title: Utility of neuroradiographic imaging in predicting outcomes after neonatal extracorporeal membrane oxygenation.
abstract: BACKGROUND
  The need for routine neuroimaging after extracorporeal membrane oxygenation (ECMO) and the optimal radiographic study remains unclear. We sought to evaluate the correlation between findings on head ultrasound (HUS) and magnetic resonance imaging (MRI) and determine the association of these findings to neurodevelopmental outcome.
  
  
  METHODS
  A retrospective review was performed (2003-2010) to identify neonates who had a MRI after ECMO. Each MRI was reviewed by a single pediatric neuroradiologist. Neurodevelopmental data was collected from the high-risk neonatal follow-up clinic.
  
  
  RESULTS
  Fifty neonates had a MRI (venoarterial 37, venovenous 13) after ECMO. HUS was abnormal in 24%, whereas MRI was abnormal in 62%. All infants with an abnormal HUS had an abnormal MRI, but an additional 50% of patients with a normal HUS had an abnormal MRI. Venoarterial ECMO was significantly associated with an abnormal MRI. Follow-up data was available for 26 neonates. The only predictor of abnormal neurodevelopment was the need for supplemental tube feeds at discharge.
  
  
  CONCLUSIONS
  MRI identified significantly more abnormalities compared to routine HUS after neonatal ECMO. However, neither MRI nor HUS findings correlated with early neurodevelopmental outcome. Feeding ability at discharge was the overall best predictor of neurologic impairment in survivors.
authors.affiliation: Division of Pediatric Surgery, University of Utah, Primary Children's Medical Center, Salt Lake City, UT 84113, USA. michael.rollins@imail.org
authors.forename: Michael D
authors.initials: MD
authors.lastname: Rollins
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Yoder
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Moore
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Barnhart
authors.forename: Chris
authors.initials: C
authors.lastname: Jones
authors.forename: Donald M
authors.initials: DM
authors.lastname: Null
authors.forename: Robert J
authors.initials: RJ
authors.lastname: DiGeronimo
mesh_terms: D001921:Brain / Q000098:blood supply*; D004453:Echoencephalography; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D009485:Neuroradiography; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016896:Treatment Outcome