Early MRI in neonatal hypoxic-ischaemic encephalopathy treated with hypothermia: Prognostic role at 2-year follow-up. Issue 8 (August 2016)

• Record Type: Journal Article
• Authors: Charon, Valérie; Proisy, Maïa; Bretaudeau, Gilles; Bruneau, Bertrand; Pladys, Patrick; Beuchée, Alain; Burnouf-Rose, Gladys; Ferré, Jean-Christophe; Rozel, Céline
• Is Part Of: European journal of radiology. Volume 85:Issue 8(2016)
• Page Start: 1366
• Page End: 1374
• Publication Date: 2016-08
• Subjects: HIE hypoxic-ischaemic encephalopathy -- MRI magnetic resonance imaging -- ADC apparent diffusion coefficient -- PLIC posterior limb of internal capsule -- RBL Revised Brunet-Lezine -- GMFCS Gross Motor Function Classification System -- DQ developmental quotient -- DWI diffusion weighted imaging -- PPWMI punctate periventricular white matter injuries -- ROI region of interest -- ROC receiver operating characteristic -- AUC area under curve -- OR odds ratio -- CI confidence interval; Neonates- -- hypoxia-Ischaemia -- Brain- -- diffusion magnetic resonance imaging- -- Hypothermia -- Induced- -- patient outcome assessment; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2016.05.005
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Early (≤6 days) and later MRIs were both good adverse outcome predictors in HIE. Both MRIs had 100% sensitivity for adverse outcome. Early MRI had higher specificity and positive predictive value than late MRI. Early MRI could reliably help parents and neonatologists with intensive care decisions. Abstract: The prognostic role of early MRI (≤ 6 days of life) is still uncertain in hypoxic-ischaemic encephalopathy (HIE) treated with hypothermia. Objective: To compare the prognostic value of early (≤ 6 days) and late MRIs (≥ 7 days) in predicting adverse outcome at 2 years old in asphyxiated term neonates treated with hypothermia. Methods: This retrospective study included all asphyxiated neonates eligible for hypothermia treatment between November 2009 and July 2012. Two MRI scans were performed at a median age of day 4 (early MRI) and day 11 (late MRI). Two radiologists analysed independently each MRI. Imaging was classified as normal/subnormal or abnormal, using a visual analysis. Apparent diffusion coefficient (ADC) values were measured within predefined areas and posterior limb of internal capsule (PLIC) signal intensity was analysed. Neurodevelopmental outcome was assessed at 18–41 months (median age 24 months) as favourable or adverse. Results: Of the 38 neonates followed up, 8 had an adverse outcome, all related to abnormal MRIs. Twenty-nine neonates had both MRIs sequentially. Both early and late MRIs yielded 100% sensitivity for adverse outcome by using the visual analysis. Early MRI had a higher specificity than late MRI (96.3% versus 89.3%). ADC measurements did not provide further information than visual analysis. PLIC signal abnormalities were a good predictor of adverse outcome on both MRIs. Conclusion: Early MRI (≤ 6 days) was a good predictor of neurodevelopmental outcome at 2 years old. It could reliably guide intensive care decisions after the end of hypothermia treatment.