Predictive Values of Location and Volumetric MRI Injury Patterns for Neurodevelopmental Outcomes in Hypoxic-Ischemic Encephalopathy Neonates.
Predictive Values of Location and Volumetric MRI Injury Patterns for Neurodevelopmental Outcomes in Hypoxic-Ischemic Encephalopathy Neonates.
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DOI：
10.3390/brainsci10120991
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发表时间：
2020-12-16
期刊：
影响因子：
3.3
通讯作者：
Youn YA
中科院分区：
文献类型：
--
作者：
Chang PD;Chow DS;Alber A;Lin YK;Youn YA
新生儿缺氧缺血性脑病（HIE）是一种严重的新生儿并发症，其远期发病率高达40-60%。本研究评估了接受治疗性低温（TH）治疗的HIE婴儿在18-24个月时MRI变化的分布和负荷，作为神经发育（ND）结局的预后指标。对2012年6月至2016年3月期间接受TH治疗HIE的足月或晚期早产儿进行了分析。对107例TH治疗的婴儿进行脑MRI扫描。对于每名婴儿，从3 T西门子扫描仪获取弥散加权脑图像（DWI）序列进行分析。107名婴儿中，36名（33.6%）婴儿的脑部MRI图像正常，71名（66.4%）婴儿的MRI表现异常。MRI异常组的临床癫痫发作次数明显高于MRI正常组（p < 0.001）。18-24个月时，76/107例（70.0%）ND分期正常，31/107例（29.0%）ND分期异常。病变大小计数>500与异常ND显著相关。同样，异常ND组的总病变计数更大（14.16 vs. 5.29）。基底神经节（BG）和丘脑区域的更多病变以及MRI扫描异常的趋势与18-24个月时的异常ND显著相关。除了临床癫痫发作外，较大的总病变计数和病变大小以及基底节和丘脑的病变累及与18-24个月时的异常神经发育显著相关。
Hypoxic-ischemic encephalopathy (HIE) is a severe neonatal complication with up to 40–60% long-term morbidity. This study evaluates the distribution and burden of MRI changes as a prognostic indicator of neurodevelopmental (ND) outcomes at 18–24 months in HIE infants who were treated with therapeutic hypothermia (TH). Term or late preterm infants who were treated with TH for HIE were analyzed between June 2012 and March 2016. Brain MRI scans were obtained from 107 TH treated infants. For each infant, diffusion weighted brain image (DWI) sequences from a 3T Siemens scanner were obtained for analysis. Of the 107 infants, 36 of the 107 infants (33.6%) had normal brain MR images, and 71 of the 107 infants (66.4%) had abnormal MRI findings. The number of clinical seizures was significantly higher in the abnormal MRI group (p < 0.001) than in the normal MRI group. At 18–24 months, 76 of the 107 infants (70.0%) showed normal ND stages, and 31 of the 107 infants (29.0%) exhibited abnormal ND stages. A lesion size count >500 was significantly associated with abnormal ND. Similarly, the total lesion count was larger in the abnormal ND group (14.16 vs. 5.29). More lesions in the basal ganglia (BG) and thalamus areas and a trend towards more abnormal MRI scans were significantly associated with abnormal ND at 18–24 months. In addition to clinical seizure, a larger total lesion count and lesion size as well as lesion involvement of the basal ganglia and thalamus were significantly associated with abnormal neurodevelopment at 18–24 months.
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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：
3
作者：
Thoresen, Marianne
通讯作者：
Thoresen, Marianne
影响因子：
168.9
作者：
Gluckman, PD;Wyatt, JS;Gunn, AJ
通讯作者：
Gunn, AJ
影响因子：
5.1
作者：
Miller, SP;Ramaswamy, V;Ferriero, DM
通讯作者：
Ferriero, DM
DOI：
10.1016/s1474-4422(12)70203-x
发表时间：
2012-10
期刊：
The Lancet. Neurology
影响因子：
--
作者：
Lansberg MG;Straka M;Kemp S;Mlynash M;Wechsler LR;Jovin TG;Wilder MJ;Lutsep HL;Czartoski TJ;Bernstein RA;Chang CW;Warach S;Fazekas F;Inoue M;Tipirneni A;Hamilton SA;Zaharchuk G;Marks MP;Bammer R;Albers GW;DEFUSE 2 study investigators
通讯作者：
DEFUSE 2 study investigators