title: Hypothermia-treated neonates with hypoxic-ischemic encephalopathy: Optimal timing of quantitative ADC measurement to predict disease severity.
abstract: To determine the optimal time window for MR imaging with quantitative ADC measurement in neonatal HIE after hypothermia treatment, a retrospective review was performed on consecutive hypothermia-treated term neonates with HIE, with an initial and follow-up MR imaging within the first two weeks of life. Three neuroradiologists categorized each set of MR imaging as normal, mild, moderate or severe HIE based on a consensus review of the serial imaging. The lowest ADC values from the white matter, corpus callosum, and basal ganglia/thalamus were measured. The ADC values between mild-moderate and severe HIE were compared using a Student's t-test over a range of different time windows. A total of 33 MR imaging examinations were performed on 16 neonates that included three normal, four mild, five moderate, and four severe HIE. The time window of 3-10 days showed a statistically significant decrease in ADC value in severe HIE compared to mild-moderate HIE in all three locations, respectively: white matter 0.5 ± 0.22 versus 0.83 ± 0.27 ( p value 0.01), corpus callosum 0.69 ± 0.19 versus 0.91 ± 0.17 ( p value 0.01), and basal ganglia/thalamus 0.63 ± 0.16 versus 0.98 ± 0.06 ( p value <0.01). The range of 3-10 days is the optimal time window for MR imaging with quantitative ADC after hypothermia treatment.
authors.affiliation: 1 Department of Radiology, Santa Clara Valley Medical Center, USA.
authors.forename: Yauk K
authors.initials: YK
authors.lastname: Lee
authors.affiliation: 1 Department of Radiology, Santa Clara Valley Medical Center, USA.
authors.forename: Alex
authors.initials: A
authors.lastname: Penn
authors.affiliation: 1 Department of Radiology, Santa Clara Valley Medical Center, USA.
authors.forename: Mahesh
authors.initials: M
authors.lastname: Patel
authors.affiliation: 1 Department of Radiology, Santa Clara Valley Medical Center, USA.
authors.forename: Rajul
authors.initials: R
authors.lastname: Pandit
authors.affiliation: 2 Department of Pediatrics, Santa Clara Valley Medical Center, USA.
authors.forename: Dongli
authors.initials: D
authors.lastname: Song
authors.affiliation: 1 Department of Radiology, Santa Clara Valley Medical Center, USA.
authors.forename: Bo Yoon
authors.initials: BY
authors.lastname: Ha
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D020925:Hypoxia-Ischemia, Brain / Q000000981:diagnostic imaging* / Q000628:therapy; D007091:Image Processing, Computer-Assisted; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
keywords: ADC; DWI; Hypothermia; MR; encephalopathy; hypoxia; ischemia; measurement; neonate