Neonatal hypoxic-ischemic encephalopathy: Detection with diffusion-weighted MR imaging

K. P.N. Forbes, James Pipe, R. Bird

Research output: Contribution to journalArticle

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Abstract

BACKGROUND AND PURPOSE: Although diffusion-weighted imaging has been shown to be highly sensitive in detecting acute cerebral infarction in adults, its use in detecting neonatal hypoxic-ischemic encephalopathy (HIE) has not been fully assessed. We examined the ability of this technique to detect cerebral changes of acute neonatal HIE in different brain locations. METHODS: Fifteen MR examinations were performed in 14 neonates with HIE (median age, 6.5 days; range, 2-11 days). Imaging comprised conventional T1-weighted, proton density-weighted, and T2-weighted sequences and echo-planar diffusion-weighted sequences. The location, extent, and image timing of ischemic damage on conventional and diffusion-weighted sequences and apparent diffusion coefficient (ADC) maps were compared. RESULTS: Although conventional sequences showed cerebral changes consistent with ischemia on all examinations, diffusion-weighted imaging showed signal hyperintensity associated with decreased ADC values in only seven subjects (47%). All subjects with isolated cortical infarction on conventional sequences had corresponding hyperintensity on diffusion-weighted images and decreased ADC values, as compared with 14% of subjects with deep gray matter/ perirolandic cortical damage. The timing of imaging did not significantly alter diffusion-weighted imaging findings. CONCLUSION: Diffusion-weighted imaging, performed with the technical parameters in this study, may have a lower correlation with clinical evidence of HIE than does conventional MR imaging. The sensitivity of diffusion-weighted imaging in detecting neonatal HIE appears to be affected by the pattern of ischemic damage, with a lower sensitivity if the deep gray matter is affected as compared with isolated cerebral cortex involvement.

Original languageEnglish (US)
Pages (from-to)1490-1496
Number of pages7
JournalAmerican Journal of Neuroradiology
Volume21
Issue number8
StatePublished - Oct 2 2000
Externally publishedYes

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Brain Hypoxia-Ischemia
Cerebral Infarction
Cerebral Cortex
Infarction
Protons
Ischemia

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

Cite this

Neonatal hypoxic-ischemic encephalopathy : Detection with diffusion-weighted MR imaging. / Forbes, K. P.N.; Pipe, James; Bird, R.

In: American Journal of Neuroradiology, Vol. 21, No. 8, 02.10.2000, p. 1490-1496.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND AND PURPOSE: Although diffusion-weighted imaging has been shown to be highly sensitive in detecting acute cerebral infarction in adults, its use in detecting neonatal hypoxic-ischemic encephalopathy (HIE) has not been fully assessed. We examined the ability of this technique to detect cerebral changes of acute neonatal HIE in different brain locations. METHODS: Fifteen MR examinations were performed in 14 neonates with HIE (median age, 6.5 days; range, 2-11 days). Imaging comprised conventional T1-weighted, proton density-weighted, and T2-weighted sequences and echo-planar diffusion-weighted sequences. The location, extent, and image timing of ischemic damage on conventional and diffusion-weighted sequences and apparent diffusion coefficient (ADC) maps were compared. RESULTS: Although conventional sequences showed cerebral changes consistent with ischemia on all examinations, diffusion-weighted imaging showed signal hyperintensity associated with decreased ADC values in only seven subjects (47{\%}). All subjects with isolated cortical infarction on conventional sequences had corresponding hyperintensity on diffusion-weighted images and decreased ADC values, as compared with 14{\%} of subjects with deep gray matter/ perirolandic cortical damage. The timing of imaging did not significantly alter diffusion-weighted imaging findings. CONCLUSION: Diffusion-weighted imaging, performed with the technical parameters in this study, may have a lower correlation with clinical evidence of HIE than does conventional MR imaging. The sensitivity of diffusion-weighted imaging in detecting neonatal HIE appears to be affected by the pattern of ischemic damage, with a lower sensitivity if the deep gray matter is affected as compared with isolated cerebral cortex involvement.",
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