Early Assessment Of Hypoxic Ischemic Encephalopathy In Neonates By DWI And Its Significanc

ObjectiveWe try to clear that diffusion weighted imaging (DWI) had important signifycha-nce in early assessment of hypoxic ischemic encephalopathy(HIE), and measure the apparent diffusion coefficient (ADC)values in the common injuried regions of the infants with hypoxic ischemic encephalopathy (HIE).MethodThe participants in this study were 26 infants with hypoxic ischemic encephalopa-thy and 12 healthy infants from neonatology ward (Shengjing Hospital of China Medical University) between July 2006 and July 2009. All the participants completed DWI and conventional MRI scans in the first 72hrs. We measured the ADC values of eight regions of interest (ROIs) in 10 patients with severe hypoxic ischemic insult and 12 healthy neonates. ROIs included ventrolateral thalami, basal ganglia, posterior limb of internal capsule (PLIC), centrum semiovale, perirolandic cortex, occipital cortex, brainstem, and frontal white matter.ResultsIn the first 72 hrs, abnormal signal intensity was not seen in the conventional MRI of each of patients. Abnormal signal intensity was found in DWI of all the patients(especially in the first 24 hrs).18 had abnormal ventrolateral thalami and perirolandic cortex; 6 had abnormal signal intensity in the watershed zone; 2 had abnormal signal intensity in the periventricular whitematter. There was statistical significance in the average ADC values of the each of 8 ROIs between infants with HIE and healthy neonates.ConlusionDWI could detect the hypoxic ischemic insult earlier than conventional MRI in the 72 hrs after birth, especially in the first 24 hrs. And the ADC values in the ROIs of infants with HIE decreased in the first 72 hrs.