A validated clinical MRI injury scoring system in neonatal hypoxic-ischemic encephalopathy.
A validated clinical MRI injury scoring system in neonatal hypoxic-ischemic encephalopathy.
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DOI：
10.1007/s00247-017-3893-y
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发表时间：
2017-10
影响因子：
2.3
通讯作者：
Mathur AM
中科院分区：
文献类型：
--
作者：
Trivedi SB;Vesoulis ZA;Rao R;Liao SM;Shimony JS;McKinstry RC;Mathur AM
新生儿缺氧缺血性脑病（HIE）的深部核灰质损伤与较差的神经发育结局相关。我们之前发表了一种定性MRI损伤评分系统，利用序列t1加权、t2加权和弥散加权成像（DWI），对深部核灰质损伤进行加权。建立18-24个月神经发育结果的MRI评分系统的有效性。对治疗性低温治疗的中度至重度HIE新生儿的MRI扫描进行评估。用t1加权、t2加权和DWI序列对信号异常进行评分，并使用已建立的系统在5个区域进行评估：(a)皮质下：尾状核、苍白球和壳核、丘脑和内囊后肢；(b)白质；(c)皮质，(d)小脑，(e)脑干。MRI损伤分为无、轻度、中度和重度。两名独立的、盲的神经放射学家对扫描的子集进行了评分间可靠性测试。幸存的婴儿在18-24个月时接受Bayley婴幼儿发育量表- iii （Bayley- iii）。数据分析采用单因素和多因素线性和逻辑回归。57名符合条件的新生儿在出生后两周内接受了至少一次核磁共振扫描。50/57例（88%）新生儿和48/54例（89%）存活婴儿在10±2天进行第二次扫描时的平均出生年龄为4±2天。在54/57（95%）的幸存者中，较高的MRI损伤等级与Bayley-III型认知、运动和语言领域的较差结果显著相关。定性MRI损伤评分系统对深部核灰质损伤进行加权，是18-24个月HIE新生儿神经发育结局的重要预测指标。
Deep nuclear gray matter injury in neonatal hypoxic-ischemic encephalopathy (HIE) is associated with worse neurodevelopmental outcomes. We previously published a qualitative MRI injury scoring system utilizing serial T1-weighted, T2-weighted and diffusion-weighted imaging (DWI), weighted for deep nuclear gray matter injury. To establish the validity of the MRI scoring system with neurodevelopmental outcome at 18–24 months. MRI scans from neonates with moderate to severe HIE treated with therapeutic hypothermia were evaluated. Signal abnormality was scored on T1-weighted, T2-weighted and DWI sequences and assessed using an established system in five regions: (a) subcortical: caudate nucleus, globus pallidus and putamen, thalamus and the posterior limb of the internal capsule; (b) white matter; (c) cortex,(d) cerebellum and (e) brainstem. MRI injury was graded as none, mild, moderate or severe. Inter-rater reliability was tested on a subset of scans by two independent and blinded neuroradiologists. Surviving infants underwent the Bayley Scales of Infant and Toddler Development-III (Bayley-III) at 18–24 months. Data were analyzed using univariate and multivariate linear and logistic regression. Fifty-seven eligible neonates underwent at least one MRI scan in the first 2 weeks of life. Mean postnatal age at scan 1 was 4±2 days in 50/57 (88%) neonates and 48/54 (89%) surviving infants underwent scan 2 at 10±2 days. In 54/57 (95%) survivors, higher MRI injury grades were significantly associated with worse outcomes in the cognitive, motor and language domains of the Bayley-III. A qualitative MRI injury scoring system weighted for deep nuclear gray matter injury is a significant predictor of neurodevelopmental outcome at 18–24 months in neonates with HIE.
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影响因子：
48
作者：
Rutherford, Mary;Ramenghi, Luca A.;Edwards, A. David;Brocklehurst, Peter;Halliday, Henry;Levene, Malcolm;Strohm, Brenda;Thoresen, Marianne;Whitelaw, Andrew;Azzopardi, Denis
通讯作者：
Azzopardi, Denis
影响因子：
5.1
作者：
Miller, SP;Ramaswamy, V;Ferriero, DM
通讯作者：
Ferriero, DM
影响因子：
8
作者：
Hunt, RW;Neil, JJ;Inder, TE
通讯作者：
Inder, TE
影响因子：
3.6
作者：
Gano, Dawn;Chau, Vann;Miller, Steven P.
通讯作者：
Miller, Steven P.
影响因子：
8
作者：
Rutherford, MA;Pennock, JM;Edwards, AD
通讯作者：
Edwards, AD