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Temporal evolution of MR perfusion in neonatal hypoxic‐ischemic encephalopathy
Author(s) -
Wintermark Pia,
Moessinger Adrien C.,
Gudinchet François,
Meuli Reto
Publication year - 2008
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.21379
Subject(s) - medicine , cerebral blood flow , magnetic resonance imaging , white matter , encephalopathy , basal ganglia , perfusion , neonatal encephalopathy , hypoxic ischemic encephalopathy , perfusion scanning , cerebral blood volume , radiology , cardiology , nuclear medicine , central nervous system
Purpose To illustrate the evolution of brain perfusion‐weighted magnetic resonance imaging (PWI‐MRI) in severe neonatal hypoxic‐ischemic (HI) encephalopathy, and its possible relation to further neurodevelopmental outcome. Materials and Methods Two term neonates with HI encephalopathy underwent an early and a late MRI, including PWI. They were followed until eight months of age. A total of three “normal controls” were also included. Perfusion maps were obtained, and relative cerebral blood flow (rCBF) and cerebral blood volume (rCBV) values were measured. Results Compared to normal neonates, a hyperperfusion (increased rCBF and rCBV) was present on early scans in the whole brain. On late scans, hyperperfusion persisted in cortical gray matter (normalization of rCBF and rCBV ratios in white matter and basal ganglia, but not in cortical gray matter). Diffusion‐weighted imaging (DWI) was normalized, and extensive lesions became visible on T2‐weighted images. Both patients displayed very abnormal outcome: Patient 2 with the more abnormal early and late hyperperfusion being the worst. Conclusion PWI in HI encephalopathy did not have the same temporal evolution as DWI, and remained abnormal for more than one week after injury. This could be a marker of an ongoing mechanism underlying severe neonatal HI encephalopathy. Evolution of PWI might help to predict further neurodevelopmental outcome. J. Magn. Reson. Imaging 2008;27:1229–1234. © 2008 Wiley‐Liss, Inc.