Westmark K D, Barkovich A J, Sola A, Ferriero D, Partridge J C
Department of Neuroradiology, University of California, San Francisco 94143-0628, USA.
AJNR Am J Neuroradiol. 1995 Apr;16(4):685-92.
To determine the presence and location of MR contrast enhancement in infants with perinatal asphyxia and to evaluate the utility of enhancement in assessing extent of brain damage.
Precontrast and postcontrast MR examinations within the first 10 days of life were evaluated in 10 infants with suspected hypoxic-ischemic birth injury. Findings were correlated with clinical birth history and short-term neurologic follow-up.
All four infants with MR signal abnormalities and contrast enhancement in the basal ganglia and brain stem had early seizures and profound neurologic deficits at early follow-up. Two infants had abnormal scans but no contrast enhancement; one with MR signal abnormality within the basal ganglia is neurologically healthy at 10-month follow-up, whereas the other, in status epilepticus at the time of imaging at age 2 days, died. Two infants with minimal parasagittal subcortical white matter enhancement had no early seizure activity and only mild developmental delay at early follow-up. Two infants with normal precontrast and postcontrast MR had no early seizures and remain healthy at early follow-up, despite initial clinical parameters similar to more severely injured infants.
Although the number of patients is small, our results indicate that the presence of contrast enhancement in asphyxiated neonates may indicate more severe brain damage and, hence, a poorer prognosis.
确定围产期窒息婴儿磁共振成像（MR）对比增强的存在及位置，并评估增强在评估脑损伤程度方面的效用。
对10例疑似缺氧缺血性脑损伤的婴儿在出生后10天内进行了MR平扫及增强检查。检查结果与临床出生史及短期神经学随访结果相关联。
所有4例在基底节和脑干有MR信号异常及对比增强的婴儿在早期随访时均出现早期惊厥及严重神经功能缺损。2例婴儿扫描结果异常但无对比增强；其中1例基底节内有MR信号异常的婴儿在10个月随访时神经学检查正常，而另1例在2日龄成像时处于癫痫持续状态，最终死亡。2例矢状旁皮质下白质轻度增强的婴儿无早期惊厥活动，在早期随访时仅有轻度发育迟缓。2例MR平扫及增强均正常的婴儿无早期惊厥，在早期随访时仍保持健康，尽管其初始临床参数与损伤更严重的婴儿相似。
尽管患者数量较少，但我们的结果表明，窒息新生儿存在对比增强可能提示脑损伤更严重，预后更差。
