Utility of Cranial Ultrasound to Investigate Brain Injury in Hypoxic-Ischemic Encephalopathy.

IF 3.2 3区医学 Q2 CLINICAL NEUROLOGY Pediatric neurology Pub Date : 2025-02-01 Epub Date: 2024-11-06 DOI:10.1016/j.pediatrneurol.2024.10.019

Aine Fox, Rocco Cuzzilla, Ailbhe Tarrant, Adam Reynolds, Michael Geary, Miriam Martinez-Biarge, Breda Hayes

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Abstract

Background: With increasing availability of brain magnetic resonance imaging (MRI) in high-income countries, cranial ultrasound (cUS) is used less frequently to evaluate infants with hypoxic-ischemic encephalopathy (HIE). This study aimed to correlate findings of brain injury on early postnatal cUS with brain injury on neonatal brain MRI performed as part of routine clinical care for near-term and term infants with moderate to severe HIE.

Methods: This was a retrospective cohort study comparing early postnatal cUS and later neonatal brain MRI using scoring systems with prognostic validity to assess brain injury in near-term/term infants with moderate or severe HIE. Infants were born between 2010 and 2021 and were treated at a single tertiary neonatal intensive care unit.

Results: A total of 94 infants were included in this study. cUS was performed in the first five days after birth and brain MRI at a median of 6.7 days (interquartile range 5.4, 7.9). Findings of white matter injury on cUS <24 hours and gray matter injury on cUS >48 hours correlated with similar nature and severity of brain injury on brain MRI. Subgroup analyses of cUS performed <24 and >48 hours and contemporaneous brain MRI performed on days 3 to 5 provided stronger evidence for correlations of brain injury between neuroimaging modalities.

Conclusion: This study provides evidence for the correlation of findings of brain injury between cUS and brain MRI. Early postnatal cUS can provide information on potential findings on brain MRI and may help inform outcome of newborns in low-middle income countries and situations where MRI is not clinically possible.

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颅超声在缺氧缺血性脑病脑损伤研究中的应用。

背景：随着脑磁共振成像（MRI）在高收入国家的日益普及，颅超声（cu）用于评估婴儿缺氧缺血性脑病（HIE）的频率越来越低。本研究旨在将新生儿脑MRI的脑损伤结果与早期出生后cu的脑损伤结果联系起来，作为中重度HIE近期和足月婴儿常规临床护理的一部分。方法：这是一项回顾性队列研究，比较出生后早期cu和后来的新生儿脑MRI，使用具有预后有效性的评分系统来评估中度或重度HIE的近期/足月婴儿的脑损伤。2010年至2021年间出生的婴儿在单一的三级新生儿重症监护病房接受治疗。结果：本研究共纳入94名婴儿。在出生后的前5天进行cu检查，中位数为6.7天（四分位数范围5.4,7.9）进行脑MRI检查。脑MRI显示，48小时脑白质损伤与脑损伤的性质和严重程度相似。48小时内进行的cu亚组分析和第3至5天同期进行的脑MRI为神经成像方式之间的脑损伤相关性提供了更有力的证据。结论：本研究为cu与脑MRI表现的相关性提供了依据。产后早期cu可以提供关于脑MRI潜在发现的信息，并可能有助于了解中低收入国家和临床不可能进行MRI的情况下新生儿的结局。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.