Mild hypoxic-ischemic encephalopathy (HIE): timing and pattern of MRI brain injury.
Mild hypoxic-ischemic encephalopathy (HIE): timing and pattern of MRI brain injury.
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DOI：
10.1038/s41390-022-02026-7
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发表时间：
2022-12
影响因子：
3.6
通讯作者：
Wu, Yvonne W.
中科院分区：
文献类型：
--
作者：
Li, Yi;Wisnowski, Jessica L.;Chalak, Lina;Mathur, Amit M.;McKinstry, Robert C.;Licona, Genesis;Mayock, Dennis E.;Chang, Taeun;Van Meurs, Krisa P.;Wu, Tai-Wei;Ahmad, Kaashif A.;Cornet, Marie-Coralie;Rao, Rakesh;Scheffler, Aaron;Wu, Yvonne W.
轻度缺氧缺血性脑病(HIE)日益被认为是新生儿脑损伤的危险因素。我们研究了轻度HIE脑损伤的时间和类型。这项回顾性队列研究包括在9家医院接受治疗的轻度HIE婴儿。两名评价者使用有效的分类系统对新生儿大脑核磁共振进行评分，差异通过共识解决。根据8日龄或之前进行的磁共振成像子集对MRI脑损伤(即急性、亚急性、慢性)的严重程度和时间进行评分。在142例轻度HIE中，87例(61%)在中位年龄5天(IQR4-6)时在MRI上有损伤。分水岭损伤(23%)、深灰色损伤(20%)和点状白质损伤(18%)最为常见。在≤第8天接受脑部核磁共振检查的125名婴儿(88%)中，轻度损伤(44%)比中度损伤(11%)或重度损伤(4%)更常见。亚急性病变(37%)比急性病变(32%)或慢性病变(1%)更常见。亚急性脑损伤在轻度HIE新生儿中很常见。治疗轻度HIE的新的神经保护疗法将理想地针对亚急性和急性损伤机制。几乎三分之二患有轻度HIE的婴儿在新生儿早期获得的MRI上有脑损伤的证据。在轻度HIE的婴儿中，37%出现了亚急性脑损伤。对于轻度HIE的神经保护治疗将是针对急性和亚急性损伤机制的理想选择。
Mild hypoxic-ischemic encephalopathy (HIE) is increasingly recognized as a risk factor for neonatal brain injury. We examined the timing and pattern of brain injury in mild HIE. This retrospective cohort study includes infants with mild HIE treated at 9 hospitals. Neonatal brain MRIs were scored by 2 reviewers using a validated classification system, with discrepancies resolved by consensus. Severity and timing of MRI brain injury (i.e., acute, subacute, chronic) was scored on the subset of MRIs that were performed at or before 8 days of age. Of 142 infants with mild HIE, 87 (61%) had injury on MRI at median age 5 (IQR 4–6) days. Watershed (23%), deep gray (20%) and punctate white matter (18%) injury were most common. Among the 125 (88%) infants who received a brain MRI at ≤8 days, mild (44%) injury was more common than moderate (11%) or severe (4%) injury. Subacute (37%) lesions were more commonly observed than acute (32%) or chronic lesions (1%). Subacute brain injury is common in newborn infants with mild HIE. Novel neuroprotective treatments for mild HIE will ideally target both subacute and acute injury mechanisms. Almost two-thirds of infants with mild HIE have evidence of brain injury on MRI obtained in the early neonatal period. Subacute brain injury was seen in 37% of infants with mild HIE. Neuroprotective treatments for mild HIE will ideally target both acute and subacute injury mechanisms.
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DOI：
10.1038/jp.2017.164
发表时间：
2018-01
期刊：
Journal of perinatology : official journal of the California Perinatal Association
影响因子：
--
作者：
Prempunpong C;Chalak LF;Garfinkle J;Shah B;Kalra V;Rollins N;Boyle R;Nguyen KA;Mir I;Pappas A;Montaldo P;Thayyil S;Sánchez PJ;Shankaran S;Laptook AR;Sant'Anna G
通讯作者：
Sant'Anna G
影响因子：
2.3
作者：
Trivedi SB;Vesoulis ZA;Rao R;Liao SM;Shimony JS;McKinstry RC;Mathur AM
通讯作者：
Mathur AM
影响因子：
2.9
作者：
Goswami, Ipsita R.;Whyte, Hilary;Lee, Shoo K.
通讯作者：
Lee, Shoo K.
影响因子：
9.9
作者：
McKinstry, RC;Miller, JH;Neil, JJ
通讯作者：
Neil, JJ
影响因子：
158.5
作者：
Shankaran, S;Laptook, AR;Jobe, AH
通讯作者：
Jobe, AH