Comparative Prognostic Utilities of Early Quantitative Magnetic Resonance Imaging Spin-Spin Relaxometry and Proton Magnetic Resonance Spectroscopy in Neonatal Encephalopathy

Shanmugalingam, S; Thornton, John S.; Iwata, Osuke; Bainbridge, Alan; O'Brien, F; Priest, Andrew N.; Ordidge, Roger J.; Cady, Ernest B.; Wyatt, John; Robertson, Nicola J.

doi:10.1542/peds.2005-2976

Cited by 42 publications

(16 citation statements)

References 50 publications

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“…Apparent diffusion coefficient values have also been correlated with favorable or unfavorable outcomes [69,[75][76][77]. Proton MR spectroscopy has emerged as an adjunct imaging modality superior in its ability to detect the full extent of injury in the first 24 h. In particular, lactate to N-acetylaspartate ratios have been correlated with long-term prognosis [73,75,76,[78][79][80]. Arterial spin labeling noninvasively assesses cerebral blood flow by inverting arterial hydrogen protons and has recently been used more frequently in the pediatric population [81,82].…”

Section: Reliability and Predictive Value Of Us Findingsmentioning

confidence: 99%

Head Ultrasound in Neonatal Hypoxic-Ischemic Injury and Its Mimickers for Clinicians: A Review of the Patterns of Injury and the Evolution of Findings Over Time

et al. 2018

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Hypoxic-ischemic injury (HII) of the neonatal brain and resulting clinical hypoxic-ischemic encephalopathy remains a significant cause of morbidity and mortality in the neonatal population. Ultrasound (US) has emerged as a powerful screening tool for evaluation of a neonate with suspected HII. The pattern of injury on brain imaging has crucial implications in therapies and predicted neurodevelopmental outcomes. US has become increasingly effective at determining the pattern, timing, and extent of injury in HII as well as differentiating these findings from a host of diagnoses that can result in a similarly appearing clinical picture. Repeated US studies over a patient’s course can define the evolution of findings from the acute through chronic phase in addition to identifying any complications of therapy. US also has the added benefits of easy portability, no need for patient sedation, and a relatively low cost when compared to other imaging modalities like magnetic resonance imaging (MRI). It is crucial that clinicians understand the full capabilities of advanced US in identifying an underlying diagnosis, directing appropriate therapy, monitoring disease progress, and finally in predicting outcomes, thus improving the care of neonates with encephalopathy. The following article demonstrates the breadth of uses for US in the full-term neonate with encephalopathy, its limitations, the patterns of injury seen, and their evolution over time. We will also briefly review several clinical mimickers of HII for comparison.

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Section: Reliability and Predictive Value Of Us Findingsmentioning

confidence: 99%

Head Ultrasound in Neonatal Hypoxic-Ischemic Injury and Its Mimickers for Clinicians: A Review of the Patterns of Injury and the Evolution of Findings Over Time

et al. 2018

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“…46 Numerous studies have used 1 H MRS to evaluate the relationship between cerebral metabolic derangements after hypoxia-ischemia and neurodevelopmental outcomes. [47][48][49][50][51][52][53][54][55] Studies have varied with regard to methodological approach, but most have performed measurements from voxels placed within the BGT region and most commonly measured N-acetyl aspartate (NAA), choline (Cho), creatine (Cr), and lactate (Lac) as metabolites of interest (Fig. 3).…”

