Reliability of Early Magnetic Resonance Imaging (MRI) and Necessity of Repeating MRI in Noncooled and Cooled Infants with Neonatal Encephalopathy

Elavazhagan Chakkarapani, Kenneth J. Poskitt, Steven P. Miller, Jill G. Zwicker, Qi Xu, Darren S T Wong, Elke H. Roland, Alan Hill, Vann Chau*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

14 Citations (Scopus)
373 Downloads (Pure)

Abstract

In cooled newborns with encephalopathy, although late magnetic resonance imaging (MRI) scan (10-14 days of age) is reliable in predicting long-term outcome, it is unknown whether early scan (3-6 days of life) is. We compared the predominant pattern and extent of lesion between early and late MRI in 89 term neonates with neonatal encephalopathy. Forty-three neonates (48%) were cooled. The predominant pattern of lesions and the extent of lesion in the watershed region agreed near perfectly in noncooled (kappa = 0.94; k = 0.88) and cooled (k = 0.89; k = 0.87) infants respectively. There was perfect agreement in the extent of lesion in the basal nuclei in noncooled infants (k = 0.83) and excellent agreement in cooled infants (k = 0.67). Changes in extent of lesions on late MRI occurred in 19 of 89 infants, with higher risk in infants with hypoglycemia and moderate-severe lesions in basal nuclei. In most term neonates with neonatal encephalopathy, early MRI (relative to late scan) robustly predicts the predominant pattern and extent of injury.

Original languageEnglish
Pages (from-to)553-559
Number of pages7
JournalJournal of Child Neurology
Volume31
Issue number5
Early online date31 Aug 2015
DOIs
Publication statusPublished - 1 Apr 2016

Keywords

  • asphyxia
  • brain injury
  • hypothermia
  • magnetic resonance imaging
  • neonatal encephalopathy
  • newborn

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