Neurodevelopmental Outcomes According to Brain Injury Patterns in Neonates with Postasphyxial Hypoxic Ischemic Encephalopathy
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: To investigate the relationship between brain injury patterns on magnetic resonance imaging (MRI) and neurodevelopmental outcomes in neonates with postasphyxial hypoxic ischemic encephalopathy (HIE). Methods: Clinical characteristics and brain MRI findings of 49 term neonates with postasphyxial HIE were retrospectively reviewed. Brain injury patterns in MRI were classified into five categories, along with evaluation of the posterior limb of internal capsule (PLIC). Neurodevelopmental outcomes were assessed by neurological examination combined with the Bayley Scales of Infant Development II between 1 and 2 years of age. Results: Twenty-three neonates (46.9%) showed abnormal brain MRI finding associated with poor neurodevelopmental outcomes (odds ratio 9.7, 95% confidence interval 1.4, 67.4, P=0.022). The following injury patterns were seen in MRI: abnormality in the basal ganglia-thalamus (BGT) in 4 neonates (17.4%), watershed predominant (WP) pattern in 5 (21.7%), extensive global injury (EGI) in 3 (13.0%), lesions restricted to periventricular white matter (LPWM) in 4 (17.4%), and perinatal arterial ischemic stroke (PAIS) in 2 (8.7%). Additionally, 6 neonate (26.1%) showed lesion in the PLIC. Neonate with BGT and EGI injury patterns showed worse neurodevelopmental outcomes than those with WP and LPWM patterns (P<0.05). Neonate with PLIC lesion also showed poor outcomes (100%). Conclusion: Abnormal brain MRI findings in neonates with postasphyxial HIE were associated with the poor neurodevelopmental outcomes. BGT, EGI and PLIC patterns of injury are expected to have worse outcomes than white matter predominant injury patterns such as those in the WP and LPWM.
Abstract
Purpose: To investigate the relationship between brain injury patterns on magnetic resonance imaging (MRI) and neurodevelopmental outcomes in neonates with postasphyxial hypoxic ischemic encephalopathy (HIE). Methods: Clinical characteristics and brain MRI findings of 49 term neonates with postasphyxial HIE were retrospectively reviewed. Brain injury patterns in MRI were classified into five categories, along with evaluation of the posterior limb of internal capsule (PLIC). Neurodevelopmental outcomes were assessed by neurological examination combined with the Bayley Scales of Infant Development II between 1 and 2 years of age. Results: Twenty-three neonates (46.9%) showed abnormal brain MRI finding associated with poor neurodevelopmental outcomes (odds ratio 9.7, 95% confidence interval 1.4, 67.4, P=0.022). The following injury patterns were seen in MRI: abnormality in the basal ganglia-thalamus (BGT) in 4 neonates (17.4%), watershed predominant (WP) pattern in 5 (21.7%), extensive global injury (EGI) in 3 (13.0%), lesions restricted to periventricular white matter (LPWM) in 4 (17.4%), and perinatal arterial ischemic stroke (PAIS) in 2 (8.7%). Additionally, 6 neonate (26.1%) showed lesion in the PLIC. Neonate with BGT and EGI injury patterns showed worse neurodevelopmental outcomes than those with WP and LPWM patterns (P<0.05). Neonate with PLIC lesion also showed poor outcomes (100%). Conclusion: Abnormal brain MRI findings in neonates with postasphyxial HIE were associated with the poor neurodevelopmental outcomes. BGT, EGI and PLIC patterns of injury are expected to have worse outcomes than white matter predominant injury patterns such as those in the WP and LPWM.
