Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA.
1st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
Pediatr Res. 2023 Mar;93(4):985-989. doi: 10.1038/s41390-022-02195-5. Epub 2022 Jul 19.
The incidence of cerebral sinovenous thrombosis (CSVT) in infants receiving therapeutic hypothermia for neonatal encephalopathy remains controversial. The aim of this study was to identify if the routine use of magnetic resonance venography (MRV) in term-born infants receiving hypothermia is associated with diagnostic identification of CSVT.
We performed a retrospective review of 291 infants who received therapeutic hypothermia from January 2014 to March 2020. Demographic and clinical data, as well as the incidence of CSVT, were compared between infants born before and after adding routine MRV to post-rewarming magnetic resonance imaging (MRI).
Before routine inclusion of MRV, 209 babies were cooled, and 25 (12%) underwent MRV. Only one baby (0.5%) was diagnosed with CSVT in that period, and it was detected by structural MRI, then confirmed with MRV. After the inclusion of routine MRV, 82 infants were cooled. Of these, 74 (90%) had MRV and none were diagnosed with CSVT.
CSVT is uncommon in our cohort of infants receiving therapeutic hypothermia for neonatal encephalopathy. Inclusion of routine MRV in the post-rewarming imaging protocol was not associated with increased detection of CSVT in this population.
Cerebral sinovenous thrombosis (CSVT) in infants with NE receiving TH may not be as common as previously indicated. The addition of MRV to routine post-rewarming imaging protocol did not lead to increased detection of CSVT in infants with NE. Asymmetry on MRV of the transverse sinus is a common anatomic variant. MRI alone may be sufficient in indicating the presence of CSVT.
接受治疗性低温治疗的新生儿脑病婴儿的脑静脉窦血栓形成（CSVT）的发生率仍存在争议。本研究的目的是确定接受低温治疗的足月出生婴儿常规使用磁共振静脉造影术（MRV）是否与 CSVT 的诊断识别相关。
我们对 2014 年 1 月至 2020 年 3 月接受治疗性低温治疗的 291 名婴儿进行了回顾性分析。比较了在添加常规 MRV 后进行复温后磁共振成像（MRI）前后出生的婴儿的人口统计学和临床数据，以及 CSVT 的发生率。
在常规纳入 MRV 之前，有 209 名婴儿接受了降温，其中 25 名（12%）接受了 MRV。在此期间，只有一名婴儿（0.5%）被诊断为 CSVT，并且通过结构 MRI 检测到，然后通过 MRV 证实。在纳入常规 MRV 后，有 82 名婴儿接受了降温。其中 74 名（90%）进行了 MRV，均未诊断为 CSVT。
在接受治疗性低温治疗的新生儿脑病婴儿中，CSVT 并不常见。在复温后成像方案中纳入常规 MRV 并未增加该人群 CSVT 的检出率。
接受 TH 的 NE 婴儿的 CSVT 可能不像以前指出的那样常见。在常规复温后成像方案中添加 MRV 并未导致 NE 婴儿 CSVT 的检出率增加。MRV 横窦的不对称性是常见的解剖变异。MRI 本身可能足以表明 CSVT 的存在。
