Valérie Charon1, Maïa Proisy2, Gilles Bretaudeau3, Bertrand Bruneau2, Patrick Pladys4, Alain Beuchée4, Gladys Burnouf-Rose5, Jean-Christophe Ferré6, Céline Rozel2. 1. CHU Rennes, Department of Paediatric Radiology, Hôpital Sud, 16 Boulevard de Bulgarie, 35200 Rennes, France. Electronic address: va.charon@gmail.com. 2. CHU Rennes, Department of Paediatric Radiology, Hôpital Sud, 16 Boulevard de Bulgarie, 35200 Rennes, France. 3. CHU Rennes, Paediatrics department, Centre d'Action Médico-Sociale Précoce, Hôpital Pontchaillou, 2 rue Henri le Guilloux, 35000 Rennes, France. 4. CHU Rennes, Paediatrics department, Neonatology and CIC 1414, Hôpital Sud, 16 Boulevard de Bulgarie, 35200 Rennes, France. 5. CHU Rennes, Paediatrics department, Centre Hospitalier Public du Cotentin, 2 Rue Aristide Briand, 50130 Cherbourg-Octeville, France. 6. CHU Rennes, Department of Neuroradiology, Hôpital Pontchaillou, 2 rue Henri le Guilloux, 35000 Rennes, France.
Abstract
UNLABELLED: The prognostic role of early MRI (≤ 6 days of life) is still uncertain in hypoxic-ischaemic encephalopathy (HIE) treated with hypothermia. OBJECTIVE: To compare the prognostic value of early (≤ 6 days) and late MRIs (≥ 7 days) in predicting adverse outcome at 2 years old in asphyxiated term neonates treated with hypothermia. METHODS: This retrospective study included all asphyxiated neonates eligible for hypothermia treatment between November 2009 and July 2012. Two MRI scans were performed at a median age of day 4 (early MRI) and day 11 (late MRI). Two radiologists analysed independently each MRI. Imaging was classified as normal/subnormal or abnormal, using a visual analysis. Apparent diffusion coefficient (ADC) values were measured within predefined areas and posterior limb of internal capsule (PLIC) signal intensity was analysed. Neurodevelopmental outcome was assessed at 18-41 months (median age 24 months) as favourable or adverse. RESULTS: Of the 38 neonates followed up, 8 had an adverse outcome, all related to abnormal MRIs. Twenty-nine neonates had both MRIs sequentially. Both early and late MRIs yielded 100% sensitivity for adverse outcome by using the visual analysis. Early MRI had a higher specificity than late MRI (96.3% versus 89.3%). ADC measurements did not provide further information than visual analysis. PLIC signal abnormalities were a good predictor of adverse outcome on both MRIs. CONCLUSION: Early MRI (≤ 6 days) was a good predictor of neurodevelopmental outcome at 2 years old. It could reliably guide intensive care decisions after the end of hypothermia treatment.
UNLABELLED: The prognostic role of early MRI (≤ 6 days of life) is still uncertain in hypoxic-ischaemic encephalopathy (HIE) treated with hypothermia. OBJECTIVE: To compare the prognostic value of early (≤ 6 days) and late MRIs (≥ 7 days) in predicting adverse outcome at 2 years old in asphyxiated term neonates treated with hypothermia. METHODS: This retrospective study included all asphyxiated neonates eligible for hypothermia treatment between November 2009 and July 2012. Two MRI scans were performed at a median age of day 4 (early MRI) and day 11 (late MRI). Two radiologists analysed independently each MRI. Imaging was classified as normal/subnormal or abnormal, using a visual analysis. Apparent diffusion coefficient (ADC) values were measured within predefined areas and posterior limb of internal capsule (PLIC) signal intensity was analysed. Neurodevelopmental outcome was assessed at 18-41 months (median age 24 months) as favourable or adverse. RESULTS: Of the 38 neonates followed up, 8 had an adverse outcome, all related to abnormal MRIs. Twenty-nine neonates had both MRIs sequentially. Both early and late MRIs yielded 100% sensitivity for adverse outcome by using the visual analysis. Early MRI had a higher specificity than late MRI (96.3% versus 89.3%). ADC measurements did not provide further information than visual analysis. PLIC signal abnormalities were a good predictor of adverse outcome on both MRIs. CONCLUSION: Early MRI (≤ 6 days) was a good predictor of neurodevelopmental outcome at 2 years old. It could reliably guide intensive care decisions after the end of hypothermia treatment.
Authors: Jessica L Wisnowski; Pia Wintermark; Sonia L Bonifacio; Christopher D Smyser; A James Barkovich; A David Edwards; Linda S de Vries; Terrie E Inder; Vann Chau Journal: Semin Fetal Neonatal Med Date: 2021-10-29 Impact factor: 3.726
Authors: Sydney E Doman; Akanksha Girish; Christina L Nemeth; Gabrielle T Drummond; Patrice Carr; Maxine S Garcia; Michael V Johnston; Sujatha Kannan; Ali Fatemi; Jiangyang Zhang; Mary Ann Wilson Journal: Front Neurol Date: 2018-05-08 Impact factor: 4.003
Authors: Andrea Lakatos; Márton Kolossváry; Miklós Szabó; Ágnes Jermendy; Hajnalka Barta; Gyula Gyebnár; Gábor Rudas; Lajos R Kozák Journal: BMC Pediatr Date: 2019-11-12 Impact factor: 2.125