Prediction of outcome from MRI and general movements assessment after hypoxic-ischaemic encephalopathy in low-income and middle-income countries: data from a randomised controlled trial.
Prediction of outcome from MRI and general movements assessment after hypoxic-ischaemic encephalopathy in low-income and middle-income countries: data from a randomised controlled trial.
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DOI：
10.1136/archdischild-2020-321309
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发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Støen R
中科院分区：
文献类型：
--
作者：
Aker K;Thomas N;Adde L;Koshy B;Martinez-Biarge M;Nakken I;Padankatti CS;Støen R
评价新生儿MRI和一般运动评估（GMA）在预测缺氧缺血性脑病（HIE）患儿神经发育结局中的准确性。随机对照试验（RCT）的次要分析。印度的三级新生儿重症监护病房。50名HIE婴儿被纳入治疗性低温的RCT（25名冷却和25名非冷却）。所有婴儿在第5天进行脑部MRI，在10-15周进行GMA，并在18个月时进行结局评估，包括贝利婴幼儿发育量表（第三版）。评估脑损伤模式、烦躁运动（FM）的存在/不存在与结果之间的关联。17/47例（36%）出现不良结局（5例（21%）冷却vs 12例（52%）非冷却，p=0.025）。八名婴儿死亡（四名在MRI之前，另外三名在GMA之前）。2例发展为重度脑瘫，7例Bayley-III运动/认知综合评分<85。12例（26%）有中度/重度MRI异常，9例（23%）无FM。中度/重度基底节和丘脑（BGT）损伤的不良结局的阳性预测值（95% CI）为89%（53%-98%），内囊后肢（PLIC）信号缺失/不明确为83%（56%-95%），FM缺失为67%（38%-87%）。正常/轻度BGT损伤的阴性预测值（95% CI）为85%（74%至92%），正常PLIC为90%（78%至96%），现有FM为86%（74%至93%）。新生儿MRI和GMA预测HIE患儿预后的准确性较高。GMA是一种可行的低成本方法，可单独使用或在低资源环境中与MRI互补，以明确和直接随访。CTRI/2013/05/003693。
To evaluate the accuracy of neonatal MRI and general movements assessment (GMA) in predicting neurodevelopmental outcomes in infants with hypoxic-ischaemic encephalopathy (HIE). Secondary analyses of a randomised controlled trial (RCT). Tertiary neonatal intensive care unit in India. Fifty infants with HIE were included in an RCT of therapeutic hypothermia (25 cooled and 25 non-cooled). All infants underwent brain MRI at day 5, GMA at 10–15 weeks and outcome assessments including Bayley Scales of Infant and Toddler Development, third edition, at 18 months. Associations between patterns of brain injury, presence/absence of fidgety movements (FMs) and outcomes were assessed. Seventeen of 47 (36%) had adverse outcome (5 (21%) cooled vs 12 (52%) non-cooled, p=0.025). Eight infants died (four before an MRI, another three before GMA). Two developed severe cerebral palsy and seven had Bayley-III motor/cognitive composite score <85. Twelve (26%) had moderately/severely abnormal MRI and nine (23%) had absent FMs. The positive predictive value (95% CI) of an adverse outcome was 89% (53% to 98%) for moderate/severe basal ganglia and thalami (BGT) injury, 83% (56% to 95%) for absent/equivocal signal in the posterior limb of the internal capsule (PLIC) and 67% (38% to 87%) for absent FMs. Negative predictive values (95% CI) were 85% (74% to 92%) for normal/mild BGT injury, 90% (78% to 96%) for normal PLIC and 86% (74% to 93%) for present FMs. Neonatal MRI and GMA predicted outcomes with high accuracy in infants with HIE. The GMA is a feasible low-cost method which can be used alone or complementary to MRI in low-resource settings to prognosticate and direct follow-up. CTRI/2013/05/003693.
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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：
26.1
作者：
Novak, Iona;Morgan, Cathy;Adde, Lars;Blackman, James;Boyd, Roslyn N.;Brunstrom-Hernandez, Janice;Cioni, Giovanni;Damiano, Diane;Darrah, Johanna;Eliasson, Ann-Christin;de Vries, Linda S.;Einspieler, Christa;Fahey, Michael;Fehlings, Darcy;Ferriero, Donna M.;Fetters, Linda;Fiori, Simona;Forssberg, Hans;Gordon, Andrew M.;Greaves, Susan;Guzzetta, Andrea;Hadders-Algra, Mijna;Harbourne, Regina;Kakooza-Mwesige, Angelina;Karlsson, Petra;Krumlinde-Sundholm, Lena;Latal, Beatrice;Loughran-Fowlds, Alison;Maitre, Nathalie;McIntyre, Sarah;Noritz, Garey;Pennington, Lindsay;Romeo, Domenico M.;Shepherd, Roberta;Spittle, Alicia J.;Thornton, Marelle;Valentine, Jane;Walker, Karen;White, Robert;Badawi, Nadia
通讯作者：
Badawi, Nadia
影响因子：
3.6
作者：
Jenster, Meike;Bonifacio, Sonia L.;Ruel, Theodore;Rogers, Elizabeth E.;Tam, Emily W.;Partridge, John Colin;Barkovich, Anthony James;Ferriero, Donna M.;Glass, Hannah C.
通讯作者：
Glass, Hannah C.
影响因子：
1.7
作者：
Goyen, Traci-Anne;Morgan, Catherine;Badawi, Nadia
通讯作者：
Badawi, Nadia
DOI：
10.1001/archpediatrics.2010.20
发表时间：
2010-04-01
影响因子：
--
作者：
Anderson, Peter J.;De Luca, Cinzia R.;Doyle, Lex W.
通讯作者：
Doyle, Lex W.