Division of Pediatric Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Canada.
Division of Newborn Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Canada.
Eur J Paediatr Neurol. 2018 May;22(3):387-395. doi: 10.1016/j.ejpn.2018.01.017. Epub 2018 Jan 31.
To determine whether an MRI scoring system, which was validated in the pre-cooling era, can still predict the neurodevelopmental outcome of asphyxiated newborns treated with hypothermia at 2 years of age.
We conducted a retrospective cohort study of asphyxiated newborns treated with hypothermia. An MRI scoring system, which was validated in the pre-cooling era, was used to grade the severity of brain injury on the neonatal brain MRI. Their neurodevelopment was assessed around 2 years of age; adverse outcome included cerebral palsy, global developmental delay, and/or epilepsy.
One hundred and sixty-nine newborns were included. Among the 131 newborns who survived and had a brain MRI during the neonatal period, 92% were evaluated around 2 years of age or later. Of these newborns, 37% displayed brain injury, and 23% developed an adverse outcome. Asphyxiated newborns treated with hypothermia who had an adverse outcome had a significantly higher MRI score (p <0.001) compared to those without an adverse outcome.
An MRI scoring system that was validated before the cooling era is still able to reliably differentiate which of the asphyxiated newborns treated with hypothermia were more prone to develop an adverse outcome around 2 years of age.
确定在冷却前时代验证的 MRI 评分系统是否仍可预测接受低温治疗的窒息新生儿在 2 岁时的神经发育结局。
我们对接受低温治疗的窒息新生儿进行了回顾性队列研究。使用在冷却前时代验证的 MRI 评分系统对新生儿脑 MRI 上的脑损伤严重程度进行分级。在大约 2 岁时评估他们的神经发育情况；不良结局包括脑瘫、全面发育迟缓、和/或癫痫。
共纳入 169 例新生儿。在 131 例存活且在新生儿期进行了脑 MRI 的新生儿中，92%在 2 岁或之后进行了评估。这些新生儿中，37%显示脑损伤，23%发生不良结局。接受低温治疗的窒息新生儿中，出现不良结局者的 MRI 评分明显更高（p<0.001）。
在冷却前时代验证的 MRI 评分系统仍然能够可靠地区分接受低温治疗的窒息新生儿中哪些更有可能在 2 岁左右出现不良结局。
