Arterial spin-labelling perfusion MRI and outcome in neonates with hypoxic-ischemic encephalopathy

Jill B. De Vis, Jeroen Hendrikse, Esben T. Petersen, Linda S. de Vries, Frank van Bel, Thomas Alderliesten, Simona Negro, Floris Groenendaal, Manon J.N.L. Benders

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Hyperperfusion may be related to outcome in neonates with hypoxic-ischemic encephalopathy (HIE). The purpose of this study was to evaluate whether arterial spin labelling (ASL) perfusion is associated with outcome in neonates with HIE and to compare the predictive value of ASL MRI to known MRI predictive markers.

Methods: Twenty-eight neonates diagnosed with HIE and assessed with MR imaging (conventional MRI, diffusion-weighted MRI, MR spectroscopy [MRS], and ASL MRI) were included. Perfusion in the basal ganglia and thalami was measured. Outcome at 9 or 18 months of age was scored as either adverse (death or cerebral palsy) or favourable.

Results: The median (range) perfusion in the basal ganglia and thalami (BGT) was 63 (28-108) ml/100 g/min in the neonates with adverse outcome and 28 (12-51) ml/100 g/min in the infants with favourable outcome (p < 0.01). The area-under-the-curve was 0.92 for ASL MRI, 0.97 for MRI score, 0.96 for Lac/NAA and 0.92 for ADC in the BGT. The combination of Lac/NAA and ASL MRI results was the best predictor of outcome (r2 = 0.86, p < 0.001).

Conclusion: Higher ASL perfusion values in neonates with HIE are associated with a worse neurodevelopmental outcome. A combination of the MRS and ASL MRI information is the best predictor of outcome.

Original languageEnglish (US)
Pages (from-to)113-121
Number of pages9
JournalEuropean radiology
Volume25
Issue number1
DOIs
StatePublished - Jan 1 2015

Keywords

  • Arterial spin labelling
  • Hypoxic-ischemic encephalopathy
  • MRI
  • Neonate
  • Perfusion

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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