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Semi-quantitative assessment of brain maturation by conventional magnetic resonance imaging in neonates with clinically mild hypoxic-ischemic encephalopathy.

Gao J, Sun QL, Zhang YM, Li YY, Li H, Hou X, Yu BL, Zhou XH, Yang J - Chin. Med. J. (2015)

Bottom Line: In four parameters of TMS scores, the M and C scores were significantly lower in mild HIE group.Of the three patterns of mild HIE, Pattern I (10 cases) showed no significant difference of TMS compared with control neonates, while Pattern II (22 cases), III (13 cases) all had significantly decreased TMS than control neonates (mean ± SD 10.56 ± 0.93 vs. 11.48 ± 0.55, P < 0.05; 12.59 ± 1.28 vs. 13.25 ± 1.29, P < 0.05).It was M, C, and GM scores that significantly decreased in Pattern II, while for Pattern III, only C score significantly decreased.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, The First Hospital of Xi'an Jiaotong University, Xi'an, Shannxi 710061, China.

ABSTRACT

Background: Mild hypoxic-ischemic encephalopathy (HIE) injury is becoming the major type in neonatal brain diseases. The aim of this study was to assess brain maturation in mild HIE neonatal brains using total maturation score (TMS) based on conventional magnetic resonance imaging (MRI).

Methods: Totally, 45 neonates with clinically mild HIE and 45 matched control neonates were enrolled. Gestated age, birth weight, age after birth and postmenstrual age at magnetic resonance (MR) scan were homogenous in the two groups. According to MR findings, mild HIE neonates were divided into three subgroups: Pattern I, neonates with normal MR appearance; Pattern II, preterm neonates with abnormal MR appearance; Pattern III, full-term neonates with abnormal MR appearance. TMS and its parameters, progressive myelination (M), cortical infolding (C), involution of germinal matrix tissue (G), and glial cell migration bands (B), were employed to assess brain maturation and compare difference between HIE and control groups.

Results: The mean of TMS was significantly lower in mild HIE group than it in the control group (mean ± standard deviation [SD] 11.62 ± 1.53 vs. 12.36 ± 1.26, P < 0.001). In four parameters of TMS scores, the M and C scores were significantly lower in mild HIE group. Of the three patterns of mild HIE, Pattern I (10 cases) showed no significant difference of TMS compared with control neonates, while Pattern II (22 cases), III (13 cases) all had significantly decreased TMS than control neonates (mean ± SD 10.56 ± 0.93 vs. 11.48 ± 0.55, P < 0.05; 12.59 ± 1.28 vs. 13.25 ± 1.29, P < 0.05). It was M, C, and GM scores that significantly decreased in Pattern II, while for Pattern III, only C score significantly decreased.

Conclusions: The TMS system, based on conventional MRI, is an effective method to detect delayed brain maturation in clinically mild HIE. The conventional MRI can reveal the different retardations in subtle structures and development processes among the different patterns of mild HIE.

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Mentions: All neonatal MRI were independently reviewed by two pediatric radiologists who were blinded to the clinical data. Disagreements regarding image findings were resolved by means of discussion and mutual agreement. Injuries in WM, basal-ganglia and thalami, posterior limb of the internal capsule (PLIC), cortex, brainstem, cerebellum, and hemorrhage were all evaluated and graded according to previous studies.[78] According to MR findings and GA, mild HIE neonates enrolled in this study were grouped into three patterns: Pattern I, neonates with normal MR appearance; Pattern II, preterm neonates (GA <36 weeks) with abnormal MR appearance; Pattern III, full-term neonates (GA ≥36 weeks) with abnormal MR appearance. The flow chart for subjects’ selection and grouping was shown in Figure 1.


Semi-quantitative assessment of brain maturation by conventional magnetic resonance imaging in neonates with clinically mild hypoxic-ischemic encephalopathy.

Gao J, Sun QL, Zhang YM, Li YY, Li H, Hou X, Yu BL, Zhou XH, Yang J - Chin. Med. J. (2015)

Flow chart.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834765&req=5

Figure 1: Flow chart.
Mentions: All neonatal MRI were independently reviewed by two pediatric radiologists who were blinded to the clinical data. Disagreements regarding image findings were resolved by means of discussion and mutual agreement. Injuries in WM, basal-ganglia and thalami, posterior limb of the internal capsule (PLIC), cortex, brainstem, cerebellum, and hemorrhage were all evaluated and graded according to previous studies.[78] According to MR findings and GA, mild HIE neonates enrolled in this study were grouped into three patterns: Pattern I, neonates with normal MR appearance; Pattern II, preterm neonates (GA <36 weeks) with abnormal MR appearance; Pattern III, full-term neonates (GA ≥36 weeks) with abnormal MR appearance. The flow chart for subjects’ selection and grouping was shown in Figure 1.

Bottom Line: In four parameters of TMS scores, the M and C scores were significantly lower in mild HIE group.Of the three patterns of mild HIE, Pattern I (10 cases) showed no significant difference of TMS compared with control neonates, while Pattern II (22 cases), III (13 cases) all had significantly decreased TMS than control neonates (mean ± SD 10.56 ± 0.93 vs. 11.48 ± 0.55, P < 0.05; 12.59 ± 1.28 vs. 13.25 ± 1.29, P < 0.05).It was M, C, and GM scores that significantly decreased in Pattern II, while for Pattern III, only C score significantly decreased.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, The First Hospital of Xi'an Jiaotong University, Xi'an, Shannxi 710061, China.

ABSTRACT

Background: Mild hypoxic-ischemic encephalopathy (HIE) injury is becoming the major type in neonatal brain diseases. The aim of this study was to assess brain maturation in mild HIE neonatal brains using total maturation score (TMS) based on conventional magnetic resonance imaging (MRI).

Methods: Totally, 45 neonates with clinically mild HIE and 45 matched control neonates were enrolled. Gestated age, birth weight, age after birth and postmenstrual age at magnetic resonance (MR) scan were homogenous in the two groups. According to MR findings, mild HIE neonates were divided into three subgroups: Pattern I, neonates with normal MR appearance; Pattern II, preterm neonates with abnormal MR appearance; Pattern III, full-term neonates with abnormal MR appearance. TMS and its parameters, progressive myelination (M), cortical infolding (C), involution of germinal matrix tissue (G), and glial cell migration bands (B), were employed to assess brain maturation and compare difference between HIE and control groups.

Results: The mean of TMS was significantly lower in mild HIE group than it in the control group (mean ± standard deviation [SD] 11.62 ± 1.53 vs. 12.36 ± 1.26, P < 0.001). In four parameters of TMS scores, the M and C scores were significantly lower in mild HIE group. Of the three patterns of mild HIE, Pattern I (10 cases) showed no significant difference of TMS compared with control neonates, while Pattern II (22 cases), III (13 cases) all had significantly decreased TMS than control neonates (mean ± SD 10.56 ± 0.93 vs. 11.48 ± 0.55, P < 0.05; 12.59 ± 1.28 vs. 13.25 ± 1.29, P < 0.05). It was M, C, and GM scores that significantly decreased in Pattern II, while for Pattern III, only C score significantly decreased.

Conclusions: The TMS system, based on conventional MRI, is an effective method to detect delayed brain maturation in clinically mild HIE. The conventional MRI can reveal the different retardations in subtle structures and development processes among the different patterns of mild HIE.

Show MeSH
Related in: MedlinePlus