Quantitative interpretation using ADC values for subjective MRI classification of neonatal hypoxic-ischemic...

Area of Science:

• Neonatal neurology
• Radiology
• Neuroimaging

Background:

• MRI, especially diffusion-weighted imaging (DWI), is used for hypoxic-ischemic encephalopathy (HIE) classification.
• Subjective bias in DWI interpretation can affect HIE assessment.
• Quantitative apparent diffusion coefficient (ADC) values offer a more objective measure of injury severity.

Purpose of the Study:

• To quantitatively assess regional ADC values in neonatal HIE.
• To evaluate brain injury depth and distribution across MRI patterns.
• To minimize reliance on subjective visual DWI interpretation.

Main Methods:

• Seventy-three term infants with HIE underwent brain MRI.
• ADC values were measured in five predefined brain regions.
• Correlations between regional ADC values and MRI pattern classifications were analyzed.

Main Results:

• Five MRI patterns identified: normal, white matter injury (WMI), watershed (WS), basal ganglia/thalamus injury (BGT), and near total brain injury (nTBI).
• No significant ADC differences were found between normal, WMI, and WS patterns.
• Significantly lower ADC values were observed in the nTBI group compared to the BGT group.

Conclusions:

• Quantitative ADC analysis reveals distinct distribution differences between BGT and nTBI patterns.
• These differences are evident in the first and second weeks of life.
• The nTBI pattern indicates more severe and widespread brain injury.