Distinguishing multicystic from focal encephalomalacia on delayed MRI in children with term hypoxic ischemic injury

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY Journal of Neuroimaging Pub Date : 2024-01-12 DOI:10.1111/jon.13190

Dana Alkhulaifat, Shyam Sunder B. Venkatakrishna, César Augusto Pinheiro Ferreira Alves, Wondwossen Lerebo, Luis Octavio Tierradentro-Garcia, Mohamed Elsingergy, Fikadu Worede, Jelena Curic, Savvas Andronikou

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Abstract

Background and Purpose

To define cystic patterns resulting from term hypoxic ischemic injury (HII) on delayed Magnetic Resonance Imaging (MRI) and determine associated HII patterns and lesions that reflect the severity of injury, from a database of African children with cerebral palsy.

Methods

Retrospective review of 1175 children with cerebral palsy due to term HII diagnosed on late MRI, identifying those with cystic changes. These were classified as multicystic or (multi-) focal-cystic, and were evaluated for associated injuries—thalami, basal ganglia, hippocampi, cerebellum, and presence of ulegyria.

Results

Three hundred and eighty-eight of 1175 (33%) children had cystic encephalomalacia. Two hundred and seven of 388 (53.3%) had focal-cystic and 181/388 (46.6%) had multicystic injury. The focal-cystic group comprised 87.9% (182/207) with thalamic injury, 25.6% (53/207) with basal ganglia injury, and 15% (31/207) with cerebellar involvement. Basal-ganglia-thalamus (BGT) pattern was present in 43.9% (91/207) and ulegyria in 69.6% (144/207). In the multicystic group, 88.9% (161/181) had thalamic injury, 30.9% (56/181) had basal ganglia injury, and 21% (38/181) had cerebellar involvement. BGT pattern was observed in 29.8% (54/181) and ulegyria in 28.7%. (52/181). Significant associations (p<.05) were found between multicystic injury and caudate/globus pallidus involvement, and between focal-cystic pattern of injury and ulegyria.

Conclusions

Cystic encephalomalacia was seen in almost one-third of patients with term HII imaged with delayed MRI, with a similar prevalence of focal-cystic and multicystic injury. Multicystic injury was associated with caudate and globus pallidi involvement, typical of the BGT pattern of HII, whereas the focal-cystic pattern was associated with ulegyria, typical of watershed injury.

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通过延迟磁共振成像鉴别缺氧缺血性损伤患儿的多囊性和局灶性脑瘤。

背景和目的：从非洲脑瘫患儿数据库中确定延迟磁共振成像（MRI）中缺氧缺血性损伤（HII）导致的囊变模式，并确定反映损伤严重程度的相关HII模式和病变：方法：回顾性分析 1175 名脑瘫患儿的晚期 MRI 诊断结果，确定其中有囊性病变的患儿。这些病例被分为多囊性或多）局灶性囊性，并对相关损伤--大脑、基底节、海马、小脑以及是否存在尿崩症进行了评估：1175名儿童中有388名（33%）患有囊性脑瘤。388名儿童中有207名（53.3%）患有局灶性囊肿，181/388名（46.6%）患有多囊性损伤。局灶性囊肿组中丘脑损伤占 87.9%（182/207），基底节损伤占 25.6%（53/207），小脑受累占 15%（31/207）。43.9%（91/207）的患者出现基底节-丘脑（BGT）模式，69.6%（144/207）的患者出现ulegyria。在多囊性组中，88.9%（161/181）丘脑受损，30.9%（56/181）基底节受损，21%（38/181）小脑受累。29.8%的患者（54/181）出现BGT模式，28.7%的患者（52/181）出现ulegyria。(52/181).两者之间存在显著关联（p结论：延迟磁共振成像显示，近三分之一的期HII患者存在囊性脑瘤，局灶性囊性损伤和多囊性损伤的发生率相似。多囊损伤与尾状和球状苍白球受累有关，是典型的 BGT 型 HII，而局灶囊肿型则与尿崩症有关，是典型的分水岭损伤。

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来源期刊

Journal of Neuroimaging 医学-核医学

CiteScore

4.70

自引率

0.00%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!