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Scanning Dos and Don'ts: Using Magnetic Resonance Imaging in Awake Children Aged 3 to 5 Years to Assess Brain Structure and Function
Published on: March 10, 2026
Serial MRI and neurodevelopmental outcome in 9- to 10-year-old children with neonatal encephalopathy
Britt J M van Kooij1, Mariëlle van Handel, Rutger A J Nievelstein
1Department of Neonatology, University Medical Center, Utrecht, The Netherlands.
Insights
Neonatal brain injury patterns on MRI correlate with long-term neurodevelopmental outcomes. Moderate to severe brain lesions in children with neonatal encephalopathy are linked to impaired motor and cognitive function.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Radiology
Background:
- Neonatal encephalopathy can lead to significant brain injury.
- Magnetic Resonance Imaging (MRI) is crucial for assessing brain structure.
- Understanding the link between early brain injury and later development is vital.
Purpose of the Study:
- To determine the relationship between brain injury patterns identified via neonatal and childhood MRI and long-term neurodevelopmental outcomes.
- To investigate if brain injury patterns are persistent from neonatal to childhood stages.
Main Methods:
- Analysis of neonatal (n=34) and childhood (n=77) MRIs in 80 children with neonatal encephalopathy and 51 controls.
- MRI grading: normal, mild (white matter lesions), or moderate/severe (watershed injury, basal ganglia/thalamus lesions, focal infarction).
- Correlation of brain injury severity with neurodevelopmental outcomes: Movement Assessment Battery for Children, IQ, cerebral palsy, epilepsy, special education needs.
Main Results:
- Neonatal and childhood MRIs showed comparable findings in 75.8% of cases.
- Children with moderate/severe lesions on neonatal or childhood MRI had significantly higher rates of total impairment (
Conclusions:
- Brain injury patterns observed on neonatal MRI are often recognizable on childhood MRI.
- Moderate to severe brain lesions identified in infancy or childhood are strong predictors of impaired motor and cognitive outcomes in children with neonatal encephalopathy.
Objective:
To assess the relation between patterns of brain injury on neonatal and childhood magnetic resonance imaging (MRI) and long-term neurodevelopmental outcome.
Study Design:
Neonatal (n = 34) and childhood MRIs (n = 77) were analyzed for 80 children with neonatal encephalopathy and for 51 control subjects during childhood. MRIs were graded as normal, mildly abnormal (white matter lesions), or moderately/severely abnormal (watershed injury, lesions in basal ganglia/thalamus or focal infarction). Severity of brain injury was related to different aspects of neurologic outcome: Total impairment score of the Movement Assessment Battery for Children, intelligence quotient score, cerebral palsy, postneonatal epilepsy, and need for special education. Seven children with neonatal encephalopathy required extracorporeal membrane oxygenation treatment.
Results:
Neonatal and childhood MRI were comparable in 25/33 children (75.8%, P < .001). Children with moderate/severe lesions on neonatal or childhood MRI more often had a total impairment score
Conclusion:
Different patterns of injury seen on neonatal MRI after neonatal encephalopathy can still be recognized on childhood MRI. Children with moderate to severe brain lesions on neonatal or childhood MRI significantly more often have impaired motor and cognitive outcomes.