Abnormal magnetic resonance signal in the internal capsule predicts poor neurodevelopmental outcome in infants with hypoxic-ischemic encephalopathy
Abnormal magnetic resonance signal in the internal capsule predicts poor neurodevelopmental outcome in infants with hypoxic-ischemic encephalopathy
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DOI：
10.1542/peds.102.2.323
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发表时间：
1998-08-01
期刊：
影响因子：
8
通讯作者：
Edwards, AD
中科院分区：
文献类型：
--
作者：
Rutherford, MA;Pennock, JM;Edwards, AD
客观的。本研究的目的是确定磁共振成像中内囊后肢 (PLIC) 的异常信号强度是否可以准确预测缺氧缺血性脑病 (HIE) 婴儿 1 岁时的神经发育结果。我们对 73 名出生后 1 至 17 天患有 HIE 的足月新生儿进行了头颅磁共振成像检查，并将磁共振成像结果与 1 岁时的神经发育结果相关联。结果。所有 PLIC 信号强度异常的婴儿均出现神经发育障碍，尽管 4 名早期扫描的婴儿直到出生后 4 天才出现异常信号。除 4 例外，所有病例的正常信号强度均与正常结果相关；其中 3 名婴儿有轻微损伤，并且所有婴儿的白质内都有持续的影像学变化。第 2 天信号强度正常的第四个婴儿在获得进一步图像之前死亡。缺乏正常信号可预测患有 HIE 的足月婴儿的异常结果，敏感性为 0.90，特异性为 1.0，阳性预测值为 1.0，阴性预测值为 0.87。根据 Sarnat 系统，该测试正确预测了 93% 的 II 级 HIE 婴儿的结果。应用贝叶斯方法，测试的预测概率（测试正确预测结果的概率）的分布平均值为 0.94，95% 置信限为 0.89 至 1.0。结论。 PLIC 中的异常信号强度可以准确预测患有 HIE 的足月婴儿的神经发育结果。
Objective. The aim of this study was to establish whether abnormal signal intensity in the posterior limb of the internal capsule (PLIC) on magnetic resonance imaging is an accurate predictor of neurodevelopmental outcome at 1 year of age in infants with hypoxic-ischemic encephalopathy (HIE).Methods. We have examined 73 term neonates with HIE between 1 and 17 days after birth with cranial magnetic resonance imaging and related the magnetic resonance imaging findings to neurodevelopmental outcome at 1 year of age.Results. All infants with an abnormal signal intensity in the PLIC developed neurodevelopmental impairment although in 4 infants with very early scans the abnormal signal was not apparent until up to 4 days after birth. A normal signal intensity was associated with a normal outcome in all but 4 cases; 3 of these infants had minor impairments and all had persistent imaging changes within the white matter. The 4th infant with a normal signal intensity on day 2 died before a further image could be obtained. The absence of normal signal predicted abnormal outcome in term infants with HIE with a sensitivity of 0.90, a specificity of 1.0, a positive predictive value of 1.0, and a negative predictive value of 0.87. The test correctly predicted outcome in 93% of infants with grade II HIE, according to the Sarnat system. Ap plying a Bayesian approach, the predictive probability of the test (the probability that the test would predict an outcome correctly) was distributed with a mean of 0.94 and 95% confidence limits of 0.89 to 1.0.Conclusion. Abnormal signal intensity in the PLIC is an accurate predictor of neurodevelopmental outcome in term infants suffering HIE.