title: Early diffusion-weighted MRI and 1H-Magnetic Resonance Spectroscopy in asphyxiated full-term neonates.
abstract: OBJECTIVE
  To assess the predictive value of early MRI and proton MR spectroscopy ((1)H-MRS), 11 full-term neonates with severe perinatal asphyxia were studied within 48 h after birth.
  
  
  METHODS
  T(1)- and T(2)-weighted MRI, diffusion-weighted MRI (DW-MRI), apparent diffusion coefficient of water (ADC) of the basal ganglia and parietal white matter, as well as (1)H-MRS of the basal ganglia were performed in a 1.5-Tesla magnetic field. Neurodevelopment was assessed in the survivors for at least 24 months.
  
  
  RESULTS
  Nine of the 11 neonates had a poor outcome (7 died, 2 developed cerebral palsy). All examinations were normal in the 2 neonates with a good outcome. T(1)- and T(2)-weighted MRI were abnormal in 7, DWI was abnormal in 7, ADC was abnormal in 5, and elevated lactate/N-acetylaspartate ratios using (1)H-MRS were seen in 7 of the 9 neonates with a poor outcome. None of these 9 had completely normal MRI or (1)H-MRS findings.
  
  
  CONCLUSIONS
  Using a combination of T(1)- and T(2)-weighted MRI, DW-MRI, ADC measurements and (1)H-MRS within 48 h after severe perinatal asphyxia, no abnormalities were seen with any of these techniques in both neonates with a good outcome.
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital/University Medical Center Utrecht, The Netherlands.
authors.forename: Carianne
authors.initials: C
authors.lastname: L'Abee
authors.forename: Linda S
authors.initials: LS
authors.lastname: de Vries
authors.forename: Jeroen
authors.initials: J
authors.lastname: van der Grond
authors.forename: Floris
authors.initials: F
authors.lastname: Groenendaal
mesh_terms: D001238:Asphyxia Neonatorum / Q000150:complications / Q000401:mortality / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D002547:Cerebral Palsy / Q000473:pathology; D004569:Electroencephalography; D005865:Gestational Age; D006801:Humans; D006863:Hydrogen-Ion Concentration; D020925:Hypoxia-Ischemia, Brain / Q000401:mortality / Q000503:physiopathology; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D011379:Prognosis; D014469:Umbilical Arteries