Volumetric apparent diffusion coefficient histogram analysis in term neonatal asphyxia treated with hypothermia

Area of Science:

• Neonatal neurology
• Radiology
• Neuroimaging

Background:

• Neonatal asphyxia is a significant cause of neurological sequelae.
• Hypothermia treatment is standard for term neonatal asphyxia.
• Predicting long-term outcomes is crucial for management.

Purpose of the Study:

• To estimate long-term neurological sequelae and prognosis in term neonatal asphyxia treated with hypothermia.
• To evaluate the utility of volumetric apparent diffusion coefficient (ADC) map histogram analysis (HA) for outcome prediction.

Main Methods:

• Retrospective analysis of brain MRI from 83 term neonates treated with hypothermia.
• Volumetric ADC map histogram analysis (HA) of frequently affected brain regions.
• Quantitative ADC value acquisition and qualitative-visual MRI assessment.
• Neurodevelopmental assessment using the Revised Brunet-Lezine scale.

Main Results:

• Volumetric ADC-HA at the thalamus (10th percentile ADC and ADCmin) distinguished adverse outcomes.
• Conventional MRI findings of cytotoxic edema in the thalamus, corpus striatum, and cerebral cortex also predicted outcomes.
• No significant difference was found between volumetric ADC-HA and conventional MRI in predicting neurological sequelae.

Conclusions:

• Volumetric ADC-HA and conventional ADC map assessment similarly estimate long-term adverse neurodevelopmental outcomes.
• Early MRI evaluation aids in predicting neurological sequelae in asphyxiated newborns treated with hypothermia.