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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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Bland–Altman plot with average total maturation score (TMS) for each neonate plotted against the difference in TMS between the two observers. The solid line represents the mean difference in score (−0.31); 2 dotted lines represent 95% limits of agreement (−1.91 to 1.30).
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Figure 3: Bland–Altman plot with average total maturation score (TMS) for each neonate plotted against the difference in TMS between the two observers. The solid line represents the mean difference in score (−0.31); 2 dotted lines represent 95% limits of agreement (−1.91 to 1.30).

Mentions: The Bland–Altman plot derived from TMS of all 90 neonates showed excellent agreement between the two independent observers [Figure 3]: The mean difference in score was −0.31 (standard deviation [SD] = 0.82), and 95% limits of agreement were from −1.91 to 1.30.


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)

Bland–Altman plot with average total maturation score (TMS) for each neonate plotted against the difference in TMS between the two observers. The solid line represents the mean difference in score (−0.31); 2 dotted lines represent 95% limits of agreement (−1.91 to 1.30).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Bland–Altman plot with average total maturation score (TMS) for each neonate plotted against the difference in TMS between the two observers. The solid line represents the mean difference in score (−0.31); 2 dotted lines represent 95% limits of agreement (−1.91 to 1.30).
Mentions: The Bland–Altman plot derived from TMS of all 90 neonates showed excellent agreement between the two independent observers [Figure 3]: The mean difference in score was −0.31 (standard deviation [SD] = 0.82), and 95% limits of agreement were from −1.91 to 1.30.

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