results Pontine involvement was observed in the dorsal portion of pons in eight neonates and cerebellar involvement was observed in dentate nucleus (n = 8), cerebellar vermis (n = 3), and hemisphere (n = 1) in 11 neonates. Combined pontine and cerebellar involvement was observed in eight neonates and only cerebellar involvement in three. The pontine and cerebellar injuries were always associated with very severe brain injury including a basal ganglia/thalamus injury pattern and a total brain injury pattern. In terms of clinical outcome, all but four lost to follow-up, had severe cerebral palsy. Conclusion Pontine and cerebellar involvement occurred in the dorsal portion of pons and mostly dentate nucleus and was always associated with a more severe brain injury pattern as well as being predictive of major disability. |
| Databáze: | OpenAIRE |
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