Serial magnetic resonance imaging in neonatal hypoxic-ischemic encephalopathy

Hypoxic-Ischemic Encephalopathy: Diagnostic Value of Conventional MR Imaging Pulse Sequences in Term-born Neonates

“…This is probably because these pulse sequences were used routinely from the moment MR imaging was introduced in neonates and because many investigations deal with the overall sensitivity of MR imaging for depicting hypoxic-ischemic abnormalities and not with separate pulse sequences (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16).…”

“…These patterns include abnormal signal intensity of the basal ganglia, abnormal signal intensity of the thalamus, abnormal signal intensity of the posterior limb of the internal capsule, cortical highlighting on T1-weighted images, nonpunctate white matter lesions, border zone infarctions, arterial infarctions, punctate white matter lesions, diffuse edema, abnormal signal intensity of the brain stem, and abnormal signal intensity of the hippocampus (2,(9)(10)(11)(12)(13)(14)(15)(16)(17). With a diagnostic confidence score, assigned by using a five-point scale as definitely abnormal, probably abnormal, equivocal, probably normal, or definitely normal, the confidence of the investigator for the detection of each of these abnormalities with each MR imaging pulse sequence was scored.…”

“…M agnetic resonance (MR) imaging findings of the brain in neonates with hypoxic-ischemic encephalopathy (HIE) have been described by many authors (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Different patterns of neonatal hypoxicischemic brain injury that depend on the severity and duration of the insult and the gestational age of the neonate have been described (2,12).…”

“…Different patterns of neonatal hypoxicischemic brain injury that depend on the severity and duration of the insult and the gestational age of the neonate have been described (2,12). The accuracy and reproducibility of conventional T1-and T2-weighted MR imaging after perinatal hypoxia-ischemia have been demonstrated (2,(9)(10)(11)(12)(13)(14)(15)(16)(17). However, despite important brain injury, T1-and T2-weighted images may appear normal during the first days after the hypoxicischemic event or show only subtle findings that may be difficult to interpret or to distinguish from normal (maturational) phenomena in the neonatal brain (2)(3)(4)18).…”

Neuroimaging in CP: Issues in pathogenesis and diagnosis

“…5). Abnormally increased T2 signal is present in the subcortical and periventricular white matter; the T2 change in the white matter may not become appreciated until after normal myelination of the surrounding white matter is near completion [Byrne et al, 1990]. Ex vacuo dilation of the adjacent ventricle may also be seen.…”