Abstract

Background: The aim was to assess whether magnetic resonance imaging (MRI) that included diffusion weighted imaging (DWI) with apparent diffusion coefficient (ADC) values and morphological MRI scoring system ultimately correlated with neurologic assessment at 1 month of age in neonates with hypoxic-ischemic encephalopathy (HIE) treated with hypothermia.
Objective: With ADC values and MRI scoring system we can predict the efficiency of treatment with hypothermia at 1 month of age for neonates with hypoxic-ischemic brain injury and we can set the threshold ADC values.
Materials and methods: The retrospective study enrolled 25 neonates with HIE treated with hypothermia. All neonates had MRI within 9 days of life and an Amiel-Tison neurologic assessment at 1 month of age. The level of injury was evaluated by Mary Rutherford scoring system and ADC values were measured. Data were analyzed by Mann-Whitney U test and ROC curve. Results Sixteen neonates had well and 9 neonates had poor clinical outcome. We confirmed a statistically significant difference of ADC values between both groups in the posterior limb of the internal capsule/thalamus (PLIC/T) and in the deep white matter (WM). The threshold ADC value measured in the PLIC/T was set at 920 × 10-6 mm2/s and the threshold ADC value measured in the WM was set at 1153 × 10-6 mm2/s. Statistically, significant differences by the morphological scoring system were confirmed in the basal ganglia/ thalamus (BG/T) and in the cortex.
Conclusion: DWI and MRI have an important role in predicting clinical outcome at 1 month of age for neonates with HIE treated with hypothermia.

Keywords: Hypoxic-ischemic encephalopathy; Neonate; Diffusion weighted imaging; Morphological scoring system; Hypothermia; Clinical outcome