Comparative prognostic utilities of early quantitative magnetic resonance imaging spin-spin relaxometry and proton magnetic resonance spectroscopy in neonatal encephalopathy

Shanthi Shanmugalingam, John S Thornton, Osuke Iwata, Alan Bainbridge, Frances E O'Brien, Andrew N Priest, Roger J Ordidge, Ernest B Cady, John S Wyatt, Nicola J Robertson

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

OBJECTIVE: We sought to compare the prognostic utilities of early MRI spin-spin relaxometry and proton magnetic resonance spectroscopy in neonatal encephalopathy.

METHODS: Twenty-one term infants with neonatal encephalopathy were studied at a mean age of 3.1 days (range: 1-5). Basal ganglia, thalamic and frontal, parietal, and occipital white matter spin-spin relaxation times were determined from images with echo times of 25 and 200 milliseconds. Metabolite ratios were determined from an 8-mL thalamic-region magnetic resonance spectroscopy voxel (1H point-resolved spectroscopy; echo time 270 milliseconds). Outcomes were assigned at age 1 year as follows: (1) normal, (2) moderate (neuromotor signs or Griffiths developmental quotient of 75-84), (3) severe (functional neuromotor deficit or developmental quotient <75 or died). Predictive efficacies for differentiation between normal and adverse (combined moderate and severe) outcomes were compared by receiver operating characteristic curve analysis and logistic regression.

RESULTS: Thalamic and basal ganglia spin-spin relaxation times correlated positively with outcome and predicted adversity. Although thalamic and basal ganglia spin-spin relaxation times were prognostic of adversity, magnetic resonance spectroscopy metabolite ratios were better predictors, and, of these, lactate/N-acetylaspartate was most accurate.

CONCLUSIONS: Deep gray matter spin-spin relaxation time was increased in the first few days after birth in infants with an adverse outcome. Proton magnetic resonance spectroscopy was more prognostic than spin-spin relaxation time, with lactate/N-acetylaspartate the best measure. Nevertheless, both techniques were useful for early prognosis, and the potential superior spatial resolution of spin-spin relaxometry may define better the precise anatomic pattern of injury in the early days after birth.

Original languageEnglish
Pages (from-to)1467-77
Number of pages11
JournalPediatrics
Volume118
Issue number4
DOIs
Publication statusPublished - Oct 2006

Keywords / Materials (for Non-textual outputs)

  • Brain Chemistry
  • Brain Diseases/diagnosis
  • Female
  • Humans
  • Infant, Newborn
  • Logistic Models
  • Magnetic Resonance Imaging/methods
  • Magnetic Resonance Spectroscopy/methods
  • Male
  • Predictive Value of Tests
  • Prognosis
  • Protons
  • ROC Curve
  • Water/analysis

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