BACKGROUND AND PURPOSE: MR imaging has been shown to be of prognostic significance in the evaluation of asphyxiated neonates. The purpose of this project was to determine whether the use of intensity ratios in key regions of the brain might better detect regions of injured brain and thus improve the correlation of imaging findings with 12-month neurodevelopmental outcome. METHODS: Prospectively acquired MR studies of 53 asphyxiated neonates were reviewed retrospectively. Signal intensities from standard T1- and T2-weighted images of seven major brain regions that are affected in asphyxia were measured. Intensity ratios were calculated by dividing the signal intensity of each brain region by the signal intensity of the ocular vitreous. The intensity ratios were then correlated with 12-month neurodevelopmental outcome. These results were compared with correlations determined by a qualitative scoring system. RESULTS: The only significant statistical correlation between the intensity ratios and 12-month neurodevelopmental outcome were those of anterior watershed injury with the Mental Development Index of the Bayley Scales of Infant Development II. The qualitative measurements showed a strong correlation with many outcome parameters. CONCLUSION: Standard qualitative assessment is more predictive of neurodevelopmental outcome than is quantitative analysis. This finding most likely reflects the inability of the quantitative assessment of intensity ratios to compensate for the day-to-day evolution of signal intensity of the injured neonatal brain. Anterior watershed injury may be predictive of abnormal cognitive outcome; examination of these patients at age 30 months will be important to determine the accuracy of this observation.
BACKGROUND AND PURPOSE: MR imaging has been shown to be of prognostic significance in the evaluation of asphyxiated neonates. The purpose of this project was to determine whether the use of intensity ratios in key regions of the brain might better detect regions of injured brain and thus improve the correlation of imaging findings with 12-month neurodevelopmental outcome. METHODS: Prospectively acquired MR studies of 53 asphyxiated neonates were reviewed retrospectively. Signal intensities from standard T1- and T2-weighted images of seven major brain regions that are affected in asphyxia were measured. Intensity ratios were calculated by dividing the signal intensity of each brain region by the signal intensity of the ocular vitreous. The intensity ratios were then correlated with 12-month neurodevelopmental outcome. These results were compared with correlations determined by a qualitative scoring system. RESULTS: The only significant statistical correlation between the intensity ratios and 12-month neurodevelopmental outcome were those of anterior watershed injury with the Mental Development Index of the Bayley Scales of Infant Development II. The qualitative measurements showed a strong correlation with many outcome parameters. CONCLUSION: Standard qualitative assessment is more predictive of neurodevelopmental outcome than is quantitative analysis. This finding most likely reflects the inability of the quantitative assessment of intensity ratios to compensate for the day-to-day evolution of signal intensity of the injured neonatal brain. Anterior watershed injury may be predictive of abnormal cognitive outcome; examination of these patients at age 30 months will be important to determine the accuracy of this observation.
Authors: P N Amess; J Penrice; M Wylezinska; A Lorek; J Townsend; J S Wyatt; C Amiel-Tison; E B Cady; A Stewart Journal: Dev Med Child Neurol Date: 1999-07 Impact factor: 5.449
Authors: A J Barkovich; K Baranski; D Vigneron; J C Partridge; D K Hallam; B L Hajnal; D M Ferriero Journal: AJNR Am J Neuroradiol Date: 1999-09 Impact factor: 3.825
Authors: J S Thornton; R J Ordidge; J Penrice; E B Cady; P N Amess; S Punwani; M Clemence; J S Wyatt Journal: Magn Reson Med Date: 1998-06 Impact factor: 4.668
Authors: H E D'Arceuil; A J de Crespigny; J Röther; S Seri; M E Moseley; D K Stevenson; W Rhine Journal: J Magn Reson Imaging Date: 1998 Jul-Aug Impact factor: 4.813
Authors: J D Hanrahan; J Sargentoni; D Azzopardi; K Manji; F M Cowan; M A Rutherford; I J Cox; J D Bell; D J Bryant; A D Edwards Journal: Pediatr Res Date: 1996-04 Impact factor: 3.756
Authors: J D Hanrahan; I J Cox; D Azzopardi; F M Cowan; J Sargentoni; J D Bell; D J Bryant; A D Edwards Journal: Dev Med Child Neurol Date: 1999-02 Impact factor: 5.449
Authors: Abdulhakim Coskun; Ali Yikilmaz; Sefer Kumandas; Okkes Ibrahim Karahan; Mustafa Akcakus; Ali Manav Journal: Eur Radiol Date: 2004-11-24 Impact factor: 5.315
Authors: Dennis P Carmody; Stanley M Dunn; Akiza S Boddie-Willis; J Kevin DeMarco; Michael Lewis Journal: Neuroradiology Date: 2004-09 Impact factor: 2.804