Early MR detection of cortical and subcortical hypoxic-ischemic encephalopathy in full-term-infants.
Four observations illustrate the potential of MR imaging in the early depiction of multiple types of neuropathologic lesions which may coexist in the full-term newborn, upon severe hypoxic-ischemic encephalopathy (HIE). In particular, diffuse, postnatal involvement of cerebral cortex and subcortical white matter (WM) is demonstrated. Cortical hyperintensity on both proton-density- and T1-weighted images is probably related to cellular necrosis which is distributed diffusely or parasagittally. Hyperintense, frontal, subcortical WM edging on proton-density-weighted images results from the increase of water concentration, induced either by infarct or by edema. Diffuse WM areas of low intensity on T1-weighted images and of high intensity on T2-weighted images are presumably related to cytotoxic and/or vasogenic edema, proportional to the underlying damaged tissues. On follow-up MR examinations, several months later, the importance of cortical atrophy and of the myelination delay appeared related to the importance of the lesions detected during the postnatal period.
Christophe
C
C
Department of Pediatric Radiology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Belgium.
Clercx
A
A
Blum
D
D
Hasaerts
D
D
Segebarth
C
C
Perlmutter
N
N
D002545:Brain Ischemia / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology; D006801:Humans; D002534:Hypoxia, Brain / Q000473:pathology*; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging