HOW EARLY AND HOW SPECIFIC ARE IMAGING METHODS IN THE DETECTION OF HYPOXIC-ISCHEMIC BRAIN-LESIONS

Pathogenic events affecting the developing brain cause malformations o r lesions, the pattern of which depend on the stage of brain developme nt. While in the past diagnosis of these patterns was made by post mor tem examinations, today advances of brain imaging allow this already d uring life time. The patterns of hypoxic-ischemic brain injuries on ma gnetic resonance imaging (MRI) are well known for the older child (aft er progress of myelination). This paper addresses the question how ear ly and how specific these patterns can be recognized by two imaging me thods, e.g. cranial ultrasound and magnetic resonance imaging. It conc ludes, that neonatal MRI but also neonatal ultrasound can reliably det ect major lesions but may fail in the detection of less extensive patt erns. Most authors therefore conclude, that a routine use of MRI for t he detection of hypoxic-ischemic lesions during the neonatal period is not recommended ind should rather be reserved for later controls.