Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Arkansas 72202, USA.
Pediatr Neurol. 2012 Aug;47(2):101-8. doi: 10.1016/j.pediatrneurol.2012.05.009.
The volume of acute injury detected by diffusion-weighted imaging and quantitative brain growth on serial cranial magnetic resonance imaging was not previously used to predict neurodevelopmental outcomes in infants with neonatal hypoxic-ischemic encephalopathy treated with head cooling. Our longitudinal study involved 16 head-cooled term infants with hypoxic-ischemic encephalopathy who underwent early and follow-up cranial magnetic resonance imaging and follow-up neurologic evaluations, out of 105 infants who received therapeutic hypothermia. The volume of acute injury was measured on initial cranial magnetic resonance imaging, using diffusion-weighted images. Total brain volumes were measured in both early and follow-up magnetic resonance imaging studies. Acute injury volume in the corpus callosum >0.5 cm(3) was associated with developing epilepsy (odds ratio, 20; 95% confidence interval, 1.01-1059.6; P = 0.013). Follow-up whole brain volume was reduced in those with unfavorable outcomes (i.e., epilepsy, cerebral palsy, and delayed developmental milestones), compared with infants without all three outcomes. Although acute brain injury volume and brain growth measurements may be useful predictors of outcomes in neonatal hypoxic-ischemic encephalopathy, the evolution of brain injury in these infants has yet to be fully understood and should be studied prospectively.
弥散加权成像检测到的急性损伤体积和连续头颅磁共振成像上的定量脑生长在接受头部冷却治疗的新生儿缺氧缺血性脑病婴儿中，以前并未用于预测神经发育结局。我们的纵向研究涉及 16 名接受头部冷却的足月缺氧缺血性脑病婴儿，他们接受了早期和随访头颅磁共振成像和随访神经评估，这些婴儿来自接受治疗性低温治疗的 105 名婴儿。在初始头颅磁共振成像上使用弥散加权图像测量急性损伤的体积。在早期和随访磁共振成像研究中测量总脑容量。胼胝体的急性损伤体积 >0.5cm³与癫痫发作有关（比值比，20；95%置信区间，1.01-1059.6；P=0.013）。与没有三种结局的婴儿相比，结局不良（即癫痫、脑瘫和发育迟缓）的婴儿随访时全脑体积减少。尽管急性脑损伤体积和脑生长测量可能是新生儿缺氧缺血性脑病结局的有用预测指标，但这些婴儿的脑损伤演变尚未完全了解，应前瞻性研究。
