title: Early diagnosis and outcome prediction of neonatal hypoxic-ischemic encephalopathy with color Doppler ultrasound.
abstract: OBJECTIVE
  To describe the ultrasound presentation of the brain and cerebral hemodynamics in neonates with hypoxic-ischemic encephalopathy (HIE) by comparison with control subjects.
  
  
  METHODS
  During June 2012 to April 2013, full term neonates who had clinical evidence of HIE were enrolled. Healthy newborns without HIE were used as a control group. Cerebral parenchyma, size of lateral ventricles and hemodynamic parameters of cerebral arteries were studied using two-dimensional duplex and color Doppler ultrasound. Neonates with moderate and severe HIE were followed-up with ultrasound for at least 3 months.
  
  
  RESULTS
  A total of 158 consecutive neonates (82 boys and 76 girls), including 54 with mild HIE, 60 with moderate HIE and 44 with severe HIE were included. One hundred and twenty healthy newborns were randomly selected as a control group. Abnormal ultrasound findings of brain parenchyma were found in 25/54 (46.3%) neonates with mild HIE whereas they were found in 58/60 (96.7%) neonates with moderate HIE and 44/44 (100%) neonates with severe HIE. Almost all neonates with severe HIE had decreased cerebral artery blood flow velocity and increased resistance index of cerebral arteries. Of the 104 neonates with moderate or severe HIE, follow-up ultrasound examination revealed cystic parenchymal lesions in 12/104 (11.5%), progressive ventricular dilatation and brain atrophy in 12/104 (11.5%), mild ventricular dilatation in 15/104 (14.4%) and leukoencephalomalacia in 2/104 (1.9%) neonates.
  
  
  CONCLUSIONS
  Ultrasound features such as the size of lateral ventricles, altered brain parenchymal echogenicity and cerebral blood flow parameters are useful for the early diagnosis of HIE and help predict outcome.
authors.affiliation: Department of ultrasound medicine, Guangzhou women and children medical center, Guangzhou medical university, 9, Jinsui road, 510120 Guangzhou, China.
authors.forename: B
authors.initials: B
authors.lastname: Guan
authors.affiliation: Department of ultrasound medicine, Guangzhou women and children medical center, Guangzhou medical university, 9, Jinsui road, 510120 Guangzhou, China. Electronic address: springhua2@aliyun.com.
authors.forename: C
authors.initials: C
authors.lastname: Dai
authors.affiliation: Department of ultrasound medicine, Guangzhou women and children medical center, Guangzhou medical university, 9, Jinsui road, 510120 Guangzhou, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of ultrasound medicine, Guangzhou women and children medical center, Guangzhou medical university, 9, Jinsui road, 510120 Guangzhou, China.
authors.forename: L
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of ultrasound medicine, Guangzhou women and children medical center, Guangzhou medical university, 9, Jinsui road, 510120 Guangzhou, China.
authors.forename: X
authors.initials: X
authors.lastname: He
authors.affiliation: Department of ultrasound medicine, Guangzhou women and children medical center, Guangzhou medical university, 9, Jinsui road, 510120 Guangzhou, China.
authors.forename: N
authors.initials: N
authors.lastname: Wang
authors.affiliation: Department of ultrasound medicine, Guangzhou women and children medical center, Guangzhou medical university, 9, Jinsui road, 510120 Guangzhou, China.
authors.forename: H
authors.initials: H
authors.lastname: Liu
mesh_terms: D001284:Atrophy / Q000000981:diagnostic imaging; D001783:Blood Flow Velocity / Q000502:physiology; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D016022:Case-Control Studies; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D003560:Cysts / Q000000981:diagnostic imaging; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis*; D007231:Infant, Newborn; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging; D008297:Male; D012720:Severity of Illness Index; D018615:Ultrasonography, Doppler, Color; D014655:Vascular Resistance / Q000502:physiology
keywords: Color Doppler ultrasound; Hypoxic-ischemic encephalopathy; Neonatal encephalopathy; Neonate; Outcome study