Department of Neonatology, University Medical Center, Utrecht, The Netherlands.
J Pediatr. 2010 Aug;157(2):221-227.e2. doi: 10.1016/j.jpeds.2010.02.016. Epub 2010 Apr 9.
To assess the relation between patterns of brain injury on neonatal and childhood magnetic resonance imaging (MRI) and long-term neurodevelopmental outcome.
Neonatal (n = 34) and childhood MRIs (n = 77) were analyzed for 80 children with neonatal encephalopathy and for 51 control subjects during childhood. MRIs were graded as normal, mildly abnormal (white matter lesions), or moderately/severely abnormal (watershed injury, lesions in basal ganglia/thalamus or focal infarction). Severity of brain injury was related to different aspects of neurologic outcome: Total impairment score of the Movement Assessment Battery for Children, intelligence quotient score, cerebral palsy, postneonatal epilepsy, and need for special education. Seven children with neonatal encephalopathy required extracorporeal membrane oxygenation treatment.
Neonatal and childhood MRI were comparable in 25/33 children (75.8%, P < .001). Children with moderate/severe lesions on neonatal or childhood MRI more often had a total impairment score <or= 15th percentile, an intelligence quotient <or= 85, and cerebral palsy, and attended special education.
Different patterns of injury seen on neonatal MRI after neonatal encephalopathy can still be recognized on childhood MRI. Children with moderate to severe brain lesions on neonatal or childhood MRI significantly more often have impaired motor and cognitive outcomes.
评估新生儿期和儿童期磁共振成像（MRI）中脑损伤模式与长期神经发育结局之间的关系。
对 80 例患有新生儿脑病的儿童和 51 例儿童对照的新生儿（n=34）和儿童 MRI（n=77）进行了分析。MRI 分级为正常、轻度异常（白质病变）或中度/重度异常（分水岭损伤、基底节/丘脑病变或局灶性梗死）。脑损伤的严重程度与神经功能结局的不同方面相关：儿童运动评估量表总损伤评分、智商评分、脑瘫、新生儿后癫痫和特殊教育需求。7 例新生儿脑病患儿需要体外膜氧合治疗。
25/33 例（75.8%，P<0.001）新生儿和儿童 MRI 具有可比性。新生儿或儿童 MRI 中度/重度病变的儿童更常出现总损伤评分<或=第 15 百分位数、智商<或=85 和脑瘫，并接受特殊教育。
新生儿脑病后新生儿 MRI 上的不同损伤模式仍可在儿童 MRI 上识别。新生儿或儿童 MRI 上有中度至重度脑损伤的儿童，其运动和认知功能结局受损的发生率显著更高。
