Apparent diffusion coefficient in the posterior limb of the internal capsule predicts outcome after perinatal asphyxia
Apparent diffusion coefficient in the posterior limb of the internal capsule predicts outcome after perinatal asphyxia
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DOI：
10.1542/peds.2003-0935-l
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发表时间：
2004-10-01
期刊：
影响因子：
8
通讯作者：
Inder, TE
中科院分区：
文献类型：
--
作者：
Hunt, RW;Neil, JJ;Inder, TE
Objective.预测缺氧缺血性脑病（HIE）婴儿的长期预后是一项困难的任务。磁共振成像，特别是弥散成像，在这方面有希望，因为它是更敏感的脑损伤比任何其他可用的成像方式。以往的研究表明，异常信号强度在后肢的内囊（PLIC），检测反转恢复T1加权成像，是一个强有力的预测结果。本研究的目的是评估PLIC的表观扩散系数（ADC）值之间的关系，通过扩散成像测量，和足月新生儿HIE的神经运动结果。28例临床诊断为HIE的足月儿在出生后尽快进行磁共振成像（平均年龄：5.6天），包括弥散加权成像，测量PLIC的ADC值。对16例存活者中的12例进行了运动预后评估。PLIC的ADC值与足月新生儿HIE的存活率显著相关。对于存活者，PLIC的平均ADC值为0.89 +/- 0.17 mum（2）/ms，而非存活者的平均ADC值为0.75 +/- 0.17 mum（2）/ms（t = 2.25）。在存活者中，PLIC的ADC值也与神经运动结局相关（F = 5.60）。PLIC的ADC值是缺血性损伤的指标，可作为HIE患儿的客观预后指标。
Objective. Predicting long-term outcome in infants with hypoxic-ischemic encephalopathy ( HIE) is a difficult task. Magnetic resonance imaging, particularly diffusion imaging, holds promise in this regard as it is more sensitive to brain injury than any other available imaging modality. Previous studies have suggested that abnormal signal intensity in the posterior limb of the internal capsule ( PLIC), detectable on inversion-recovery T1-weighted imaging, is a strong predictor of outcome. The aim of this study was to assess the relationship between apparent diffusion coefficient ( ADC) values from the PLIC, measured by diffusion imaging, and neuromotor outcome in term infants with HIE.Methods. Twenty-eight term infants with a clinical diagnosis of HIE underwent magnetic resonance imaging as soon as practicable after birth (mean age: 5.6 days), including diffusion-weighted imaging, from which ADC values in the PLIC were measured. Motor outcome was assessed in 12 of 16 survivors.Results. The ADC value in the PLIC was significantly associated with survival in term infants with HIE. For survivors, the mean ADC value in the PLIC was 0.89 +/- 0.17 mum(2)/ms, whereas the mean ADC value for nonsurvivors was 0.75 +/- 0.17 mum(2)/ms (t = 2.25). Among survivors, the ADC value in the PLIC was also associated with neuromotor outcome (F = 5.60).Conclusion. The ADC value in the PLIC is an indicator of ischemic injury and may be of use as an objective prognostic marker for infants with HIE.