Rutherford M, Pennock J, Schwieso J, Cowan F, Dubowitz L
Department of Paediatrics and Neonatal Medicine, Hammersmith Hospital, London.
Arch Dis Child Fetal Neonatal Ed. 1996 Nov;75(3):F145-51. doi: 10.1136/fn.75.3.f145.
Sixteen infants with hypoxic-ischaemic encephalopathy (HIE) were studied using serial magnetic resonance imaging (MRI) up to the age of 2 years. The infants had regular neurological and developmental assessments. An nuclear magnetic resonance (NMR) score was devised to quantify the early and late MRI findings and a neurological optimality score was used to quantify abnormal neurological signs at the time of the final examination. The follow up MRI score was compared with the neonatal MRI score and the outcome of the child. There was a strong positive correlation between the neonatal and follow up MRI scores and between MRI scores and optimality score. All infants with a normal outcome had patchy white matter abnormalities. All infants with an abnormal outcome had extensive white matter abnormalities. The outcome was most severe in those infants with additional basal ganglia atrophy with or without cyst formation. Infants with mild HIE who are developmentally normal at the age of 2 years do not have normal MRI scans and may be at risk of minor neurological problems by school age. Bilateral basal ganglia abnormalities are associated with severe developmental delay, but infants with mainly white matter and cortical abnormalities have less severe problems despite extensive tissue loss.
对16名患有缺氧缺血性脑病（HIE）的婴儿进行了研究，采用连续磁共振成像（MRI），直至2岁。这些婴儿接受了定期的神经学和发育评估。设计了一个核磁共振（NMR）评分来量化早期和晚期MRI结果，并使用神经学最优性评分来量化最后检查时的异常神经学体征。将随访MRI评分与新生儿MRI评分及儿童的预后进行比较。新生儿和随访MRI评分之间以及MRI评分与最优性评分之间存在很强的正相关。所有预后正常的婴儿都有散在的白质异常。所有预后异常的婴儿都有广泛的白质异常。在那些伴有或不伴有囊肿形成的基底节萎缩的婴儿中，预后最为严重。2岁时发育正常的轻度HIE婴儿没有正常的MRI扫描结果，到学龄期可能有轻微神经问题的风险。双侧基底节异常与严重发育迟缓有关，但主要有白质和皮质异常的婴儿尽管有广泛的组织损失，问题相对较轻。
