Abstract
The prognostic significance of magnetic resonance imaging (MRI) in the neonatal period
was studied prospectively in 43 term infants with perinatal asphyxia. MRI was performed
between 1 and 14 days after birth with a high field system (2.35 Tesla). Neurodevelopmental
outcome was assessed by a standardized neurological examination and the Griffiths
developmental test at a mean age of 18.9 months. The predictive value of the various
MRI patterns was as follows: Severe diffuse brain injury (pattern AII+III; n = 7)
and lesions of thalamus and basal ganglia (pattern C; n = 5) were strongly associated
with poor outcome and greatly reduced head growth. Mild diffuse brain injury (pattern
AI; n = 7), parasagittal lesions (B; n = 7), periventricular hyperintensity (D; n
= 2), focal brain necrosis and hemorrhage (E; n = 3) and periventricular hypointense
stripes (on T2-weighted images; F; n = 3) led in one third of the infants to minor neurological
disturbances and mild developmental delay. Infants with normal MRI findings (G; n
= 9) developed normally with the exception of one infant who was mildly delayed at
18 months. The results indicate that MRI examination during the first two weeks of
life is of prognostic significance in term infants suffering from perinatal asphyxia.
Severe hypoxic-ischemic brain lesions were associated highly significantly with poor
neurodevelopmental outcome, whereas infants with inconspicuous MRI developed normally.
Abbreviations
CT: computed tomography
DQ: developmental quotient
HC: head circumference
MRI: magnetic resonance imaging
NE: neonatal encephalopathy
NOS: neurological optimality score
SD: standard deviation
Key words
Perinatal asphyxia - Term infants - Magnetic resonance imaging - Neurodevelopmental
outcome
