Head Ultrasound Resistive Indices Are Associated With Brain Injury on Diffusion Tensor Imaging Magnetic Resonance Imaging in Neonates With Hypoxic-Ischemic Encephalopathy.
Head Ultrasound Resistive Indices Are Associated With Brain Injury on Diffusion Tensor Imaging Magnetic Resonance Imaging in Neonates With Hypoxic-Ischemic Encephalopathy.
复制标题
DOI：
10.1097/rct.0000000000001069
复制
发表时间：
2020
影响因子：
1.3
通讯作者：
Tekes A
中科院分区：
文献类型：
--
作者：
Snyder EJ;Perin J;Chavez-Valdez R;Northington FJ;Lee JK;Tekes A
新生儿缺氧缺血性脑病（HIE）与脑自动调节功能障碍有关。在经<$颅头部超声上测量大脑前动脉的阻力指数（RI）是一种无创性血流测量方法，可能表明自动调节功能障碍。我们在磁共振成像（MRI）上检测RI是否与脑损伤有关。入组了75名接受治疗性低温治疗HIE的新生儿。阻力指数值是从低温治疗结束时进行的头部超声获得的。在出生前10天进行MRI，测量表观扩散系数标量。RI较低与半卵圆中心、基底节、丘脑和内囊后肢的表观扩散系数较低相关。RI和Apgar评分相结合，相对于单独使用任一指标，可提高MRI上区分损伤严重程度的能力。低RI与扩散张量成像上脑损伤严重相关，可作为冷却HIE新生儿脑损伤的早期标志。
Neonatal hypoxic-ischemic encephalopathy (HIE) is associated with dysfunctional cerebral autoregulation. Resistive index (RI) measured in the anterior cerebral artery on transfontanellar head ultrasound is a noninvasive measure of blood flow and may indicate autoregulation dysfunction. We tested whether RI was associated with brain injury on diffusion tensor imaging magnetic resonance imaging (MRI). Seventy-five neonates who underwent therapeutic hypothermia for HIE were enrolled. Resistive index values were obtained from head ultrasound performed at the end of therapeutic hypothermia. Apparent diffusion coefficient scalars were measured on MRIs performed before day of life 10. Lower RI was associated with lower apparent diffusion coefficient in the centrum semiovale, basal ganglia, thalamus, and posterior limb of the internal capsule. Combining RI and Apgar scores improved the ability to distinguish injury severity on MRI relative to either metric alone. Low RI correlated with worse brain injury on diffusion tensor imaging and may serve as an early marker of brain injury in cooled HIE neonates.