Document Detail


Impact of therapeutic hypothermia on MRI diffusion changes in neonatal encephalopathy.
MedLine Citation:
PMID:  22517107     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of this work was to determine the impact of therapeutic hypothermia (TH) on the magnitude and time course of mean diffusivity (MD) changes following hypoxic-ischemic encephalopathy (HIE) in newborns.
METHODS: Cerebral MRI scans of infants undergoing whole body TH for HIE from 2007 to 2010 were retrospectively reviewed. The data were analyzed identically to a control group of newborns with HIE previously published, prior to the development of TH. Anatomic injury was defined on T1- and T2-weighted ("late") MRI obtained after the fifth day of life. Since MD values vary regionally, the ratios of MD values for injured and normal tissue were calculated for areas of injury. Normal values were obtained from corresponding brain regions of 12 infants undergoing TH who had no injury on MRI studies.
RESULTS: Twenty-three of 59 infants who underwent TH and MRI displayed cerebral injury on late MRI and were included in the study. MD ratios were decreased in all injured infants within the first 7 days of life. The return of MD to normal (pseudonormalization) occurred after the tenth day as compared to 6-8 days in the control group. Infants with severest injury demonstrated greater reduction in MD, but no difference in time to pseudonormalization.
CONCLUSION: TH slows the evolution of diffusion abnormalities on MRI following HIE in term infants.
Authors:
N Bednarek; A Mathur; T Inder; J Wilkinson; J Neil; J Shimony
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Publication Detail:
Type:  Journal Article     Date:  2012-04-18
Journal Detail:
Title:  Neurology     Volume:  78     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-01     Completed Date:  2012-06-27     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1420-7     Citation Subset:  AIM; IM    
Affiliation:
Neonatology Unit, Alix de Champagne, Reims, France.
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MeSH Terms
Descriptor/Qualifier:
Asphyxia Neonatorum / diagnosis,  therapy*
Brain / pathology
Brain Damage, Chronic / diagnosis,  therapy*
Diffusion Magnetic Resonance Imaging*
Female
Fetal Hypoxia / diagnosis,  therapy*
Follow-Up Studies
Humans
Hypothermia, Induced*
Hypoxia-Ischemia, Brain / diagnosis,  therapy*
Infant, Newborn
Magnetic Resonance Imaging*
Male
Neurologic Examination
Prognosis
Retrospective Studies
Whole Body Imaging
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