title: Arterial spin-labelling perfusion MRI and outcome in neonates with hypoxic-ischemic encephalopathy.
abstract: OBJECTIVE
  Hyperperfusion may be related to outcome in neonates with hypoxic-ischemic encephalopathy (HIE). The purpose of this study was to evaluate whether arterial spin labelling (ASL) perfusion is associated with outcome in neonates with HIE and to compare the predictive value of ASL MRI to known MRI predictive markers.
  
  
  METHODS
  Twenty-eight neonates diagnosed with HIE and assessed with MR imaging (conventional MRI, diffusion-weighted MRI, MR spectroscopy [MRS], and ASL MRI) were included. Perfusion in the basal ganglia and thalami was measured. Outcome at 9 or 18 months of age was scored as either adverse (death or cerebral palsy) or favourable.
  
  
  RESULTS
  The median (range) perfusion in the basal ganglia and thalami (BGT) was 63 (28-108) ml/100 g/min in the neonates with adverse outcome and 28 (12-51) ml/100 g/min in the infants with favourable outcome (p < 0.01). The area-under-the-curve was 0.92 for ASL MRI, 0.97 for MRI score, 0.96 for Lac/NAA and 0.92 for ADC in the BGT. The combination of Lac/NAA and ASL MRI results was the best predictor of outcome (r(2) = 0.86, p < 0.001).
  
  
  CONCLUSIONS
  Higher ASL perfusion values in neonates with HIE are associated with a worse neurodevelopmental outcome. A combination of the MRS and ASL MRI information is the best predictor of outcome.
  
  
  CONCLUSIONS
  • Arterial spin labelling MRI can predict outcome in neonates with hypoxic-ischemic encephalopathy • Basal ganglia and thalami perfusion is higher in neonates with adverse outcome • Arterial spin labelling complements known MRI parameters in the prediction of outcome • The combined information of ASL and MRS measurements is the best predictor of outcome.
authors.affiliation: Department of Radiology, University Medical Center Utrecht, HP E 01.132, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands, j.devis-2@umcutrecht.nl.
authors.forename: Jill B
authors.initials: JB
authors.lastname: De Vis
authors.forename: Jeroen
authors.initials: J
authors.lastname: Hendrikse
authors.forename: Esben T
authors.initials: ET
authors.lastname: Petersen
authors.forename: Linda S
authors.initials: LS
authors.lastname: de Vries
authors.forename: Frank
authors.initials: F
authors.lastname: van Bel
authors.forename: Thomas
authors.initials: T
authors.lastname: Alderliesten
authors.forename: Simona
authors.initials: S
authors.lastname: Negro
authors.forename: Floris
authors.initials: F
authors.lastname: Groenendaal
authors.forename: Manon J N L
authors.initials: MJ
authors.lastname: Benders
mesh_terms: D001479:Basal Ganglia / Q000098:blood supply; D002547:Cerebral Palsy / Q000209:etiology / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D004578:Electron Spin Resonance Spectroscopy / Q000379:methods; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis* / Q000503:physiopathology; D007223:Infant; D007231:Infant, Newborn; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D013113:Spin Labels; D013788:Thalamus / Q000098:blood supply
chemical_list: D013113:Spin Labels
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