Neuropediatrics 1994; 25(4): 191-200
DOI: 10.1055/s-2008-1073021
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Prognostic Value of Early MR Imaging in Term Infants with Severe Perinatal Asphyxia

Ch.  Kuenzle1 , O.  Baenziger1 , E.  Martin2 , L.  Thun-Hohenstein1 , M.  Steinlin1 , M.  Good1 , S.  Fanconi3 , E.  Boltshauser1 , R. H. Largo4
  • 1Division of Neurology, Department of Pediatrics, University of Zurich, Switzerland
  • 2Division of Magnetic Resonance, Department of Pediatrics, University of Zurich, Switzerland
  • 3Division of intensive Care, Department of Pediatrics, University of Zurich, Switzerland
  • 4Division of Growth and Development, Department of Pediatrics, University of Zurich, Switzerland
Further Information

Publication History

Publication Date:
19 March 2008 (online)

Abstract

The prognostic significance of magnetic resonance imaging (MRI) in the neonatal period was studied prospectively in 43 term infants with perinatal asphyxia. MRI was performed between 1 and 14 days after birth with a high field system (2.35 Tesla). Neurodevelopmental outcome was assessed by a standardized neurological examination and the Griffiths developmental test at a mean age of 18.9 months. The predictive value of the various MRI patterns was as follows: Severe diffuse brain injury (pattern AII+III; n = 7) and lesions of thalamus and basal ganglia (pattern C; n = 5) were strongly associated with poor outcome and greatly reduced head growth. Mild diffuse brain injury (pattern AI; n = 7), parasagittal lesions (B; n = 7), periventricular hyperintensity (D; n = 2), focal brain necrosis and hemorrhage (E; n = 3) and periventricular hypointense stripes (on T2-weighted images; F; n = 3) led in one third of the infants to minor neurological disturbances and mild developmental delay. Infants with normal MRI findings (G; n = 9) developed normally with the exception of one infant who was mildly delayed at 18 months. The results indicate that MRI examination during the first two weeks of life is of prognostic significance in term infants suffering from perinatal asphyxia. Severe hypoxic-ischemic brain lesions were associated highly significantly with poor neurodevelopmental outcome, whereas infants with inconspicuous MRI developed normally.

Abbreviations

CT: computed tomography
DQ: developmental quotient
HC: head circumference
MRI: magnetic resonance imaging
NE: neonatal encephalopathy
NOS: neurological optimality score
SD: standard deviation

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