Rusli Emilia Rosniza Mohammed, Ismail Juriza, Wei Wong Saw, Ishak Shareena, Jaafar Rohana, Zaki Faizah Mohd
Department of Radiology, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latiff, Cheras, 56000 Kuala Lumpur, Malaysia.
Department of Pediatrics, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latiff, Cheras, 56000 Kuala Lumpur, Malaysia.
Indian J Radiol Imaging. 2019 Oct-Dec;29(4):350-355. doi: 10.4103/ijri.IJRI_62_19. Epub 2019 Dec 31.
This study aims to evaluate the magnetic resonance imaging (MRI) brain patterns among hypoxic-ischemic encephalopathy (HIE) babies who underwent post-cooling MRI brain as well as to correlate the post-cooling brain scoring with patient's neurodevelopmental outcome at 2 years.
It was a retrospective cross sectional study carried out at a tertiary university hospital. Record of patients diagnosed with neonatal HIE from 2007 until 2016 who completed 72 h of cooling therapy and had MRI brain within 2 weeks of life were included in this study. A new scoring system by Trivedi . that emphasizes on subcortical deep gray matter and posterior limb internal capsule injury were utilized upon MRI assessment, using TW, T2W, and diffusion-weighted imaging (DWI) sequences. Cumulative MRI brain score was obtained and graded as none, mild, moderate, and severe brain injury. The MRI brain scoring was then correlated with patient's 2 years neurodevelopmental outcome using Fisher's Exact Test.
A total of 23 patients were eligible of which 19 term neonates were included. 13% of these neonates ( = 3) had mild MRI brain injury grading with 52.2% ( = 12) moderate and 34.8% ( = 8) severe. There was no significant correlation seen between MRI brain grading and developmental outcome at 2 years old ( > 0.05).
There was no significant correlation between neonatal MRI brain injury grading and 2 years neurodevelopmental outcome. Nevertheless, the new MRI brain scoring by Trivedi . is reproducible and comprehensive as it involves various important brain structures, assessed from different MRI sequences.
本研究旨在评估接受亚低温治疗后进行头颅磁共振成像（MRI）检查的缺氧缺血性脑病（HIE）患儿的脑部MRI表现，并将亚低温治疗后的脑部评分与患儿2岁时的神经发育结局进行相关性分析。
这是一项在一所三级大学医院开展的回顾性横断面研究。本研究纳入了2007年至2016年期间诊断为新生儿HIE、完成72小时亚低温治疗且在出生后2周内进行了头颅MRI检查的患者记录。在MRI评估中，采用了Trivedi等人提出的一种新的评分系统，该系统强调皮质下深部灰质和内囊后肢损伤，使用T1加权（TW）、T2加权（T2W）和扩散加权成像（DWI）序列。获得累积头颅MRI评分，并将其分为无、轻度、中度和重度脑损伤。然后使用Fisher精确检验将头颅MRI评分与患者2岁时的神经发育结局进行相关性分析。
共有23例患者符合条件，其中包括19例足月儿。这些新生儿中，13%（n = 3）为轻度头颅MRI脑损伤分级，52.2%（n = 12）为中度，34.8%（n = 8）为重度。在2岁时，头颅MRI分级与发育结局之间未发现显著相关性（P>0.05）。
新生儿头颅MRI脑损伤分级与2岁时的神经发育结局之间无显著相关性。然而，Trivedi等人提出的新的头颅MRI评分具有可重复性和全面性，因为它涉及从不同MRI序列评估的各种重要脑结构。
