Early brain proton magnetic resonance spectroscopy and neonatal neurology related to neurodevelopmental outcome at 1 year in term infants after presumed hypoxic-ischaemic brain injury
Early brain proton magnetic resonance spectroscopy and neonatal neurology related to neurodevelopmental outcome at 1 year in term infants after presumed hypoxic-ischaemic brain injury
复制标题
DOI：
10.1017/s0012162299000973
复制
发表时间：
1999-07-01
影响因子：
3.8
通讯作者：
Stewart, A
中科院分区：
文献类型：
--
作者：
Amess, PN;Penrice, J;Stewart, A
本研究探讨了使用脑质子磁共振波谱（MRS）和结构化新生儿神经功能评估预测缺氧缺血性脑损伤后足月婴儿1年神经发育结局的准确性。18名对照组婴儿和88名假定缺氧缺血性脑损伤的婴儿进行了质子MRS研究。研究在脑损伤后尽快进行，大多数在48小时内进行。婴儿在假定缺氧缺血性损伤后中位19小时（范围0小时至9天）进行早期结构化神经系统评估，并在恢复期间中位休息日（范围3至25天）进行晚期评估。质子MRS测量的最大脑峰面积比乳酸：N-乙酰天冬氨酸准确预测1年时的不良结局，特异性为93%，阳性预测值为92%。神经学评估有假阳性预测的倾向。然而，早期和晚期神经系统检查可用作1年时良好结局的可靠指标，阴性预测值分别为100%和91%。
This study investigated the accuracy of prediction of neurodevelopmental outcome at 1 year using cerebral proton magnetic resonance spectroscopy (MRS) and structured neonatal neurological assessment in term infants after presumed hypoxic-ischaemic brain injury. Eighteen control infants and 88 infants with presumed hypoxic-ischaemic brain injury underwent proton MRS investigation. Studies were carried out as soon as possible after the cerebral insult, most within 48 hours. Infants had an early structured neurological assessment at a median of 19 hours (range 0 hours to 9 days) from the presumed hypoxic-ischaemic insult and a late assessment at a median off days (range 3 to 25 days) during recovery. The maximum cerebral peak-area ratio lactate:N-acetylaspartate measured by proton MRS accurately predicted adverse outcome at 1 year with a specificity of 93% and positive predictive value of 92%. Neurological assessment had a tendency for false-positive predictions. However, both early and late neurological examination can be used as a reliable indicator for a favourable outcome at 1 year having negative predictive values of 100% and 91% respectively.