MR Imaging of hypoxic ischemic encephalopathy – Distribution Patterns and ADC value correlations

Rana, Lokesh; Sood, Dinesh; Chauhan, Ramesh Chand; Shukla, Roshni; Gurnal, Pooja; Nautiyal, Himanshu; Tomar, Manvendra

doi:10.1016/j.ejro.2018.08.001

Cited by 15 publications

(10 citation statements)

References 10 publications

(14 reference statements)

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“…These changes may represent the coexistence of early fluid shifts and late cell necrosis, more typical of hypoxic brain injury 19 . Findings similar to hypoxic brain injury may also be associated with another common mechanism that anoxia and hyperammonemia in UCDs share 20 . Increased glutamate/glutamine has been previously demonstrated by MRS in both hypoxic brain injury and UCD 21 .…”

Section: Discussionmentioning

confidence: 94%

Urea Cycle Disorders: A Neuroimaging Pattern Approach Using Diffusion and FLAIR MRI

Öztürk

McKinney

Nascene

2020

Journal of Neuroimaging

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BACKGROUND AND PURPOSE This study aimed to assess characteristic regions of MRI involvement utilizing diffusion weighted imaging (DWI) and fluid‐attenuated inversion recovery (FLAIR) at urea cycle disorder (UCD) diagnosis to determine the possible association between initial MRI patterns within 10 days of the first hyperammonemia episode, serum ammonia levels, and severity of neurological outcome based on clinical follow‐up of >30 days. METHODS Ten patients with UCDs (4 females; median age: 5.4 years, age range: 6 days‐54 years) were included who underwent MRI during a first episode of hyperammonemia. The topographical distribution of the DWI and FLAIR abnormalities in the cerebral cortex, deep gray matter, white matter, posterior limb of internal capsule, cerebral peduncle, and cerebellum was evaluated. Possible correlations between the brain injury patterns on DWI/FLAIR images, serum ammonia levels, and severity of neurological outcome were investigated by a trend correlation. RESULTS The UCD cohort (n = 10) involved four ornithine transcarbamoylase deficiencies, four argininosuccinic aciduria, one carbomoylphosphate synthetase deficiency, and one citrullinemia type‐1. The observed trend in the distribution of DWI abnormalities as the severity of neurological sequela outcome increased was with diffuse cerebral cortex or corpus striatum involvement. Patients with initial peak serum ammonia ≥450 µmol/L had a grade 2 to 4 outcome, and those with peak ammonia <450 µmol/L had a grade 0 or 1 outcome. CONCLUSIONS The presence of more severe neurological outcome could be associated with diffuse cerebral cortex or corpus striatum involvement on DWI and high serum ammonia levels in patients with UCD.

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Section: Discussionmentioning

confidence: 94%

Urea Cycle Disorders: A Neuroimaging Pattern Approach Using Diffusion and FLAIR MRI

Öztürk

McKinney

Nascene

2020

Journal of Neuroimaging

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“…MRI is nowadays a standard tool for determining the pattern and severity of brain injury as well as the prognosis in infants with HIE. The usefulness of conventional and modern MRI techniques, such as: T2*weighted imaging (GRE/T2*WI), susceptibility-weighted imaging (SWI), diffusion-weighted imaging (DWI), as well as the magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI) has been proven [7][8][9][10][11][12] . Scoring scales have also been developed to quantify hypoxic brain injury [13][14][15][16] .…”

Section: Discussionmentioning

confidence: 99%

“…Neuroimaging, especially magnetic resonance imaging (MRI), plays a special role in determining the prognosis of newborns after PA. Both conventional and newer MRI techniques are used and MRI is nowadays a standard tool for determining the pattern and severity of brain injury as well as the prognosis in infants with HIE [7][8][9][10][11][12] . Scales for objective, numerical assessment of the degree of brain damage in neonates with HIE were developed [13][14][15][16][17] .…”

Section: Introductionmentioning

confidence: 99%

Thermal Index for Early Non-invasive Assessment of Brain Injury in Newborns Treated With Therapeutic Hypothermia – Preliminary Report of Non-invasive Thermal Measurements

