Reliability of Early Magnetic Resonance Imaging (MRI) and Necessity of Repeating MRI in Noncooled and Cooled Infants With Neonatal Encephalopathy.
In cooled newborns with encephalopathy, although late magnetic resonance imaging (MRI) scan (10-14 days of age) is reliable in predicting long-term outcome, it is unknown whether early scan (3-6 days of life) is. We compared the predominant pattern and extent of lesion between early and late MRI in 89 term neonates with neonatal encephalopathy. Forty-three neonates (48%) were cooled. The predominant pattern of lesions and the extent of lesion in the watershed region agreed near perfectly in noncooled (kappa = 0.94; k = 0.88) and cooled (k = 0.89; k = 0.87) infants respectively. There was perfect agreement in the extent of lesion in the basal nuclei in noncooled infants (k = 0.83) and excellent agreement in cooled infants (k = 0.67). Changes in extent of lesions on late MRI occurred in 19 of 89 infants, with higher risk in infants with hypoglycemia and moderate-severe lesions in basal nuclei. In most term neonates with neonatal encephalopathy, early MRI (relative to late scan) robustly predicts the predominant pattern and extent of injury.
Department of Pediatrics (Neonatology), University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada Department of Pediatrics (Neurology), University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada School of Clinical Sciences, University of Bristol, St Michael's Hospital, Bristol, United Kingdom.
Elavazhagan
E
Chakkarapani
Department of Pediatrics (Neurology), University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada Department of Radiology, University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada.
Kenneth J
KJ
Poskitt
Department of Pediatrics (Neonatology), University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada Child and Family Research Institute, Vancouver, British Columbia, Canada Department of Pediatrics (Neurology), University of Toronto and the Hospital for Sick Children, Toronto, Ontario, Canada Neurosciences & Mental Health Research Institute, Toronto, Ontario, Canada.
Steven P
SP
Miller
Department of Pediatrics (Developmental Pediatrics), University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada Department of Occupational Science and Occupational Therapy, Vancouver, British Columbia, Canada Child and Family Research Institute, Vancouver, British Columbia, Canada Sunny Hill Health Centre for Children, Vancouver, British Columbia, Canada.
Jill G
JG
Zwicker
Department of Pediatrics (Neurology), University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada.
Qi
Q
Xu
Department of Pediatrics (Neurology), University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada.
Darren S T
DS
Wong
Department of Pediatrics (Neurology), University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada.
Elke H
EH
Roland
Department of Pediatrics (Neurology), University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada.
Alan
A
Hill
Child and Family Research Institute, Vancouver, British Columbia, Canada Department of Pediatrics (Neurology), University of Toronto and the Hospital for Sick Children, Toronto, Ontario, Canada Neurosciences & Mental Health Research Institute, Toronto, Ontario, Canada vann.chau@sickkids.ca.
Vann
V
Chau
D001921:Brain / Q000000981:diagnostic imaging; D001927:Brain Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D007091:Image Processing, Computer-Assisted; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors
asphyxia; brain injury; hypothermia; magnetic resonance imaging; neonatal encephalopathy; newborn