@article {AlderliestenF147, author = {Thomas Alderliesten and Linda S de Vries and Liza Staats and Ingrid C van Haastert and Lauren Weeke and Manon J N L Benders and Corine Koopman-Esseboom and Floris Groenendaal}, title = {MRI and spectroscopy in (near) term neonates with perinatal asphyxia and therapeutic hypothermia}, volume = {102}, number = {2}, pages = {F147--F152}, year = {2017}, doi = {10.1136/archdischild-2016-310514}, publisher = {BMJ Publishing Group}, abstract = {Background Previous studies have demonstrated the association of abnormalities on diffusion-weighted MRI (DW-MRI) and proton magnetic resonance spectroscopy (1H-MRS) in infants with perinatal asphyxia. The use of therapeutic hypothermia might change this association.Aim To study the association between DW-MRI and 1H-MRS and outcome after perinatal asphyxia and therapeutic hypothermia in infants with a gestational age of >=36 weeks.Patients and methods Infants with perinatal asphyxia and therapeutic hypothermia (n=88) were included when an MR examination was performed within 7 days after birth. Apparent diffusion coefficient (ADC) values of the basal ganglia and thalamus were calculated, as were lactate/N-acetylaspartate (LAC/NAA) and N-acetylaspartate/choline (NAA/Cho) ratios. Death or an abnormal neurodevelopment at >=24 months was considered an adverse outcome. Receiver operating characteristic analysis was performed to determine cut-off levels.Results Of the 88 infants, 22 died and 7 had an adverse neurodevelopmental outcome. In infants with an adverse outcome, ADC values of the basal ganglia and thalamus were significantly lower, and Lac/NAA ratios were significantly higher than in infants with a normal outcome. Areas under the curve of ADC of the basal ganglia, thalami and Lac/NAA ratio were 0.89, 0.88 and 0.87, respectively. NAA/Cho ratios were in this cohort not associated with outcome.Conclusions During and after therapeutic hypothermia, low ADC values and high Lac/NAA ratios of the basal ganglia and thalamus are associated with an adverse outcome in infants with perinatal asphyxia.}, issn = {1359-2998}, URL = {https://fn.bmj.com/content/102/2/F147}, eprint = {https://fn.bmj.com/content/102/2/F147.full.pdf}, journal = {Archives of Disease in Childhood - Fetal and Neonatal Edition} }