Evaluation of Clinical Grading for Neonates with Hypoxic-ischemic Encephalopathy by Diffusion Weighted Imaging_West China Medical Journal

Authors：

 LIJun ¹ , ZHANGXue-yan ² , DUMei-ling ¹ , QIAOChang-xiu ²

1. Department of Radiology, Yantai Affiliated Hospital;
2. Nursing College, Binzhou Medical University, Yantai, Shandong 264003, P. R. China;

Corresponding?author：

Keywords：

Diffusion weighted imaging; Hypoxic-ischemic encephalopathy; Neonates

DOI：

10.7507/1002-0179.20150014

Video：

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Objective To discuss the evaluation of clinical grading for neonates with hypoxic-ischemic encephalopathy (HIE) by diffusion weighted imaging (DWI). Methods We retrospectively analyzed the DWI findings of 39 neonates with HIE diagnosed by clinical criteria from December 2009 to July 2013. Abnormal signals were observed for 23 neonates (59%). These neonates were divided into three groups (group A, B and C) according to the shape and range of abnormal signals. Then Kappa test was performed between groups of different clinical grading (light, medium, severe). Results For groups arranged based on abnormal signals and clinical grading, the Kappa value of the consistency test was 0.797 (P < 0.001). Conclusions DWI negativity cannot exclude the existence of HIE. However, when abnormal signals occur, we can infer the severity in neonates with HIE according to the shape and range of abnormal signals by DWI.

Citation： LIJun, ZHANGXue-yan, DUMei-ling, QIAOChang-xiu. Evaluation of Clinical Grading for Neonates with Hypoxic-ischemic Encephalopathy by Diffusion Weighted Imaging. West China Medical Journal, 2015, 30(1): 53-55. doi: 10.7507/1002-0179.20150014 Copy

1.	Gano D, Chau V, Poskitt KJ, et al. Evolution of pattern of injury and quantitative MRI on days 1 and 3 in term newborns with hypoxic-ischemic encephalopathy[J]. Pediatr Res, 2013, 74(1):82-87.
2.	高鳳霄, 賈林燚, 李永才, 等.彌散加權成像對新生兒缺氧缺血性腦病的診斷價值[J].現代中西醫結合雜志, 2013, 22(6):651-652.
3.	中華醫學會兒科學分會新生兒學組.新生兒缺氧缺血性腦病診斷標準[J].中國當代兒科雜志, 2005, 43(2):97-98.
4.	Chau V, Poskitt KJ, Sargent MA, et al. Comparison of computer tomography and magnetic resonance imaging scans on the third day of life in term newborns with neonatal encephalopathy[J]. Pediatrics, 2009, 123(1):319-326.
5.	Bonifacio SL, Glass HC, Vanderpluym JA, et al. Perinatal events and early magnetic resonance imaging in therapeutic hypothermia EDITORIAL COMMENT[J]. Obstet Gynecol Surv, 2011, 66(6):334-336.
6.	Wintermark P, Hansen A, Soul J, et al. Early versus late MRI in asphyxiated newborns treated with hypothermia[J]. Arch Dis Child Fetal Neonatal Ed, 2011, 96(1):F36-F44.
7.	夏正榮, 李玉華.新生兒缺氧缺血性腦病的磁共振成像[J].中國醫學計算機成像雜志, 2009, 15(5):403-409.
8.	Bednarek N, Mathur A, Inder T, et al. Impact of therapeutic hypothermia on MRI diffusion changes in neonatal encephalopathy[J]. Neurology, 2012, 78(18):1420-1427.
9.	Bonifacio SL, Saporta A, Glass HC, et al. Therapeutic hypothermia for neonatal encephalopathy results in improved microstructure and metabolism in the deep gray nuclei[J]. Am J Neuroradiol, 2012, 33(11):2050-2055.
10.	Mckinstry RC, Miller JH, Snyder AZ, et al. A prospective, longitudinal diffusion tensor imaging study of brain injury in newborns[J]. Neurology, 2002, 59(6):824-833.
11.	Wintermark P, Moessinger AC, Gudinchet F, et al. Temporal evolution of Mr perfusion in neonatal hypoxic-ischemic encephalopathy[J]. J Magn Reson Imaging, 2008, 27(6):1229-1234.
12.	Daq Y, Firat AK, Karakas HM, et al. Clinical outcomes of neonatal hypoxic ischemic encephalopathy evaluated with diffusion-weighted magnetic resonance imaging[J]. Diagn Interv Radiol, 2006, 12(3):109-114.
13.	富建華, 薛辛東, 毛健, 等.彌散加權成像在新生兒重度缺氧缺血性腦病早期評價中的意義[J].中華兒科雜志, 2007, 45(11):843-847.
14.	廖偉華, 王小宜, 吳武林, 等. MRI鑒別新生兒缺氧缺血性腦病與急性膽紅素腦病的價值[J].中國當代兒科雜志, 2009, 11(3):181-184.
15.	Li YK, Liu GR, Zhou XG, et al. Experimental hypoxic-ischemic encephalopathy:comparison of apparent diffusion coefficients and proton magnetic resonance spectroscopy[J]. Magn Reson Imaging, 2010, 28(4):487-494.

