PROGNOSTIC VALUE OF EARLY MR-IMAGING IN TERM INFANTS WITH SEVERE PERINATAL ASPHYXIA

The prognostic significance of magnetic resonance imaging (MRI) in the neonatal period was studied prospectively in 43 term infants with per inatal asphyxia. MRI was performed between 1 and 14 days after birth w ith a high field system (2.35 Tesla). Neurodevelopmental outcome was a ssessed by a standardized neurological examination and the Griffiths d evelopmental test at a mean age of 18.9 months. The predictive value o f the various MRT patterns was as follows: Severe diffuse brain injury (pattern AII+III; n = 7) and lesions of thalamus and basal ganglia (p attern C; n = 5) were strongly associated with poor outcome and greatl y reduced head growth. Mild diffuse brain injury (patten AT; n = 7), p arasagittal lesions (B; n = 7), periventricular hyperintensity (D; n = 2), focal brain necrosis and hemorrhage (E; n = 3) and periventricula r hypointense stripes (on T-2-weighted images; F; n = 3) led in one th ird of the infants to minor neurological disturbances and mild develop mental delay. Infants with normal MRI findings (G; n = 9) developed no rmally with the exception of one infant who was mildly delayed at 18 m onths. 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 as sociated highly significantly with poor neurodevelopmental outcome, wh ereas infants with inconspicuous MRT developed normally.