Walas

Mączko

Halaba

et al. 2021

Preprint

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Perinatal asphyxia (PA) is the 3rd most common cause of neonatal death and one of the most common causes of severe neurological impairments in children. Current tools and measurements mainly based on the analysis of clinical evaluation and laboratory and electrophysiological tests do not give consistent data allowing to predict the severity of hypoxic-ischemic encephalopathy (HIE) until an magnetic resonance imaging (MRI) score is performed. The aim of this work is to evaluate the usefulness of the new index, called Thermal Index (TI) in the assessment of the degree of brain damage in newborns in the course of therapeutic hypothermia (TH) due to PA.This was a prospective, observational, pilot study which did not require any changes in the applicable procedures. Analysis has been applied to six newborn babies treated with TH in Neonatal/Paediatric ICU in University Hospital in Opole in 2018 due to PA. They all met criteria for TH according to the current recommendations. Brain MRI was performed after the end of TH when the children were brought back to normal temperature, with the use of 1.5 T scanner, using T1-, T2-weighted images, fluid-attenuated inversion recovery (FLAIR), inversion recovery (IR), susceptibility-weighted imaging (SWI), and diffusion-weighted imaging (DWI). The images were assessed using MRI score according to the scoring system proposed by Weeke et al. The Thermal Index assessing endogenous heat production was calculated according to the formula proposed in this paper. High, statistically significant positive correlation were found between MRI scores and TI values (0.98; p = 0.0003) in the 1st hour of therapy. High correlation with MRI assessment, the non-invasiveness of measurements and the availability of results within the first few hours of treatment, allow authors to propose the Thermal Index as a tool for early evaluating of the brain injury in newborns treated with TH. Further research is required to confirm the usefulness of the proposed method.

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“…[6][7][8][9] More accurate markers would be useful for detection, classification, early therapeutic interventions, and predictors of long-term outcome. Several studies have investigated various alternative methods for measuring HIE, such as DWI, 10 MR spectroscopy, 11,12 urinary nuclear MR metabolomic profiling, 13 and visual evoked potentials, 14 with varying levels of reported success.…”

mentioning

confidence: 99%

Quantitative Susceptibility Mapping of Venous Vessels in Neonates with Perinatal Asphyxia

Weber¹,

Zhang

Kames

et al. 2021

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Cerebral venous oxygen saturation can be used as an indirect measure of brain health, yet it often requires either an invasive procedure or a noninvasive technique with poor sensitivity. We aimed to test whether cerebral venous oxygen saturation could be measured using quantitative susceptibility mapping, an MR imaging technique, in 3 distinct groups: healthy term neonates, injured term neonates, and preterm neonates. MATERIALS AND METHODS:We acquired multiecho gradient-echo MR imaging data in 16 neonates with perinatal asphyxia and moderate or severe hypoxic-ischemic encephalopathy (8 term age: average, 40.0 [SD, 0.8] weeks' gestational age; 8 preterm, 33.5 [SD, 2.0] weeks' gestational age) and in 8 healthy term-age controls (39.3 [SD, 0.6] weeks, for a total of n ¼ 24. Data were postprocessed as quantitative susceptibility mapping images, and magnetic susceptibility was measured in cerebral veins by thesholding out 99.95% of lower magnetic susceptibility values. RESULTS:The mean magnetic susceptibility value of the cerebral veins was found to be 0.36 (SD, 0.04) ppm in healthy term neonates, 0.36 (SD, 0.06) ppm in term injured neonates, and 0.29 (SD, 0.04) ppm in preterm injured neonates. Correspondingly, the derived cerebral venous oxygen saturation values were 73.6% (SD, 2.8%), 71.5% (SD, 7.4%), and 72.2% (SD, 5.9%). There was no statistically significant difference in cerebral venous oxygen saturation among the 3 groups (P ¼ .751). CONCLUSIONS:Quantitative susceptibility mapping-derived oxygen saturation values in preterm and term neonates agreed well with values in past literature. Cerebral venous oxygen saturation in preterm and term neonates with hypoxic-ischemic encephalopathy, however, was not found to be significantly different between neonates or healthy controls. ABBREVIATIONS: x ¼ magnetic susceptibility; CSaO 2 ¼ cerebral arterial oxygen saturation; CSvO 2 ¼ cerebral venous oxygen saturation; Hct ¼ hematocrit; HIE ¼ hypoxic-ischemic encephalopathy; NIRS ¼ near-infrared resonance spectroscopy; QSM ¼ quantitative susceptibility mapping; SSS ¼ superior sagittal sinus; TRUST ¼ T2-relaxation-under-spin tagging

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MR Imaging of hypoxic ischemic encephalopathy – Distribution Patterns and ADC value correlations

Cited by 15 publications

References 10 publications

Urea Cycle Disorders: A Neuroimaging Pattern Approach Using Diffusion and FLAIR MRI

Urea Cycle Disorders: A Neuroimaging Pattern Approach Using Diffusion and FLAIR MRI

Thermal Index for Early Non-invasive Assessment of Brain Injury in Newborns Treated With Therapeutic Hypothermia – Preliminary Report of Non-invasive Thermal Measurements

Quantitative Susceptibility Mapping of Venous Vessels in Neonates with Perinatal Asphyxia

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