Reliability of Early Magnetic Resonance Imaging (MRI) and Necessity of Repeating MRI in Noncooled and Cooled Infants With Neonatal Encephalopathy
Reliability of Early Magnetic Resonance Imaging (MRI) and Necessity of Repeating MRI in Noncooled and Cooled Infants With Neonatal Encephalopathy
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DOI：
10.1177/0883073815600865
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发表时间：
2016-04-01
影响因子：
1.9
通讯作者：
Chau, Vann
中科院分区：
文献类型：
--
作者：
Chakkarapani, Elavazhagan;Poskitt, Kenneth J.;Chau, Vann
在患有脑病的冷却新生儿中，尽管晚期磁共振成像（MRI）扫描（10-14天）在预测长期结局方面是可靠的，但尚不清楚早期扫描（3-6天）是否可靠。我们比较了89例足月新生儿脑病的早期和晚期MRI的主要形式和病变范围。43名新生儿（48%）进行了冷却。病变的主要模式和病变的程度在分水岭区域同意接近完美的noncooled（Kappa = 0.94; K = 0.88）和冷却（K = 0.89; K = 0.87）婴儿分别。未冷却婴儿基底核病变程度完全一致（k = 0.83），冷却婴儿一致性极佳（k = 0.67）。89名婴儿中有19名在晚期MRI上出现病变范围的变化，低血糖和基底核中重度病变的婴儿风险更高。在大多数患有新生儿脑病的足月新生儿中，早期MRI（相对于晚期扫描）可以有力地预测主要的损伤模式和程度。
In cooled newborns with encephalopathy, although late magnetic resonance imaging (MRI) scan (10-14 days of age) is reliable in predicting long-term outcome, it is unknown whether early scan (3-6 days of life) is. We compared the predominant pattern and extent of lesion between early and late MRI in 89 term neonates with neonatal encephalopathy. Forty-three neonates (48%) were cooled. The predominant pattern of lesions and the extent of lesion in the watershed region agreed near perfectly in noncooled (kappa = 0.94; k = 0.88) and cooled (k = 0.89; k = 0.87) infants respectively. There was perfect agreement in the extent of lesion in the basal nuclei in noncooled infants (k = 0.83) and excellent agreement in cooled infants (k = 0.67). Changes in extent of lesions on late MRI occurred in 19 of 89 infants, with higher risk in infants with hypoglycemia and moderate-severe lesions in basal nuclei. In most term neonates with neonatal encephalopathy, early MRI (relative to late scan) robustly predicts the predominant pattern and extent of injury.