Department of Neonatal Medicine, University of Modena and Reggio Emilia, Modena, Italy.
J Pediatr. 2011 Jun;158(6):904-11. doi: 10.1016/j.jpeds.2010.11.037. Epub 2011 Jan 13.
To correlate the site and severity of brain lesions seen on magnetic resonance imaging (MRI) with the quality of general movements in term infants with hypoxic-ischemic encephalopathy (HIE) and compare the prognostic value of general movements and MRI for motor outcome.
Early brain MRI scans in 34 term infants with HIE not treated with hypothermia were reviewed and scored for site of injury and lesion pattern by an experienced neuroradiologist. General movement quality and trajectories at 1 and 3 postnatal months were evaluated. Motor outcome was assessed at 24 months.
MRI scores for the basal ganglia and thalami, posterior limb of the internal capsule, white matter, and cortex and lesion patterns were correlated with 1-month and 3-month general movements and general movement trajectories; central gray matter scores were correlated most strongly with cramped-synchronized general movements and abnormal motor outcome. MRI scores were 100% sensitive and 72.2% specific for motor outcome, and cramped-synchronized general movements were 100% specific and 68.7% sensitive for motor outcome.
In term infants with HIE, the site and severity of brain lesions seen on early MRI are highly correlated with general movements. Central gray matter damage leads to cramped-synchronized general movements and poor motor outcome. Early MRI scans and general movements are complementary tools for predicting motor outcome.
将磁共振成像（MRI）上观察到的脑损伤部位和严重程度与缺氧缺血性脑病（HIE）足月婴儿的一般运动质量相关联，并比较一般运动和 MRI 对运动预后的预测价值。
回顾了 34 例未接受低温治疗的 HIE 足月婴儿的早期脑 MRI 扫描，并由经验丰富的神经放射科医生对损伤部位和损伤模式进行评分。在出生后 1 个月和 3 个月评估一般运动质量和轨迹。在 24 个月时评估运动预后。
基底节和丘脑、内囊后肢、白质和皮质的 MRI 评分与 1 个月和 3 个月的一般运动和一般运动轨迹相关；与局限性同步性运动相关最强的是中央灰质评分，与运动预后不良相关。MRI 评分对运动预后的敏感性为 100%，特异性为 72.2%，局限性同步性一般运动对运动预后的特异性为 100%，敏感性为 68.7%。
在 HIE 的足月婴儿中，早期 MRI 上观察到的脑损伤部位和严重程度与一般运动高度相关。中央灰质损伤导致局限性同步性一般运动和运动预后不良。早期 MRI 扫描和一般运动是预测运动预后的互补工具。
