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Role of brain SPECT in neonates with hypoxic ischemic encephalopathy and its correlation with neurodevelopmental
S Shah1, A R Fernandez, D Chirla
1Division of Neonatology, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai 400 022, India. sshah@pnc.com.au
Objective:
To study cerebral blood flow pattern seen on single photon emission computed tomography (SPECT) scan in neonates with hypoxic ischaemic encephalopathy (HIE) and to correlate it with immediate neurological status and neurodevelopmental outcome; and to compare it with Ultrasonogaphy (USG).
Design:
Prospective cohort study.
Setting:
Tertiary level Neonatal Intensive Care Unit.
Methods:
All the neonates HIE stage 2 or 3 underwent SPECT scan and USG between the ages of 1-2 weeks. The pattern of deficit seen on SPECT scan was correlated with neurological status, duration of altered sensorium, severity of seizures and short-term neurodevelopmental outcome at 3 months.
Results:
The commonest pattern of defect noted was parasagittal hypoperfusion. Babies with severe perfusion defect had higher incidence of difficult to control seizures and longer duration of altered sensorium. The positive predictive value of SPECT scan was 75% while that of USG was 60% and the negative predictive value of SPECT was 100% while that of USG was 76%, when neurodevelopmental outcome at 3 months was considered.
Conclusion:
SPECT scan is superior to ultrasonography in predicting neurodevelopmental outcome in babies with HIE.