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Article: Diffusion-weighted imaging and proton magnetic resonance spectroscopy in perinatal hypoxic-ischemic encephalopathy: Association with neuromotor outcome at 18 months of age

TitleDiffusion-weighted imaging and proton magnetic resonance spectroscopy in perinatal hypoxic-ischemic encephalopathy: Association with neuromotor outcome at 18 months of age
Authors
Issue Date2004
PublisherSage Publications, Inc.. The Journal's web site is located at http://jcn.sagepub.com
Citation
Journal Of Child Neurology, 2004, v. 19 n. 11, p. 872-881 How to Cite?
AbstractWe evaluated early diffusion-weighted imaging findings, the quantitative apparent diffusion coefficient, and magnetic resonance spectroscopy (the presence of lactate and ratios of N-acetylaspartate to total creatine and choline to total creatine) in the prediction of the 18-month neuromotor outcome of term newborns with hypoxic-ischemic encephalopathy. Conventional T 1-and T 2-weighted and diffusion-weighted imaging was performed in 20 asphyxiated term newborns, with additional basal ganglia magnetic resonance spectroscopy in 15 newborns between 2 and 18 days of life (mean 7.3 days). Neuromotor outcome was dichotomized into normal and abnormal for statistical analysis. Statistically significant differences in the ratios of N-acetylaspartate to total creatine, but not apparent diffusion coefficient values and ratios of choline to total creatine, were found between infants with a normal and an abnormal outcome (Mann-Whitney U-test, P = .010). There was a significant association between the presence of a lactate peak and an abnormal outcome (chi-square test, P = .017). The presence of a lactate peak for predicting an abnormal outcome had a sensitivity of 100% and a specificity of 80%, and the odds ratio was 37.4. Ischemic lesions were more conspicuous and/or extensive on diffusion-weighted imaging in all except one neonate. The presence of normal findings on both diffusion-weighted imaging and conventional magnetic resonance imaging is predictive of a normal neuromotor outcome, whereas lactate and a reduced ratio of N-acetylaspartate to total creatine in the basal ganglia, but not an apparent diffusion coefficient, are associated with an abnormal outcome at 18 months of age.
Persistent Identifierhttp://hdl.handle.net/10722/72378
ISSN
2015 Impact Factor: 1.434
2015 SCImago Journal Rankings: 0.694
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKhong, PLen_HK
dc.contributor.authorTse, Cen_HK
dc.contributor.authorWong, IYCen_HK
dc.contributor.authorLam, BCCen_HK
dc.contributor.authorCheung, PTen_HK
dc.contributor.authorGoh, WHSen_HK
dc.contributor.authorKwong, NSen_HK
dc.contributor.authorOoi, GCen_HK
dc.date.accessioned2010-09-06T06:41:06Z-
dc.date.available2010-09-06T06:41:06Z-
dc.date.issued2004en_HK
dc.identifier.citationJournal Of Child Neurology, 2004, v. 19 n. 11, p. 872-881en_HK
dc.identifier.issn0883-0738en_HK
dc.identifier.urihttp://hdl.handle.net/10722/72378-
dc.description.abstractWe evaluated early diffusion-weighted imaging findings, the quantitative apparent diffusion coefficient, and magnetic resonance spectroscopy (the presence of lactate and ratios of N-acetylaspartate to total creatine and choline to total creatine) in the prediction of the 18-month neuromotor outcome of term newborns with hypoxic-ischemic encephalopathy. Conventional T 1-and T 2-weighted and diffusion-weighted imaging was performed in 20 asphyxiated term newborns, with additional basal ganglia magnetic resonance spectroscopy in 15 newborns between 2 and 18 days of life (mean 7.3 days). Neuromotor outcome was dichotomized into normal and abnormal for statistical analysis. Statistically significant differences in the ratios of N-acetylaspartate to total creatine, but not apparent diffusion coefficient values and ratios of choline to total creatine, were found between infants with a normal and an abnormal outcome (Mann-Whitney U-test, P = .010). There was a significant association between the presence of a lactate peak and an abnormal outcome (chi-square test, P = .017). The presence of a lactate peak for predicting an abnormal outcome had a sensitivity of 100% and a specificity of 80%, and the odds ratio was 37.4. Ischemic lesions were more conspicuous and/or extensive on diffusion-weighted imaging in all except one neonate. The presence of normal findings on both diffusion-weighted imaging and conventional magnetic resonance imaging is predictive of a normal neuromotor outcome, whereas lactate and a reduced ratio of N-acetylaspartate to total creatine in the basal ganglia, but not an apparent diffusion coefficient, are associated with an abnormal outcome at 18 months of age.en_HK
dc.languageengen_HK
dc.publisherSage Publications, Inc.. The Journal's web site is located at http://jcn.sagepub.comen_HK
dc.relation.ispartofJournal of Child Neurologyen_HK
dc.subject.meshAspartic Acid - analogs & derivatives - analysisen_HK
dc.subject.meshAsphyxia Neonatorum - diagnosis - physiopathologyen_HK
dc.subject.meshBasal Ganglia - pathologyen_HK
dc.subject.meshBrain - pathologyen_HK
dc.subject.meshCholine - analysisen_HK
dc.subject.meshCreatine - analysisen_HK
dc.subject.meshDiffusion Magnetic Resonance Imagingen_HK
dc.subject.meshEnergy Metabolism - physiologyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHumansen_HK
dc.subject.meshHypoxia, Brain - diagnosis - physiopathologyen_HK
dc.subject.meshInfanten_HK
dc.subject.meshInfant, Newbornen_HK
dc.subject.meshLactic Acid - analysisen_HK
dc.subject.meshMagnetic Resonance Spectroscopyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshNeurologic Examination - statistics & numerical dataen_HK
dc.subject.meshPredictive Value of Testsen_HK
dc.subject.meshStatistics as Topicen_HK
dc.titleDiffusion-weighted imaging and proton magnetic resonance spectroscopy in perinatal hypoxic-ischemic encephalopathy: Association with neuromotor outcome at 18 months of ageen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0883-0738&volume=19&issue=11&spage=872&epage=881&date=2004&atitle=Diffusion-Weighted+Imaging+and+Proton+Magnetic+Resonance+Spectroscopy+in+Perinatal+Hypoxic-Ischemic+Encephalopathy:+Association+With+Neuromotor+Outcome+at+18+Months+of+Ageen_HK
dc.identifier.emailKhong, PL:plkhong@hkucc.hku.hken_HK
dc.identifier.emailCheung, PT:ptcheung@hkucc.hku.hken_HK
dc.identifier.authorityKhong, PL=rp00467en_HK
dc.identifier.authorityCheung, PT=rp00351en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1177/08830738040190110501-
dc.identifier.pmid15658792-
dc.identifier.scopuseid_2-s2.0-11844288278en_HK
dc.identifier.hkuros97099en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-11844288278&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume19en_HK
dc.identifier.issue11en_HK
dc.identifier.spage872en_HK
dc.identifier.epage881en_HK
dc.identifier.isiWOS:000228703600005-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridKhong, PL=7006693233en_HK
dc.identifier.scopusauthoridTse, C=50361920200en_HK
dc.identifier.scopusauthoridWong, IYC=7102513930en_HK
dc.identifier.scopusauthoridLam, BCC=8553938300en_HK
dc.identifier.scopusauthoridCheung, PT=7202595465en_HK
dc.identifier.scopusauthoridGoh, WHS=7005651404en_HK
dc.identifier.scopusauthoridKwong, NS=12646682000en_HK
dc.identifier.scopusauthoridOoi, GC=7006176119en_HK

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