1. Gano D, Chau V, Poskitt KJ, et al. Evolution of pattern of injury and quantitative MRI on days 1 and 3 in term newborns with hypoxic-ischemic encephalopathy[J]. Pediatr Res, 2013, 74(1):82-87.
2. 高鳳霄, 賈林燚, 李永才, 等.彌散加權成像對新生兒缺氧缺血性腦病的診斷價值[J].現代中西醫結合雜志, 2013, 22(6):651-652.
3. 中華醫學會兒科學分會新生兒學組.新生兒缺氧缺血性腦病診斷標準[J].中國當代兒科雜志, 2005, 43(2):97-98.
4. Chau V, Poskitt KJ, Sargent MA, et al. Comparison of computer tomography and magnetic resonance imaging scans on the third day of life in term newborns with neonatal encephalopathy[J]. Pediatrics, 2009, 123(1):319-326.
5. Bonifacio SL, Glass HC, Vanderpluym JA, et al. Perinatal events and early magnetic resonance imaging in therapeutic hypothermia EDITORIAL COMMENT[J]. Obstet Gynecol Surv, 2011, 66(6):334-336.
6. Wintermark P, Hansen A, Soul J, et al. Early versus late MRI in asphyxiated newborns treated with hypothermia[J]. Arch Dis Child Fetal Neonatal Ed, 2011, 96(1):F36-F44.
7. 夏正榮, 李玉華.新生兒缺氧缺血性腦病的磁共振成像[J].中國醫學計算機成像雜志, 2009, 15(5):403-409.
8. Bednarek N, Mathur A, Inder T, et al. Impact of therapeutic hypothermia on MRI diffusion changes in neonatal encephalopathy[J]. Neurology, 2012, 78(18):1420-1427.
9. Bonifacio SL, Saporta A, Glass HC, et al. Therapeutic hypothermia for neonatal encephalopathy results in improved microstructure and metabolism in the deep gray nuclei[J]. Am J Neuroradiol, 2012, 33(11):2050-2055.
10. Mckinstry RC, Miller JH, Snyder AZ, et al. A prospective, longitudinal diffusion tensor imaging study of brain injury in newborns[J]. Neurology, 2002, 59(6):824-833.
11. Wintermark P, Moessinger AC, Gudinchet F, et al. Temporal evolution of Mr perfusion in neonatal hypoxic-ischemic encephalopathy[J]. J Magn Reson Imaging, 2008, 27(6):1229-1234.
12. Daq Y, Firat AK, Karakas HM, et al. Clinical outcomes of neonatal hypoxic ischemic encephalopathy evaluated with diffusion-weighted magnetic resonance imaging[J]. Diagn Interv Radiol, 2006, 12(3):109-114.
13. 富建華, 薛辛東, 毛健, 等.彌散加權成像在新生兒重度缺氧缺血性腦病早期評價中的意義[J].中華兒科雜志, 2007, 45(11):843-847.
14. 廖偉華, 王小宜, 吳武林, 等. MRI鑒別新生兒缺氧缺血性腦病與急性膽紅素腦病的價值[J].中國當代兒科雜志, 2009, 11(3):181-184.
15. Li YK, Liu GR, Zhou XG, et al. Experimental hypoxic-ischemic encephalopathy:comparison of apparent diffusion coefficients and proton magnetic resonance spectroscopy[J]. Magn Reson Imaging, 2010, 28(4):487-494.

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West China Medical Journal

Evaluation of Clinical Grading for Neonates with Hypoxic-ischemic Encephalopathy by Diffusion Weighted Imaging

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