Prognostic correlative values of the late-infancy MRI pattern in term infants with perinatal asphyxia

Area of Science:

• Neuroimaging
• Neonatal Neurology
• Pediatric Radiology

Background:

• Perinatal asphyxia poses a significant risk to term infants, potentially leading to long-term neurological deficits.
• Early identification of prognostic indicators is crucial for timely intervention and management.

Purpose of the Study:

• To establish the risk ratios of specific late-infancy magnetic resonance imaging (MRI) patterns for predicting long-term outcomes in term infants diagnosed with perinatal asphyxia.
• To correlate MRI findings in infancy with developmental trajectories.

Main Methods:

• A cohort of 65 term infants with perinatal asphyxia underwent MRI between 4 and 12 months of age.
• MRI scans were categorized into distinct patterns: periventricular leukomalacia, cortical atrophy, multicystic encephalomalacia, deep gray matter involvement, focal cortical involvement, and myelination delay.
• Long-term outcomes were assessed and correlated with the identified MRI patterns.

Main Results:

• Overall favorable outcomes were observed in 29% of the infants.
• Infants with diffuse cortical involvement (multicystic encephalomalacia and marked cortical atrophy) showed a significantly higher likelihood (odds ratios of 4.4 and 4.1, respectively) of unfavorable outcomes compared to other MRI patterns.
• Focal cortical involvement was associated with a relatively favorable outcome in 60% of cases.

Conclusions:

• Late-infancy MRI patterns serve as reliable predictors of long-term outcomes in term infants with perinatal asphyxia.
• The presence and type of brain injury visualized on MRI, particularly diffuse cortical changes, are strongly associated with developmental prognosis.