Magnetic Resonance Imaging of Neonates with Hypoxic Ischaemic Encephalopathy
KKY Cheung, JK Ip, LY Ko, MWM Law, WWM Lam
Hong Kong J Radiol 2017;20:131-9
DOI: 10.12809/hkjr1716399
Objectives: To review magnetic resonance imaging (MRI) of the brain of neonates who underwent cerebral hypothermia for hypoxic ischaemic encephalopathy (HIE) and to correlate the MRI findings with neurodevelopmental outcomes.
Methods: Records of all neonates who underwent cerebral hypothermia for moderate-to-severe HIE between May 2010 and October 2014 were reviewed. Signal abnormalities of the basal ganglia and thalami (BGT), posterior limb of the internal capsule (PLIC), cortex at central fissure, cortex at interhemispheric fissure, and white matter were graded. Long-term neurodevelopmental outcomes (overall, gross motor, fine motor, speech and language, and social) were assessed using the Griffiths Mental Development Scales.
Results: In 11 male and 4 female neonates, signal abnormality in the PLIC was associated with adverse overall outcome (p = 0.02) and adverse fine motor outcome (p = 0.011). Signal abnormalities in both the PLIC and BGT were associated with adverse fine motor outcome (p = 0.03) and borderline adverse overall outcome (p = 0.06).
Conclusion: Signal abnormalities in the PLIC and BGT are predictive of adverse long-term overall and fine motor neurodevelopmental outcomes.
Authors’ affiliations:
KKY Cheung: Department of Radiology, Hong Kong Children’s Hospital, Kai Tak, Hong Kong; Department of Radiology, Queen Mary Hospital, Pokfulam, Hong Kong
JK Ip, MWM Law, WWM Lam: Department of Radiology, Queen Mary Hospital, Pokfulam, Hong Kong
LY Ko: Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Pokfulam, Hong Kong
中文摘要
新生兒低氧缺血性腦病的磁共振成像
張棨壹、葉精勤、高利源、羅惠明、林慧文
目的：回顧分析接受腦低溫治療低氧缺血性腦病（HIE）的新生兒腦磁共振成像（MRI），並將其與神經發育結果相關聯。
方法：回顧分析從2010年5月至2014年10月所有接受腦低溫治療中至重度HIE的新生兒。將基底神經節和丘腦（BGT）、內囊後肢（PLIC）、中樞裂隙皮質、大腦半球裂隙皮質和白質的信號異常分級。並使用格里菲斯心理發展量表評估長期神經發育（總體、大肌肉運動、精細運動、言語和語言、社交）結果。
結果：在11例男性和4例女性新生兒中，PLIC信號異常與總體結果（p = 0.02）和精細運動結果（p = 0.011）負相關。PLIC和BGT的信號異常與精細運動結果負相關（p = 0.03），和總體結果趨向負相關（p = 0.06）。
結論：PLIC和BGT的信號異常能預測不利的整體和精細運動神經發育結果。