참고문헌 (35)
- Badr Zahr LK, "Brain injury in the infant: the old, the new, and the uncertain", J Perinat Neonatal Nurs, 20, pp.163~175 (2006)
- Simon NP, "Long-term neurodevelopmental outcome of asphyxiated newborns", Clin Perinatol, 26, pp.767~778 (1999)
- Sarnat HB, "Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study", Arch Neurol, 33, pp.696~705 (1976)
- Mercuri E, "Neonatal neurological examination in infants with hypoxic ischaemic encephalopathy: correlation with MRI findings", Neuropediatrics, 30, pp.83~89 (1999)
- van Laerhoven H, "Prognostic tests in term neonates with hypoxic-ischemic encephalopathy:a systematic review", Pediatrics, 131, pp.88~98 (2013)
- van Wezel-Meijler G, "Cranial ultrasonography in neonates: role and limitations", Semin Perinatol, 34, pp.28~38 (2010)
- Latchaw RE, "Imaging of perinatal hypoxic-ischemic brain injury", Semin Pediatr Neurol, 2, pp.72~89 (1995)
- Swarte R, "Imaging patterns of brain injury in term-birth asphyxia", Acta Paediatr, 98, pp.586~592 (2009)
- Barkovich AJ, "Perinatal asphyxia: MR findings in the first 10 days", AJNR Am J Neuroradiol, 16, pp.427~438 (1995)
- Barkovich AJ, "Prediction of neuromotor outcome in perinatal asphyxia: evaluation of MR scoring systems", AJNR Am J Neuroradiol, 19, pp.143~149 (1998)
- de Vries LS, "Patterns of neonatal hypoxicischaemic brain injury", Neuroradiology, 52, pp.555~566 (2010)
- Steinman KJ, "Neonatal watershed brain injury on magnetic resonance imaging correlates with verbal IQ at 4years", Pediatrics, 123, pp.1025~1030 (2009)
- Miller SP, "Patterns of brain injury in term neonatal encephalopathy", J Pediatr, 146, pp.453~460 (2005)
- Roland EH, "Perinatal hypoxic-ischemic thalamic injury: clinical features and neuroimaging", Ann Neurol, 44, pp.161~166 (1998)
- Miller SP, "Predictors of 30-month outcome after perinatal depression: role of proton MRS and socioeconomic factors", Pediatr Res, 52, pp.71~77 (2002)
- Martinez-Biarge M, "White matter and cortical injury in hypoxic-ischemic encephalopathy: antecedent factors and 2-year outcome", J Pediatr, 161, pp.799~807 (2012)
- Liauw L, "Hypoxicischemic encephalopathy: diagnostic value of conventional MR imaging pulse sequences in term-born neonates", Radiology, 247, pp.204~212 (2008)
- Duran R, "The impact of Neonatal Resuscitation Program courses on mortality and morbidity of newborn infants with perinatal asphyxia", Brain Dev, 30, pp.43~46 (2008)
- Huang CC, "Measurement of the urinary lactate:creatinine ratio for the early identification of newborn infants at risk for hypoxic-ischemic encephalopathy", N Engl J Med, 341, pp.328~335 (1999)
- Graham EM, "A systematic review of the role of intrapartum hypoxia-ischemia in the causation of neonatal encephalopathy", Am J Obstet Gynecol, 199, pp.587~595 (2008)
- Low JA, "Threshold of metabolic acidosis associated with newborn complications", Am J Obstet Gynecol, 177, pp.1391~1394 (1997)
- Rutherford M, "MRI of perinatal brain injury", Pediatr Radiol, 40, pp.819~833 (2010)
- Rutherford MA, "Abnormal magnetic resonance signal in the internal capsule predicts poor neurodevelopmental outcome in infants with hypoxic-ischemic encephalopathy", Pediatrics, 102, pp.323~328 (1998)
- Okereafor A, "Patterns of brain injury in neonates exposed to perinatal sentinel events", Pediatrics, 121, pp.906~914 (2008)
- Triulzi F, "Patterns of damage in the mature neonatal brain", Pediatr Radiol, 36, pp.608~620 (2006)
- McQuillen PS, "Selective vulnerability in the developing central nervous system", Pediatr Neurol, 30, pp.227~235 (2004)
- Pasternak JF, "The syndrome of acute near-total intrauterine asphyxia in the term infant", Pediatr Neurol, 18, pp.391~398 (1998)
- Myers RE, "Two patterns of perinatal brain damage and their conditions of occurrence", Am J Obstet Gynecol, 112, pp.246~276 (1972)
- Biagioni E, "Combined use of electroencephalogram and magnetic resonance imaging in full-term neonates with acute encephalopathy", Pediatrics, 107, pp.461~468 (2001)
- Aida N, "MR imaging of perinatal brain damage: comparison of clinical outcome with initial and follow-up MR findings", AJNR Am J Neuroradiol, 19, pp.1909~1921 (1998)
- Kuenzle C, "Prognostic value of early MR imaging in term infants with severe perinatal asphyxia", Neuropediatrics, 25, pp.191~200 (1994)
- van Kooij BJ, "Serial MRI and neurodevelopmental outcome in 9- to 10-year-old children with neonatal encephalopathy", J Pediatr, 157, pp.221~227 (2010)
- Casey BM, "The continuing value of the Apgar score for the assessment of newborn infants", N Engl J Med, 344, pp.467~471 (2001)
- Mercuri E, "MRI lesions and infants with neonatal encephalopathy. Is the apgar score predictive?", Neuropediatrics, 33, pp.150~156 (2002)
- Rutherford MA, "Hypoxic ischaemic encephalopathy: early magnetic resonance imaging findings and their evolution", Neuropediatrics, 26, pp.183~191 (1995)
