title: Prognostic Value of the Apparent Diffusion Coefficient in Newborns with Hypoxic-Ischaemic Encephalopathy Treated with Therapeutic Hypothermia.
abstract: BACKGROUND
  Apparent diffusion coefficient (ADC) quantification has been proven to be of prognostic value in term newborns with hypoxic-ischaemic encephalopathy (HIE) who were treated under normothermia.
  
  
  OBJECTIVE
  To evaluate the prognostic value of ADC in standardized brain regions in neonates with HIE who were treated with therapeutic hypothermia (TH).
  
  
  METHODS
  This prospective cohort study included 54 term newborns who were admitted with HIE and treated with TH. All magnetic resonance imaging examinations were performed between days 4 and 6 of life, and ADC values were measured in 13 standardized regions of the brain. At 2 years of age we explored whether ADC values were related to composite outcomes (death or survival with abnormal neurodevelopment).
  
  
  RESULTS
  The severity of HIE is inversely related to ADC values in different brain regions. We found that lower ADC values in the posterior limb of the internal capsule (PLIC), the thalami, the semioval centre, and frontal and parietal white matter were related to adverse outcomes. ADC values in the PLIC and thalami are good predictors of adverse outcomes (AUC 0.86 and 0.76).
  
  
  CONCLUSIONS
  Low ADC values in the PLIC, thalamus, semioval centre, and frontal and parietal white matter in full-term infants with HIE treated with TH were associated with a poor outcome.
authors.affiliation: Radiology Department, "Puerta del Mar" University Hospital, Cadiz, Spain.
authors.forename: Eva-Marie
authors.initials: EM
authors.lastname: Heursen
authors.forename: Amaya
authors.initials: A
authors.lastname: Zuazo Ojeda
authors.forename: Isabel
authors.initials: I
authors.lastname: Benavente Fernández
authors.forename: Gema
authors.initials: G
authors.lastname: Jimenez Gómez
authors.forename: Rosalía
authors.initials: R
authors.lastname: Campuzano Fernández-Colima
authors.forename: José
authors.initials: J
authors.lastname: Paz-Expósito
authors.forename: Simón Pedro
authors.initials: SP
authors.lastname: Lubián López
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000000981:diagnostic imaging / Q000628:therapy*; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Apparent diffusion coefficient; Hypoxic-ischaemic encephalopathy; Prognosis; Therapeutic hypothermia