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Erschienen in:
01.12.2015 | Original Article
Comparison of early and late MRI in neonatal hypoxic–ischemic encephalopathy using three assessment methods
Erschienen in: Pediatric Radiology | Ausgabe 13/2015
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Background
There is no consensus on the optimum timing of MRI in neonates with hypoxic–ischemic encephalopathy treated with hypothermia. Reliable early imaging assessment might help managing treatment.
Objective
To assess non-random differences between early and late MRI that might influence intensive-care decisions.
Materials and methods
This single-center retrospective study included all asphyxiated term neonates eligible for hypothermia treatment November 2009–July 2012. MRI scans were systematically performed at day 4 (early MRI) and day 11 of life as part of routine protocol. Two experienced pediatric radiologists reviewed both scans according to three assessment methods: a pattern classification, a scoring system and a simplified classification. Agreement between early and late imaging findings was assessed using Cohen’s kappa coefficients.
Results
Thirty-three neonates were included. Interobserver agreement was excellent. Early MRI detected all severe injuries. Agreement between early and late MRI was excellent for the simplified classification (κ = 0.82), good for the pattern classification (κ = 0.64), and good to excellent for 3 scores out of 4 in the scoring system (κ = 0.70–0.89).
Conclusion
Early MRI may provide valuable information about brain injury to help parents and neonatologists in intensive-care decisions at the end of hypothermia treatment.