Serial 1- and 2-Dimensional Cerebral MRI Measurements in Full-Term Infants after Perinatal Asphyxia

Abstract

Objective: Cranial magnetic resonance imaging (MRI) is associated with neurodevelopmental outcome in full-term infants with neonatal encephalopathy (NE) following presumed perinatal asphyxia. The aim of this study is to relate 2-dimensional measurements of the basal ganglia and thalami (BGT) and cerebellum in the first week after birth and after 3 months with neurodevelopmental outcome at 18 months. Methods: Retrospectively, 29 full-term infants with NE following presumed perinatal asphyxia who had a cranial MRI in the first week after birth were studied serially. One- and 2-dimensional measurements were obtained and related to different patterns of brain injury, and neurodevelopmental outcome at 18 months. A Griffiths developmental quotient <85 or cerebral palsy was considered adverse. Results: On the first MRI, the adverse outcome group showed increased basal ganglia width (42.1 ± 0.1 vs. 40.3 ± 0.3 mm, p < 0.001), thalamic width (40.3 ± 0.1 vs. 39.3 ± 1.0 mm, p < 0.001), and basal ganglia surface (1,230 ± 21 vs. 1,199 ± 36 mm², p = 0.007) compared to the favorable outcome group. In the BGT lesions group, basal ganglia width and thalamic width were increased compared to the watershed infarction group (42.1 ± 0.1 vs. 40.9 ± 0.8 mm, p < 0.001, and 40.3 ± 0.1 vs. 39.9 ± 0.5 mm, p = 0.01, respectively). On the second MRI, cerebellar width was larger in the favorable outcome group (p = 0.025). There was a greater increase in dimensions between both MRI time points for basal ganglia width (p = 0.014), basal ganglia surface (p = 0.028) and thalamic width (p = 0.012) in the favorable outcome group. Conclusions: One- and 2-dimensional measurements for basal ganglia surface, BGT width and cerebellar width are associated with neurodevelopmental outcome at 18 months.

Dyskinesia Impairment Scale scores in Dutch pre-school children after neonatal therapeutic hypothermia

“…Analogous with the DIS-score profiles, we observed that the ataxia rating scale scores (SARA) in these two children were higher than the SARA-scores in age-matched controls [12], and clearly lower (more favorable) than the SARAscores in children with early onset ataxia (data not shown) [29]. Previous studies have demonstrated that there is a relationship between hampered cerebellar growth and asphyxia [30]. In addition to cerebellar impairment [31], injury to the white matter [32] causing disturbed signaling within the cerebral motor network, could also induce suboptimal motor coordination.…”

Cerebral Blood Flow Measured by Phase-Contrast Magnetic Resonance Angiography in Preterm and Term Neonates

“…For all infants, 2D brain surface measurements were performed as described previously [22]. The AP measurements were preferentially carried out in the sagittal plane, with the measurement tool as close to the longitudinal fissure as possible.…”

“…The LR measurements were obtained in either the axial or coronal plane. Using the AP maximum length and LR maximum width, a 2D oval-shaped slice was calculated using the formula: 2D slice = π × 0.5 AP (mm) × 0.5 LR (mm) [22]. …”

Cranial MRI beyond the Neonatal Period and Neurodevelopmental Outcomes in Neonatal Encephalopathy Due to Perinatal Asphyxia: A Systematic Review

“…Most studies used the Griffiths Mental Development Scales (n = 4) and/or different editions of the Denver Developmental Screening Test (n = 4) and the Bayley Scales of Infant and Toddler Development (n = 3) to assess neurodevelopmental outcomes. All twelve studies analyzed infants with a later MRI performed within 18 months after birth [10,[16][17][18][19][20][21][22][23][24][25][26] and three studies also described a subset of infants with MRI performed at 18-24 months after birth [10,16,24]. For six papers, the data as presented by the study were re-analyzed in SPSS, as a complete statistical analysis was not provided in the article.…”

“…All demonstrated a significant association between later MRI abnormalities and the composite adverse outcome as defined by the specific study [10,[17][18][19]22,23,26]. Three studies, one graded as high-quality and two as moderate-quality, demonstrated a significant association between biometrics on MRI performed at 2-18 months and a composite neurodevelopmental outcome [10,20,21]…”