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出生第一天的短期常规脑电图与接受亚低温治疗的新生儿缺氧缺血性脑病脑磁共振成像之间的相关性

The Correlation Between a Short-term Conventional Electroencephalography in the First Day of Life and Brain Magnetic Resonance Imaging in Newborns Undergoing Hypothermia for Hypoxic-Ischemic Encephalopathy.

作者信息

Obeid Rawad, Sogawa Yoshimi, Gedela Satyanarayana, Naik Monica, Lee Vince, Telesco Richard, Wisnowski Jessica, Magill Christine, Painter Michael J, Panigrahy Ashok

机构信息

Department of Neurology, Children's National Health System, Washington, District of Columbia.

Division of Pediatric Neurology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.

出版信息

Pediatr Neurol. 2017 Feb;67:91-97. doi: 10.1016/j.pediatrneurol.2016.10.020. Epub 2016 Nov 3.

Abstract

OBJECTIVE

Electroencephalograph recorded in the first day of life in newborns treated with hypothermia for hypoxic-ischemic encephalopathy could be utilized as a predictive tool for the severity of brain injury on magnetic resonance imaging and mortality.

STUDY DESIGN

We analyzed newborns who were admitted for therapeutic hypothermia due to hypoxic-ischemic encephalopathy. All enrolled infants underwent encephalography within the first 24 hours of life and underwent brain magnetic resonance imaging after rewarming. All encephalographs were independently reviewed for background amplitude, continuity, and variability. Brain injury determined by magnetic resonance imaging was scored using methods described by Bonifacio et al.

RESULTS

Forty-one newborns were included in the study. Each encephalograph variable correlated significantly with the severity of injury on brain magnetic resonance imaging (P < 0.001 for each). The overall encephalograph severity estimated as mild, moderate, and severe also correlated with injury (P < 0.001). Each encephalograph variable correlated with mortality (P < 0.001 for each) and also the overall encephalograph severity (P < 0.001).

CONCLUSION

Severity of electrographic findings on encephalograph in the first day of life during therapeutic hypothermia for hypoxic-ischemic encephalopathy correlated with the extent of injury on brain magnetic resonance imaging. This information may be useful for families and aid guide clinical decision making.

摘要

目的

对于因缺氧缺血性脑病接受低温治疗的新生儿,出生第一天记录的脑电图可用作磁共振成像脑损伤严重程度及死亡率的预测工具。

研究设计

我们分析了因缺氧缺血性脑病入院接受治疗性低温的新生儿。所有纳入的婴儿在出生后24小时内接受脑电图检查,并在复温后接受脑磁共振成像检查。所有脑电图均由独立人员检查背景振幅、连续性和变异性。磁共振成像确定的脑损伤采用博尼法西奥等人描述的方法进行评分。

结果

41名新生儿纳入研究。每个脑电图变量与脑磁共振成像的损伤严重程度均显著相关(每个P<0.001)。脑电图总体严重程度分为轻度、中度和重度,也与损伤相关(P<0.001)。每个脑电图变量与死亡率相关(每个P<0.001),也与脑电图总体严重程度相关(P<0.001)。

结论

在因缺氧缺血性脑病进行治疗性低温期间,出生第一天脑电图检查结果的严重程度与脑磁共振成像的损伤程度相关。该信息可能对家庭有用,并有助于指导临床决策。

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