Perinatal Events and Early Magnetic Resonance Imaging in Therapeutic Hypothermia - 20/08/11
, Hannah C. Glass, MDCM a, b, Juliana Vanderpluym, MD e, Ashish T. Agrawal, BS d, Duan Xu, PhD c, A. James Barkovich, MD c, Donna M. Ferriero, MD a, b
Reprint requests: Dr Sonia L. Bonifacio, MD, Division of Neonatology, University of California San Francisco, School of Medicine, 533 Parnassus Avenue, U585, Box 0748, San Francisco, CA 94143-0748.Abstract |
Objective |
To compare the association between perinatal events and the pattern and extent of brain injury on early magnetic resonance imaging in newborn infants with and without therapeutic hypothermia for hypoxic-ischemic encephalopathy.
Study design |
We performed a cohort study of 35 treated and 25 nontreated neonates who underwent magnetic resonance imaging. The injury patterns were defined a priori as: normal, watershed, or basal ganglia/thalamus-predominant, as well as a dichotomous outcome of moderate-to-severe versus mild-no injury.
Results |
Neonates with hypothermia had less extensive watershed and basal ganglia/thalamus injuries and a greater proportion had normal imaging. Therapeutic hypothermia was associated with a decreased risk of both basal ganglia/thalamus injury (relative risk, 0.29; 95% CI, 0.10 to 0.81, P = .01) and moderate-severe injury. Neonates with sentinel events showed a decrease in basal ganglia/thalamus-predominant injury and an increase in normal imaging. All neonates with decreased fetal movements had injury, predominantly watershed, regardless of therapeutic hypothermia.
Conclusions |
These results validate reports of reduced brain injury after therapeutic hypothermia and suggest that perinatal factors are important indicators of response to treatment.
Le texte complet de cet article est disponible en PDF.Mots-clés : BG/T, DWI, HIE, MRI, MRS, RR, TE, TR, UCSF, WS
Plan
| Supported by NIH/NCRR UCSF-CTSI (grant UL1 RR024131) and NIH (grant P50 NS035902-12). S.B. was supported by NIH (training grant 5T32HD007162), H.G. is supported by NINDS (1K23NS66137), and J.V. was supported by the APS/SPR Student Research Program. The contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. Information on NCRR is available at www.ncrr.nih.gov/. Re-engineering the Clinical Research Enterprise can be obtained from overview-translational.asp. The authors declare no conflicts of interest. |
Vol 158 - N° 3
P. 360-365 - mars 2011 Retour au numéro
Article précédent
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