Prognostic Value of the Apparent Diffusion Coefficient in Newborns with Hypoxic-Ischaemic Encephalopathy Treated with Therapeutic Hypothermia
Prognostic Value of the Apparent Diffusion Coefficient in Newborns with Hypoxic-Ischaemic Encephalopathy Treated with Therapeutic Hypothermia
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DOI：
10.1159/000456707
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发表时间：
2017-01-01
期刊：
影响因子：
2.5
通讯作者：
Lubian Lopez, Simon Pedro
中科院分区：
文献类型：
--
作者：
Heursen, Eva-Marie;Zuazo Ojeda, Amaya;Lubian Lopez, Simon Pedro
背景：表观弥散系数（ADC）定量已被证明对于在常温下治疗的患有缺氧缺血性脑病（HIE）的足月新生儿具有预后价值。目的：评估接受治疗性低温 (TH) 治疗的 HIE 新生儿标准化脑区域 ADC 的预后价值。方法：这项前瞻性队列研究纳入了 54 名因 HIE 入院并接受 TH 治疗的足月新生儿。所有磁共振成像检查均在出生后第 4 天至第 6 天之间进行，并测量大脑 13 个标准化区域的 ADC 值。在 2 岁时，我们探讨了 ADC 值是否与复合结局（神经发育异常的死亡或生存）相关。结果：HIE的严重程度与不同脑区的ADC值呈负相关。我们发现内囊后肢 (PLIC)、丘脑、半卵圆中心以及额叶和顶叶白质的 ADC 值较低与不良后果相关。 PLIC 和丘脑的 ADC 值是不良后果的良好预测因子（AUC 0.86 和 0.76）。结论：接受 TH 治疗的足月 HIE 婴儿的 PLIC、丘脑、半卵圆中心以及额叶和顶叶白质的 ADC 值较低与不良结局相关。 (C) 2017 S. Karger AG，巴塞尔
Background: Apparent diffusion coefficient (ADC) quantification has been proven to be of prognostic value in term newborns with hypoxic-ischaemic encephalopathy (HIE) who were treated under normothermia. Objectives: To evaluate the prognostic value of ADC in standardized brain regions in neonates with HIE who were treated with therapeutic hypothermia (TH). Methods: This prospective cohort study included 54 term newborns who were admitted with HIE and treated with TH. All magnetic resonance imaging examinations were performed between days 4 and 6 of life, and ADC values were measured in 13 standardized regions of the brain. At 2 years of age we explored whether ADC values were related to composite outcomes (death or survival with abnormal neurodevelopment). Results: The severity of HIE is inversely related to ADC values in different brain regions. We found that lower ADC values in the posterior limb of the internal capsule (PLIC), the thalami, the semioval centre, and frontal and parietal white matter were related to adverse outcomes. ADC values in the PLIC and thalami are good predictors of adverse outcomes (AUC 0.86 and 0.76). Conclusions: Low ADC values in the PLIC, thalamus, semioval centre, and frontal and parietal white matter in full-term infants with HIE treated with TH were associated with a poor outcome. (C) 2017 S. Karger AG, Basel