Role of brain SPECT in neonates with hypoxic ischemic encephalopathy and its correlation with neurodevelopmental outcome.
OBJECTIVE
To study cerebral blood flow pattern seen on single photon emission computed tomography (SPECT) scan in neonates with hypoxic ischaemic encephalopathy (HIE) and to correlate it with immediate neurological status and neurodevelopmental outcome; and to compare it with Ultrasonogaphy (USG).


METHODS
Prospective cohort study.


METHODS
Tertiary level Neonatal Intensive Care Unit.


METHODS
All the neonates HIE stage 2 or 3 underwent SPECT scan and USG between the ages of 1-2 weeks. The pattern of deficit seen on SPECT scan was correlated with neurological status, duration of altered sensorium, severity of seizures and short-term neurodevelopmental outcome at 3 months.


RESULTS
The commonest pattern of defect noted was parasagittal hypoperfusion. Babies with severe perfusion defect had higher incidence of difficult to control seizures and longer duration of altered sensorium. The positive predictive value of SPECT scan was 75% while that of USG was 60% and the negative predictive value of SPECT was 100% while that of USG was 76%, when neurodevelopmental outcome at 3 months was considered.


CONCLUSIONS
SPECT scan is superior to ultrasonography in predicting neurodevelopmental outcome in babies with HIE.
Shah
S
S
Division of Neonatology, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai 400 022, India. sshah@pnc.com.au
Fernandez
A R
AR
Chirla
D
D
D001238:Asphyxia Neonatorum / Q000000981:diagnostic imaging*; D001783:Blood Flow Velocity; D001921:Brain / Q000098:blood supply; D001925:Brain Damage, Chronic / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000000981:diagnostic imaging*; D007194:India; D007231:Infant, Newborn; D008297:Male; D009460:Neurologic Examination; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000502:physiology; D015899:Tomography, Emission-Computed, Single-Photon; D017585:Ultrasonography, Doppler, Transcranial