Aj. Johnson et al., Echoplanar diffusion-weighted imaging in neonates and infants with suspected hypoxic-ischemic injury: Correlation with patient outcome, AM J ROENTG, 172(1), 1999, pp. 219-226
Citations number
35
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
OBJECTIVE. Our objective was to examine the effectiveness of echoplanar dif
fusion-weighted (DW) imaging in detecting CNS ischemia in neonates and infa
nts and to determine how well the imaging findings using this technique cor
relate with short-term neurologic deficit.
MATERIALS AND METHODS. Echoplanar DW images, turbo T2-weighted images, and
fluid-attenuated inversion recovery (FLAIR) sequences were obtained in a cl
inically defined cohort of 26 consecutive neonates and infants with suspect
ed hypoxic-ischemic injury. Echoplanar DW imaging was performed with the di
ffusion gradient in the slice-select direction: b value, 1200 sec/mm(2); ma
trix, 128 x 128, interpolated to 256 x 256. Four scans (4 sec per scan) wer
e obtained and averaged to optimize the signal-to-noise ratio. Most patient
s were not sedated (n = 19). Abnormalities seen on DW imaging were correlat
ed with clinical findings at short-term followup and compared with findings
on FLAIR and turbo T2-weighted images.
RESULTS. Short-term clinical follow-up showed neurologic deficit in 10 (83%
) of 12 patients with DW images with abnormal findings, and no neurologic s
equelae in 12 (86%) of 14 patients with DW images with normal findings. Ech
oplanar DW images revealed a greater extent of and a larger number of abnor
malities compared with FLAIR or turbo T2-weighted images in 11 (92%) of 12
patients with DW images with abnormal findings.
CONCLUSION. Echoplanar DW imaging reveals abnormalities poorly depicted on
turbo T2-weighted and FLAIR images in neonates and infants with clinically
suspected hypoxic-ischemic injury. DW imaging may be able to identify which
patients are likely to develop at least short-term neurologic deficits and
may afford the best early evaluation of shortterm neurologic prognosis in
these patients.