Department of Pediatric Neurology, Loma Linda University Medical Center, Loma Linda, California, USA.
Pediatr Res. 2012 Jan;71(1):85-92. doi: 10.1038/pr.2011.8.
Magnetic resonance imaging (MRI) and spectroscopy (MRS) have proven valuable in evaluating neonatal hypoxic-ischemic injury (HII).
MRI scores in the basal ganglia of HII/HT(+) neonates were significantly lower than HII/HT(-) neonates, indicating less severe injury and were associated with lower discharge encephalopathy severity scores in the HII/HT(+) group (P = 0.01). Lactate (Lac) was detected in the occipital gray matter (OGM) and thalamus (TH) of significantly more HII/HT(-) neonates (31.6 and 35.3%) as compared to the HII/HT(+) group (10.5 and 15.8%). In contrast, the -N-acetylaspartate (NAA)-based ratios in the OGM and TH did not differ between the HII groups.
Our data show that the HT was associated with a decrease in the number of HII neonates with detectable cortical and subcortical Lac as well as a decrease in the number of MRI-detectable subcortical lesions.
We retrospectively compared the medical and neuroimaging data of 19 HII neonates who received 72 h of whole-body cooling (HII/HT(+)) with those of 19 noncooled HII neonates (HII/HT(-)) to determine whether hypothermia was associated with improved recovery from the injury as measured by MRI and MRS within the first 14 days of life. MRI scores and metabolite ratios of HII/HT(+) and HII/HT(-) neonates were also compared with nine healthy, nonasphyxiated "control" neonates.
磁共振成像（MRI）和波谱（MRS）已被证明可用于评估新生儿缺氧缺血性损伤（HII）。
HII/HT(+)新生儿基底节的 MRI 评分明显低于 HII/HT(-)新生儿，表明损伤程度较轻，与 HII/HT(+)组的出院脑病严重程度评分较低相关（P = 0.01）。与 HII/HT(+)组（10.5%和 15.8%）相比，更多的 HII/HT(-)新生儿的枕叶灰质（OGM）和丘脑（TH）中检测到乳酸（Lac）（31.6%和 35.3%）。相比之下，OGM 和 TH 中的 -N- 乙酰天门冬氨酸（NAA）比值在 HII 组之间没有差异。
我们的数据表明，HT 与皮质和皮质下 Lac 可检测到的 HII 新生儿数量减少以及 MRI 可检测到的皮质下病变数量减少有关。
我们回顾性比较了 19 名接受 72 小时全身冷却（HII/HT(+)）的 HII 新生儿与 19 名未冷却的 HII 新生儿（HII/HT(-)）的医学和神经影像学数据，以确定低温是否与 MRI 和 MRS 在生命的前 14 天内评估的损伤恢复有关。还将 HII/HT(+)和 HII/HT(-)新生儿的 MRI 评分和代谢物比值与 9 名无窒息的健康“对照”新生儿进行了比较。
