title: Semi-quantitative assessment of brain maturation by conventional magnetic resonance imaging in neonates with clinically mild hypoxic-ischemic encephalopathy.
abstract: BACKGROUND
  Mild hypoxic-ischemic encephalopathy (HIE) injury is becoming the major type in neonatal brain diseases. The aim of this study was to assess brain maturation in mild HIE neonatal brains using total maturation score (TMS) based on conventional magnetic resonance imaging (MRI).
  
  
  METHODS
  Totally, 45 neonates with clinically mild HIE and 45 matched control neonates were enrolled. Gestated age, birth weight, age after birth and postmenstrual age at magnetic resonance (MR) scan were homogenous in the two groups. According to MR findings, mild HIE neonates were divided into three subgroups: Pattern I, neonates with normal MR appearance; Pattern II, preterm neonates with abnormal MR appearance; Pattern III, full-term neonates with abnormal MR appearance. TMS and its parameters, progressive myelination (M), cortical infolding (C), involution of germinal matrix tissue (G), and glial cell migration bands (B), were employed to assess brain maturation and compare difference between HIE and control groups.
  
  
  RESULTS
  The mean of TMS was significantly lower in mild HIE group than it in the control group (mean ± standard deviation [SD] 11.62 ± 1.53 vs. 12.36 ± 1.26, P < 0.001). In four parameters of TMS scores, the M and C scores were significantly lower in mild HIE group. Of the three patterns of mild HIE, Pattern I (10 cases) showed no significant difference of TMS compared with control neonates, while Pattern II (22 cases), III (13 cases) all had significantly decreased TMS than control neonates (mean ± SD 10.56 ± 0.93 vs. 11.48 ± 0.55, P < 0.05; 12.59 ± 1.28 vs. 13.25 ± 1.29, P < 0.05). It was M, C, and GM scores that significantly decreased in Pattern II, while for Pattern III, only C score significantly decreased.
  
  
  CONCLUSIONS
  The TMS system, based on conventional MRI, is an effective method to detect delayed brain maturation in clinically mild HIE. The conventional MRI can reveal the different retardations in subtle structures and development processes among the different patterns of mild HIE.
authors.forename: Jie
authors.initials: J
authors.lastname: Gao
authors.forename: Qin-Li
authors.initials: QL
authors.lastname: Sun
authors.forename: Yu-Miao
authors.initials: YM
authors.lastname: Zhang
authors.forename: Yan-Yan
authors.initials: YY
authors.lastname: Li
authors.forename: Huan
authors.initials: H
authors.lastname: Li
authors.forename: Xin
authors.initials: X
authors.lastname: Hou
authors.forename: Bo-Lang
authors.initials: BL
authors.lastname: Yu
authors.forename: Xi-Hui
authors.initials: XH
authors.lastname: Zhou
authors.affiliation: Department of Diagnostic Radiology, The First Hospital of Xi'an Jiaotong University, Xi'an, Shannxi 710061, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Yang
mesh_terms: D001921:Brain / Q000473:pathology*; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis*; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male