Section: Advanced Quantitative Mri In Neonatal Hiementioning

confidence: 99%

MRI for neurodevelopmental prognostication in the high-risk term infant

Massaro

2015

Seminars in Perinatology

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“…Many centers perform sequential sonograms (US) during the first week of life (De Vries et al, 2004, Huppi, Sizonengo, Amato 2006 or cranial magnetic resonance imaging (MRI) during the first week of life and subsequently during the neonatal period ( Byrne et al, 1990, Huppi et al, 1998, Inder et al, 2005. However, perinatal brain injury in the preterm infant typically represented by cystic or diffuse periventricular leukomalacia (PVL), the lesion that is most responsible for diplegia, often is not evident by cranial ultrasonography until three or four weeks of life (Shanmugalingam et al, 2006). As routine use of effective neuroprotective agents becomes increasingly likely in neonatal encephalopathy secondary to perinatal hypoxiaischemia, methods are needed to assess the pattern, severity and precise focalization of cerebral injury shortly after birth (Gluckman et al, 2005;Gluckman, Pinal, and Gunn, 2001).…”

Section: Introductionmentioning

confidence: 99%

Perinatal Asphyxia in Preterm Neonates Leads to Serum Changes in Protein S-100 and Neuron Specific Enolase

Distefano¹,

Curreri²,

Betta³

et al. 2009

CNR

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In preterm infants, neurological signs and clinical manifestations of brain damage are limited criteria for diagnosis of neurologic sequelae. Early indicators of brain damage are needed and currently some specific biochemical markers of brain injury are investigated to assess regional brain damage after perinatal asphyxia in neonates. In this study Protein S-100 (PS-100) and Neuron Specific Enolase (NSE) serum levels were studied serially during the perinatal period in preterm neonates with perinatal asphyxia as markers of glial and neuronal damage respectively. Thirty outborn preterm infants with perinatal asphyxia were studied at 3, 24, 48 hours and 7 days of life. According to Apgar scores at 1' and cord blood pH and lacticidemia (LA), patients were divided in two groups: 15 of them (GA 33+/-1.2 wk, BW 1790+/-383 g) with severe asphyxia (Apgar <4, pH7.0+/-0.08, LA 6.29+/-0.79 mM/L) and 15 (GA 32+/-1.8 wk, BW 1810+/-290 g) with mild asphyxia (Apgar between 4-6, pH 7.18+/-0.05, LA 2.59+/-0.61 mM/L). Ten gestational age matched healthy preterm neonates were studied as control group. Cerebral ultrasound examinations (7 MHz) were performed at birth and repeated at 3 weeks of life. The results of this study show that neonates with severe asphyxia at any time had significantly more elevated mean serum levels of both markers compared to the group with mild asphyxia and to the control group (p<0.05). The values of control group were also significantly lower in comparison with that of mild asphyxia. In neonates with severe asphyxia, NSE values decreased constantly from birth to the seventh day of life, while PS-100 showed a different pattern increasing progressively between 3 h and 7 days. In neonates with mild asphyxia serum values of both markers showed decreasing levels through the study period. The results of this study suggest that perinatal asphyxia is associated with the release of different brain cellular proteins in the blood of preterm infants with different time course indicating specific regional cellular injury. The more elevated levels of NSE at birth found in the newborns with severe asphyxia could be considered as an early biomarker of neuronal necrotic damage in the ischaemic phase of perinatal cerebral hypoxic-ischaemic insult; progressive increase of PS-100 during the first week of life in the same neonates could be expression of apoptotic damage of glial cells occurring in the reperfusion phase of cerebral ischaemia.

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Comparative Prognostic Utilities of Early Quantitative Magnetic Resonance Imaging Spin-Spin Relaxometry and Proton Magnetic Resonance Spectroscopy in Neonatal Encephalopathy

Cited by 42 publications

References 50 publications

Head Ultrasound in Neonatal Hypoxic-Ischemic Injury and Its Mimickers for Clinicians: A Review of the Patterns of Injury and the Evolution of Findings Over Time

Head Ultrasound in Neonatal Hypoxic-Ischemic Injury and Its Mimickers for Clinicians: A Review of the Patterns of Injury and the Evolution of Findings Over Time

MRI for neurodevelopmental prognostication in the high-risk term infant

Perinatal Asphyxia in Preterm Neonates Leads to Serum Changes in Protein S-100 and Neuron Specific Enolase

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