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Can cerebellar and brainstem apparent diffusion coefficient (ADC) values predict neuromotor outcome in term neonates with hypoxic-ischemic encephalopathy (HIE) treated with hypothermia?

BACKGROUND AND PURPOSE: To determine the apparent diffusion coefficient (ADC) in specific infratentorial brain structures during the first week of life and its relation with neuromotor outcome for Hypoxic-ischemic encephalopathy (HIE) in term neonates with and without whole-body hypothermia (TH). MA...

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Autores principales: Arca-Díaz, Gemma, Re, Thomas J., Drottar, Marie, Fortuno, Carmen Rosa, De Macedo-Rodrigues, Katyucia, Im, Kiho, Figueras-Aloy, Josep, Grant, Patricia Ellen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501430/
https://www.ncbi.nlm.nih.gov/pubmed/28686592
http://dx.doi.org/10.1371/journal.pone.0178510
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author Arca-Díaz, Gemma
Re, Thomas J.
Drottar, Marie
Fortuno, Carmen Rosa
De Macedo-Rodrigues, Katyucia
Im, Kiho
Figueras-Aloy, Josep
Grant, Patricia Ellen
author_facet Arca-Díaz, Gemma
Re, Thomas J.
Drottar, Marie
Fortuno, Carmen Rosa
De Macedo-Rodrigues, Katyucia
Im, Kiho
Figueras-Aloy, Josep
Grant, Patricia Ellen
author_sort Arca-Díaz, Gemma
collection PubMed
description BACKGROUND AND PURPOSE: To determine the apparent diffusion coefficient (ADC) in specific infratentorial brain structures during the first week of life and its relation with neuromotor outcome for Hypoxic-ischemic encephalopathy (HIE) in term neonates with and without whole-body hypothermia (TH). MATERIALS AND METHODS: We retrospectively evaluated 45 MRI studies performed in the first week of life of term neonates born between 2010 and 2013 at Boston Children's Hospital. Selected cases were classified into three groups: 1) HIE neonates who underwent TH, 2) HIE normothermics (TN), and 3) controls. The neuromotor outcome was categorized as normal, abnormal and death. The ADC(mean) was calculated for six infratentorial brain regions. RESULTS: A total of 45 infants were included: 28 HIE TH treated, 8 HIE TN, and 9 controls. The mean gestational age was 39 weeks; 57.8% were male; 11.1% were non-survivors. The median age at MRI was 3 days (interquartile range, 1–4 days). A statistically significant relationship was shown between motor outcome or death and the ADC(mean) in the vermis (P = 0.002), cerebellar left hemisphere (P = 0.002), midbrain (P = 0.009), pons (P = 0.014) and medulla (P = 0.005). In patients treated with TH, the ADC (mean) remained significantly lower than that in the controls only in the hemispheres (P = 0.01). In comparison with abnormal motor outcome, ADC(mean) was lowest in the left hemisphere (P = 0.003), vermis (P = 0.003), pons (P = 0.0036) and medulla (P = 0.008) in case of death. CONCLUSION: ADC(mean) values during the first week of life in the left hemisphere, vermis, pons and medulla are related to motor outcome or death in infants with HIE either with or without hypothermic therapy. Therefore, this objective tool can be assessed prospectively to determine if it can be used to establish prognosis in the first week of life, particularly in severe cases of HIE.
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spelling pubmed-55014302017-07-25 Can cerebellar and brainstem apparent diffusion coefficient (ADC) values predict neuromotor outcome in term neonates with hypoxic-ischemic encephalopathy (HIE) treated with hypothermia? Arca-Díaz, Gemma Re, Thomas J. Drottar, Marie Fortuno, Carmen Rosa De Macedo-Rodrigues, Katyucia Im, Kiho Figueras-Aloy, Josep Grant, Patricia Ellen PLoS One Research Article BACKGROUND AND PURPOSE: To determine the apparent diffusion coefficient (ADC) in specific infratentorial brain structures during the first week of life and its relation with neuromotor outcome for Hypoxic-ischemic encephalopathy (HIE) in term neonates with and without whole-body hypothermia (TH). MATERIALS AND METHODS: We retrospectively evaluated 45 MRI studies performed in the first week of life of term neonates born between 2010 and 2013 at Boston Children's Hospital. Selected cases were classified into three groups: 1) HIE neonates who underwent TH, 2) HIE normothermics (TN), and 3) controls. The neuromotor outcome was categorized as normal, abnormal and death. The ADC(mean) was calculated for six infratentorial brain regions. RESULTS: A total of 45 infants were included: 28 HIE TH treated, 8 HIE TN, and 9 controls. The mean gestational age was 39 weeks; 57.8% were male; 11.1% were non-survivors. The median age at MRI was 3 days (interquartile range, 1–4 days). A statistically significant relationship was shown between motor outcome or death and the ADC(mean) in the vermis (P = 0.002), cerebellar left hemisphere (P = 0.002), midbrain (P = 0.009), pons (P = 0.014) and medulla (P = 0.005). In patients treated with TH, the ADC (mean) remained significantly lower than that in the controls only in the hemispheres (P = 0.01). In comparison with abnormal motor outcome, ADC(mean) was lowest in the left hemisphere (P = 0.003), vermis (P = 0.003), pons (P = 0.0036) and medulla (P = 0.008) in case of death. CONCLUSION: ADC(mean) values during the first week of life in the left hemisphere, vermis, pons and medulla are related to motor outcome or death in infants with HIE either with or without hypothermic therapy. Therefore, this objective tool can be assessed prospectively to determine if it can be used to establish prognosis in the first week of life, particularly in severe cases of HIE. Public Library of Science 2017-07-07 /pmc/articles/PMC5501430/ /pubmed/28686592 http://dx.doi.org/10.1371/journal.pone.0178510 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication.
spellingShingle Research Article
Arca-Díaz, Gemma
Re, Thomas J.
Drottar, Marie
Fortuno, Carmen Rosa
De Macedo-Rodrigues, Katyucia
Im, Kiho
Figueras-Aloy, Josep
Grant, Patricia Ellen
Can cerebellar and brainstem apparent diffusion coefficient (ADC) values predict neuromotor outcome in term neonates with hypoxic-ischemic encephalopathy (HIE) treated with hypothermia?
title Can cerebellar and brainstem apparent diffusion coefficient (ADC) values predict neuromotor outcome in term neonates with hypoxic-ischemic encephalopathy (HIE) treated with hypothermia?
title_full Can cerebellar and brainstem apparent diffusion coefficient (ADC) values predict neuromotor outcome in term neonates with hypoxic-ischemic encephalopathy (HIE) treated with hypothermia?
title_fullStr Can cerebellar and brainstem apparent diffusion coefficient (ADC) values predict neuromotor outcome in term neonates with hypoxic-ischemic encephalopathy (HIE) treated with hypothermia?
title_full_unstemmed Can cerebellar and brainstem apparent diffusion coefficient (ADC) values predict neuromotor outcome in term neonates with hypoxic-ischemic encephalopathy (HIE) treated with hypothermia?
title_short Can cerebellar and brainstem apparent diffusion coefficient (ADC) values predict neuromotor outcome in term neonates with hypoxic-ischemic encephalopathy (HIE) treated with hypothermia?
title_sort can cerebellar and brainstem apparent diffusion coefficient (adc) values predict neuromotor outcome in term neonates with hypoxic-ischemic encephalopathy (hie) treated with hypothermia?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501430/
https://www.ncbi.nlm.nih.gov/pubmed/28686592
http://dx.doi.org/10.1371/journal.pone.0178510
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