title: Correlation of MRI Brain Injury Findings with Neonatal Clinical Factors in Infants with Congenital Diaphragmatic Hernia.
abstract: Infants with congenital diaphragmatic hernia are reported to have evidence of brain MR imaging abnormalities. Our study aimed to identify perinatal clinical factors in infants with congenital diaphragmatic hernia that are associated with evidence of brain injury on MR imaging performed before hospital discharge.
  
  
  
  MRIs performed before hospital discharge in infants with congenital diaphragmatic hernia were scored for brain injury by 2 pediatric neuroradiologists. Perinatal variables and clinical variables from the neonatal intensive care unit stay were analyzed for potential associations with brain MR imaging findings.
  
  
  
  Fifty-three infants with congenital diaphragmatic hernia (31 boys) were included. At least 1 abnormality was seen on MR imaging in 32 infants (60%). The most common MR imaging findings were enlarged extra-axial spaces (36%), intraventricular hemorrhage (23%), ventriculomegaly (19%), white matter injury (17%), and cerebellar hemorrhage (17%). The MR imaging brain injury score was associated with extracorporeal membrane oxygenation (P = .0001), lack of oral feeding at discharge (P = .012), use of inotropes (P = .027), and gastrostomy tube placement before hospital discharge (P = .024). The MR imaging brain injury score was also associated with a large diaphragmatic defect size (P = .011).
  
  
  
  Most infants with congenital diaphragmatic hernia have at least 1 abnormality identified on MR imaging of the brain performed before discharge. The main predictors of brain injury in this population are a requirement for extracorporeal membrane oxygenation, large diaphragmatic defect size, and lack of oral feeding at discharge.
authors.affiliation: From the Departments of Radiology (R.R., B.K.-F.) rupa.radhakrishnan@cchmc.org.
authors.forename: R
authors.identifier: 0000-0001-5224-1891
authors.initials: R
authors.lastname: Radhakrishnan
authors.affiliation: Perinatal Institute (S.M., B.H.), Division of Neonatology.
authors.forename: S
authors.identifier: 0000-0002-3331-4220
authors.initials: S
authors.lastname: Merhar
authors.affiliation: Biostatistics and Epidemiology (J.M.-D.).
authors.forename: J
authors.identifier: 0000-0001-7765-6006
authors.initials: J
authors.lastname: Meinzen-Derr
authors.affiliation: Perinatal Institute (S.M., B.H.), Division of Neonatology.
authors.forename: B
authors.identifier: 0000-0003-0158-6050
authors.initials: B
authors.lastname: Haberman
authors.affiliation: Fetal Care Center (F.Y.L., P.B.), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: F Y
authors.identifier: 0000-0003-4362-8431
authors.initials: FY
authors.lastname: Lim
authors.affiliation: Fetal Care Center (F.Y.L., P.B.), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: P
authors.identifier: 0000-0002-5211-3045
authors.initials: P
authors.lastname: Burns
authors.affiliation: Pediatrics (E.Z.).
authors.forename: E
authors.identifier: 0000-0003-4271-811X
authors.initials: E
authors.lastname: Zorn
authors.affiliation: From the Departments of Radiology (R.R., B.K.-F.).
authors.forename: B
authors.identifier: 0000-0003-3872-9027
authors.initials: B
authors.lastname: Kline-Fath
mesh_terms: D020201:Brain Hemorrhage, Traumatic / Q000000981:diagnostic imaging; D001930:Brain Injuries / Q000000981:diagnostic imaging*; D003964:Diaphragm / Q000002:abnormalities; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects; D005260:Female; D065630:Hernias, Diaphragmatic, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging; D007441:Intubation, Gastrointestinal / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D008297:Male; D011247:Pregnancy; D066127:White Matter / Q000000981:diagnostic imaging