Sánchez Fernández Iván, Morales-Quezada J Leon, Law Samuel, Kim Paggie
1 Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
2 Department of Child Neurology, Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, Spain.
J Child Neurol. 2017 Nov;32(13):1065-1073. doi: 10.1177/0883073817726681. Epub 2017 Sep 19.
To quantify the prognostic value of neonatal brain magnetic resonance imaging (MRI) in neonatal hypoxic-ischemic encephalopathy.
Meta-analysis of studies with ≥35-week neonates with hypoxic-ischemic encephalopathy who underwent brain MRI within age 4 weeks and had neurodevelopmental follow-up for at least 12 months.
An abnormal neonatal brain MRI was more frequent among patients with unfavorable neurodevelopmental outcome: odds ratio = 18.2 (95% confidence interval: 9.4-34.9), P <.0001. The prognostic value of neonatal brain MRI in moderate hypoxic-ischemic encephalopathy had an odds ratio of 17.7 (95% confidence interval: 5.3-59.3) and in severe hypoxic-ischemic encephalopathy, the odds ratio was 125.0 (95% confidence interval: 2.0-7917.1). Therapeutic hypothermia did not change the prognostic value of neonatal brain MRI (odds ratio for hypothermia, 14.0 [95% confidence interval: 3.1-63.6], vs no hypothermia, 18.1 [95% confidence interval: 10.0-33.1], P = .7525).
Neonatal brain MRI provides prognostic information on outcome beyond early infancy in hypoxic-ischemic encephalopathy and therapeutic hypothermia does not change its prognostic value.
量化新生儿脑磁共振成像（MRI）在新生儿缺氧缺血性脑病中的预后价值。
对孕周≥35周、患有缺氧缺血性脑病且在4周龄内接受脑MRI检查并进行至少12个月神经发育随访的研究进行荟萃分析。
神经发育结局不良的患者中，新生儿脑MRI异常更为常见：比值比=18.2（95%置信区间：9.4-34.9），P<.0001。新生儿脑MRI在中度缺氧缺血性脑病中的预后价值比值比为17.7（95%置信区间：5.3-59.3），在重度缺氧缺血性脑病中，比值比为125.0（95%置信区间：2.0-7917.1）。治疗性低温并未改变新生儿脑MRI的预后价值（低温治疗的比值比为14.0[95%置信区间：3.1-63.6]，未进行低温治疗的比值比为18.1[95%置信区间：10.0-33.1]，P=.7525）。
新生儿脑MRI可为缺氧缺血性脑病婴儿期后的预后提供预后信息，治疗性低温不会改变其预后价值。
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