Premium
Perfusion‐weighted magnetic resonance imaging patterns of hypoxic–ischemic encephalopathy in term neonates
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.21525
Subject(s) - white matter , magnetic resonance imaging , medicine , basal ganglia , cerebral blood flow , encephalopathy , hypoxic ischemic encephalopathy , perfusion , neonatal encephalopathy , radiology , pathology , nuclear medicine , cardiology , central nervous system
Purpose To determine whether an early magnetic resonance imaging (MRI) study using perfusion‐weighted imaging (PWI) may define the pattern of brain injury in term neonatal hypoxic–ischemic (HI) encephalopathy. Materials and Methods Five newborns with HI encephalopathy or a marker of perinatal depression, and 2 controls underwent an early MRI (at 2 to 4 days), including PWI. Relative cerebral blood flow (rCBF) values were measured. Results On early (≤4 days) PWI‐MRI, marked hyperperfusion was seen in areas of HI brain damage, allowing the classification of the children into different patterns according to the predominant site of injury: 1 with a “normal pattern”; 1 with a “watershed pattern” with increased rCBF ratios in white matter; 1 with a “basal ganglia pattern” with increased rCBF ratios in basal ganglia; and 2 with a “total cortical pattern” with increased rCBF ratios in cortical gray matter, white matter, and basal ganglia. These patterns were confirmed in all infants on late (9 to 11 days) conventional MRI (T2‐weighted images) (4 of 5 patients) or on postmortem examination (1 of 5 patients). Conclusion PWI is technically feasible in neonates with HI encephalopathy in a reproducible way, permitting comparisons between children. It provides a practical means to identify early after birth the future definitive ischemic areas that may be shown on conventional MRI only later. J. Magn. Reson. Imaging 2008;28:1019–1025. © 2008 Wiley‐Liss, Inc.