title: Comparison of early and late MRI in neonatal hypoxic-ischemic encephalopathy using three assessment methods.
abstract: BACKGROUND
  There is no consensus on the optimum timing of MRI in neonates with hypoxic-ischemic encephalopathy treated with hypothermia. Reliable early imaging assessment might help managing treatment.
  
  
  OBJECTIVE
  To assess non-random differences between early and late MRI that might influence intensive-care decisions.
  
  
  METHODS
  This single-center retrospective study included all asphyxiated term neonates eligible for hypothermia treatment November 2009-July 2012. MRI scans were systematically performed at day 4 (early MRI) and day 11 of life as part of routine protocol. Two experienced pediatric radiologists reviewed both scans according to three assessment methods: a pattern classification, a scoring system and a simplified classification. Agreement between early and late imaging findings was assessed using Cohen's kappa coefficients.
  
  
  RESULTS
  Thirty-three neonates were included. Interobserver agreement was excellent. Early MRI detected all severe injuries. Agreement between early and late MRI was excellent for the simplified classification (κ = 0.82), good for the pattern classification (κ = 0.64), and good to excellent for 3 scores out of 4 in the scoring system (κ = 0.70-0.89).
  
  
  CONCLUSIONS
  Early MRI may provide valuable information about brain injury to help parents and neonatologists in intensive-care decisions at the end of hypothermia treatment.
authors.affiliation: Department of Imaging, Hôpital Sud, University Hospital, 16 Boulevard de Bulgarie, BP 90347, 35203, Rennes, Cedex 2, France. valerie.charon@chu-rennes.fr.
authors.forename: Valérie
authors.initials: V
authors.lastname: Charon
authors.affiliation: Department of Imaging, Hôpital Sud, University Hospital, 16 Boulevard de Bulgarie, BP 90347, 35203, Rennes, Cedex 2, France.
authors.forename: Maïa
authors.initials: M
authors.lastname: Proisy
authors.affiliation: Department of Neuroradiology, Hôpital Pontchaillou, University Hospital, Rennes, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Ferré
authors.affiliation: Department of Imaging, Hôpital Sud, University Hospital, 16 Boulevard de Bulgarie, BP 90347, 35203, Rennes, Cedex 2, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Bruneau
authors.affiliation: Department of Imaging, Hôpital Sud, University Hospital, 16 Boulevard de Bulgarie, BP 90347, 35203, Rennes, Cedex 2, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Tréguier
authors.affiliation: Department of Neonatology, Hôpital Sud, University Hospital, Rennes, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Beuchée
authors.affiliation: Department of Neonatology, Saint Brieuc Hospital, Saint-Brieuc, France.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Chauvel
authors.affiliation: Department of Imaging, Hôpital Sud, University Hospital, 16 Boulevard de Bulgarie, BP 90347, 35203, Rennes, Cedex 2, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Rozel
mesh_terms: D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000473:pathology* / Q000628:therapy*; D021621:Imaging, Three-Dimensional; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors
keywords: Brain injury; Diffusion-weighted magnetic resonance imaging; Hypoxia-ischemia brain; Induced hypothermia; Neonates