Early MRI in neonatal hypoxic-ischaemic encephalopathy treated with hypothermia: Prognostic role at 2-year follow-up

Charon, Valérie; Proisy, Maïa; Bretaudeau, G.; Bruneau, Bertrand; Pladys, Patrick; Beuchée, Alain; Burnouf-Rose, Gladys; Ferré, Jean–Christophe; Rozel, Céline

doi:10.1016/j.ejrad.2016.05.005

Cited by 36 publications

(35 citation statements)

References 32 publications

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“…In the present review, late MRI predicted an unfavorable neurological outcome with a sensitivity and specificity of 0.88 and 0.88, respectively, whereas early MRI showed less specificity of 0.73. However, Charon et al reported that the specificity of MRI for predicting death or disability to 18 months of age in HT infants with HIE was 96.3% in the first week and 89.3% in the second week (18). The discrepancy between our findings and those reported by Charon et al might be explained by the various abnormal findings and the thresholds for the index tests.…”

Section: Discussioncontrasting

confidence: 99%

Prognostic Value of Clinical Tests in Neonates With Hypoxic-Ischemic Encephalopathy Treated With Therapeutic Hypothermia: A Systematic Review and Meta-Analysis

et al. 2020

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Background and Objective: There remains an unmet clinical need for markers that predict outcomes in the hypothermia-treated (HT) infants with HIE. The aim of this meta-analysis was to investigate the prognostic accuracy of currently available clinical tests performed in the immediate post-natal period for predicting neurological outcomes between 18 months and 3 years of age in HT near-term and term infants with perinatal asphyxia and HIE. Methods: A comprehensive review of the Embase, Cochrane library, and PubMed databases was performed to identify studies that evaluated the prognostic value of clinical tests for neurological outcomes in HT near-term and term infants with perinatal asphyxia and hypoxic-ischemic encephalopathy. Pooled sensitivity and specificity with corresponding 95% confidence intervals and area under the receiver operating characteristic (ROC) curve (AUC) were calculated. Results: Of the 1,144 relevant studies, 26 studies describing four clinical tests conducted in 1458 HT near-term or term infants were included. For predicting an unfavorable neurological outcome, of the imaging techniques, MRI within 2 weeks of birth performed best on sensitivity 0.85 (95% CI 0.79-0.89), specificity 0.72 (95% CI 0.66-0.77), and AUC 0.88; among the neurophysiological tests, multichannel EEG (Electroencephalogram) demonstrated the sensitivity 0.63 (95% CI 0.49-0.76), specificity 0.82 (95% CI 0.70-0.91), and AUC 0.88, and for aEEG (amplitude-integrated electroencephalography) background pattern pooled sensitivity, specificity and AUC were 0.90 (95% CI 0.86-0.94), 0.46 (95% CI 0.42-0.51), and 0.78 whereas for SEPs (Somatosensory evoked potentials), pooled sensitivity and specificity were 0.52 (95% CI 0.34-0.69), 0.76 (95% CI 0.63-0.87), and AUC 0.84, respectively. Liu et al. Clinical Trials Prognosis of HIE Conclusions: In the wake of the era of TH, MRI and neurophysiological tests (aEEG or EEG) were promising predictors of adverse outcomes, while SEPs need high-quality studies to confirm the findings. Continued follow-up of the children and well-designed large prospective studies are essential to determine whether these benefits are maintained in later childhood.

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Section: Discussioncontrasting

confidence: 99%

Prognostic Value of Clinical Tests in Neonates With Hypoxic-Ischemic Encephalopathy Treated With Therapeutic Hypothermia: A Systematic Review and Meta-Analysis

et al. 2020

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“…Alderliesten et al [8] demonstrated that the ADC value in the corpus callosum is a good predictor (AUC = 0.87) of death or survival with adverse neurodevelopment at 18 months of age. Charon et al [18] studied 32 patients treated with TH, 5 of them with an adverse outcome (death or disability at 2 years), and found, in a similar manner to our results, that ADC values on MRI that was performed on days 3-6 of life were good predictors of outcome. In this study the best predictors of neurological outcome with the highest AUCs were ADC values within the posterior white matter, semioval centres, and PLIC.…”

Section: Discussionsupporting

confidence: 72%

Prognostic Value of the Apparent Diffusion Coefficient in Newborns with Hypoxic-Ischaemic Encephalopathy Treated with Therapeutic Hypothermia

Heursen

Ojeda

Fernández³

et al. 2017

Neonatology

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Background: Apparent diffusion coefficient (ADC) quantification has been proven to be of prognostic value in term newborns with hypoxic-ischaemic encephalopathy (HIE) who were treated under normothermia. Objectives: To evaluate the prognostic value of ADC in standardized brain regions in neonates with HIE who were treated with therapeutic hypothermia (TH). Methods: This prospective cohort study included 54 term newborns who were admitted with HIE and treated with TH. All magnetic resonance imaging examinations were performed between days 4 and 6 of life, and ADC values were measured in 13 standardized regions of the brain. At 2 years of age we explored whether ADC values were related to composite outcomes (death or survival with abnormal neurodevelopment). Results: The severity of HIE is inversely related to ADC values in different brain regions. We found that lower ADC values in the posterior limb of the internal capsule (PLIC), the thalami, the semioval centre, and frontal and parietal white matter were related to adverse outcomes. ADC values in the PLIC and thalami are good predictors of adverse outcomes (AUC 0.86 and 0.76). Conclusions: Low ADC values in the PLIC, thalamus, semioval centre, and frontal and parietal white matter in full-term infants with HIE treated with TH were associated with a poor outcome.

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“…[13][14][15] The neurodevelopmental outcomes in neonates with HIE correlate with abnormalities on brain magnetic resonance imaging (MRI) performed during the neonatal period. [16][17][18] The primary objective of this study was to determine survival without abnormalities on brain MRI in late preterm and term neonates (!35 weeks of gestation) with no signs of life at 10 minutes of age (Apgar 0 at 10 minutes) who received therapeutic hypothermia. We also sought to compare the number of infants who survived with abnormalities on brain MRI between the groups with Apgar scores of 0, 1 to 4, and !…”

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confidence: 99%

Apgar Scores at 10 Minutes and Outcomes in Term and Late Preterm Neonates with Hypoxic-Ischemic Encephalopathy in the Cooling Era

et al. 2018

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Early MRI in neonatal hypoxic-ischaemic encephalopathy treated with hypothermia: Prognostic role at 2-year follow-up

Cited by 36 publications

References 32 publications

Prognostic Value of Clinical Tests in Neonates With Hypoxic-Ischemic Encephalopathy Treated With Therapeutic Hypothermia: A Systematic Review and Meta-Analysis

Prognostic Value of Clinical Tests in Neonates With Hypoxic-Ischemic Encephalopathy Treated With Therapeutic Hypothermia: A Systematic Review and Meta-Analysis

Prognostic Value of the Apparent Diffusion Coefficient in Newborns with Hypoxic-Ischaemic Encephalopathy Treated with Therapeutic Hypothermia

Apgar Scores at 10 Minutes and Outcomes in Term and Late Preterm Neonates with Hypoxic-Ischemic Encephalopathy in the Cooling Era

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