title: Comparison of computer tomography and magnetic resonance imaging scans on the third day of life in term newborns with neonatal encephalopathy.
abstract: OBJECTIVE
  Our goal was to compare the patterns of brain injury detected by computed tomography, conventional MRI (T1- and T2-weighted sequences), and diffusion-weighted MRI in a cohort of term newborns with neonatal encephalopathy studied uniformly with all 3 modalities on the third day of life.
  
  
  METHODS
  Term newborns (> or =36 weeks' gestation) admitted to our center with neonatal encephalopathy were scanned with computed tomography, MRI, and diffusion-weighted MRI at 72 (+/-12) hours of life (n = 48). Each modality was scored independently of the other with previously validated scoring systems. The predominant pattern of brain injury was classified as: normal, watershed, basal nuclei, total (maximal basal nuclei and watershed), and focal-multifocal (presence of strokes and/or white matter injury alone).
  
  
  RESULTS
  The agreement for the predominant pattern of injury was excellent between MRI and diffusion-weighted MRI (77% agreement). The agreement for the pattern of injury was also good for computed tomography and diffusion-weighted MRI (67% agreement). The extent of cortical injury and focal-multifocal lesions, such as strokes and white matter injury, were less apparent on computed tomography than diffusion-weighted MRI. In 19 newborns with a repeat MRI in the second week of life, the predominant pattern seen on the day 3 diffusion-weighted MRI was confirmed.
  
  
  CONCLUSIONS
  Diffusion-weighted MRI is the most sensitive technique with which to assess brain injury on day 3 of life in term newborns with neonatal encephalopathy, particularly for cortical injury and focal-multifocal lesions such as stroke and white matter injury. All 3 modalities identify the most serious patterns of brain injury similarly.
authors.affiliation: Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Vann
authors.initials: V
authors.lastname: Chau
authors.forename: Kenneth John
authors.initials: KJ
authors.lastname: Poskitt
authors.forename: Michael Andrew
authors.initials: MA
authors.lastname: Sargent
authors.forename: Brian Alexander
authors.initials: BA
authors.lastname: Lupton
authors.forename: Alan
authors.initials: A
authors.lastname: Hill
authors.forename: Elke
authors.initials: E
authors.lastname: Roland
authors.forename: Steven Paul
authors.initials: SP
authors.lastname: Miller
mesh_terms: D000367:Age Factors; D015331:Cohort Studies; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D007231:Infant, Newborn; D008297:Male; D047929:Term Birth / Q000502:physiology; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000592:standards