Neonatal hypoxic encephalopathy: Correlation between post-cooling brain MRI findings and 2 years neurodevelopmental outcome

• Published in: The Indian journal of radiology & imaging Vol. 29; no. 4; pp. 350 - 355
• Main Authors: Mohammed Rusli, Emilia Rosniza, Ismail, Juriza, Wei, Wong Saw, Ishak, Shareena, Jaafar, Rohana, Zaki, Faizah Mohd
• Format: Journal Article
• Language: English
• Published: A-12, Second Floor, Sector -2, NOIDA -201301, India Thieme Medical and Scientific Publishers Private Ltd 01-10-2019; Wolters Kluwer India Pvt. Ltd; Medknow Publications and Media Pvt. Ltd; Georg Thieme Verlag Stuttgart; Wolters Kluwer - Medknow; Thieme Medical and Scientific Publishers Pvt. Ltd
• Subjects: Age; Archives & records; Babies; Brain; Brain damage; Brain research; Care and treatment; Cerebral palsy; Cooling; Correlation analysis; Diagnostic imaging; Encephalopathy; Head injuries; Hypoxia; Infants; Magnetic resonance imaging; Medical imaging; Medical records; mri brain scoring; neonatal hypoxic ischemic encephalopathy; Neuroimaging; Newborn infants; NMR; Nuclear magnetic resonance; Patient outcomes; Patients; post-cooling therapy; Statistical analysis; Traumatic brain injury; neonatal hypoxic ischemic encephalopathy; MRI brain scoring; post-cooling therapy
• ISSN: 0971-3026; 0970-2016; 1998-3808; 0971-3026
• DOI: 10.4103/ijri.IJRI_62_19

Abstract
Objective
: This study aims to evaluate the magnetic resonance imaging (MRI) brain patterns among hypoxic-ischemic encephalopathy (HIE) babies who underwent post-cooling MRI brain as well as to correlate the post-cooling brain scoring with patient’s neurodevelopmental outcome at 2 years.
Subjects and Methods
: It was a retrospective cross sectional study carried out at a tertiary university hospital. Record of patients diagnosed with neonatal HIE from 2007 until 2016 who completed 72 h of cooling therapy and had MRI brain within 2 weeks of life were included in this study. A new scoring system by Trivedi
et al
. that emphasizes on subcortical deep gray matter and posterior limb internal capsule injury were utilized upon MRI assessment, using TW, T2W, and diffusion-weighted imaging (DWI) sequences. Cumulative MRI brain score was obtained and graded as none, mild, moderate, and severe brain injury. The MRI brain scoring was then correlated with patient’s 2 years neurodevelopmental outcome using Fisher’s Exact Test.
Results
: A total of 23 patients were eligible of which 19 term neonates were included. 13% of these neonates (
n
= 3) had mild MRI brain injury grading with 52.2% (
n
= 12) moderate and 34.8% (
n
= 8) severe. There was no significant correlation seen between MRI brain grading and developmental outcome at 2 years old (
P
> 0.05).
Conclusion
: There was no significant correlation between neonatal MRI brain injury grading and 2 years neurodevelopmental outcome. Nevertheless, the new MRI brain scoring by Trivedi
et al
. is reproducible and comprehensive as it involves various important brain structures, assessed from different MRI sequences.