Echoplanar diffusion-weighted imaging in neonates and infants with suspected hypoxic-ischemic injury: Correlation with patient outcome

Annette Johnson, Benjamin C.P. Lee, Weili Lin

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

OBJECTIVE. Our objective was to examine the effectiveness of echoplanar diffusion-weighted (DW) imaging in detecting CNS ischemia in neonates and infants and to determine how well the imaging findings using this technique correlate 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 clinically defined cohort of 26 consecutive neonates and infants with suspected hypoxic- ischemic injury. Echoplanar DW imaging was performed with the diffusion gradient in the slice-select direction: b value, 1200 sec/mm2; matrix, 128 x 128, interpolated to 256 x 256. Four scans (4 sec per scan) were obtained and averaged to optimize the signal-to-noise ratio. Most patients were not sedated (n = 19). Abnormalities seen on DW imaging were correlated with clinical findings at short-term follow-up 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 sequelae in 12 (86%) of 14 patients with DW images with normal findings. Echoplanar DW images revealed a greater extent of and a larger number of abnormalities 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 short-term neurologic prognosis in these patients.

Original languageEnglish (US)
Pages (from-to)219-226
Number of pages8
JournalAmerican Journal of Roentgenology
Volume172
Issue number1
DOIs
StatePublished - Jan 1 1999
Externally publishedYes

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Newborn Infant
Wounds and Injuries
Neurologic Manifestations
Sequence Inversion
Signal-To-Noise Ratio
Nervous System
Ischemia

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Echoplanar diffusion-weighted imaging in neonates and infants with suspected hypoxic-ischemic injury : Correlation with patient outcome. / Johnson, Annette; Lee, Benjamin C.P.; Lin, Weili.

In: American Journal of Roentgenology, Vol. 172, No. 1, 01.01.1999, p. 219-226.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE. Our objective was to examine the effectiveness of echoplanar diffusion-weighted (DW) imaging in detecting CNS ischemia in neonates and infants and to determine how well the imaging findings using this technique correlate 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 clinically defined cohort of 26 consecutive neonates and infants with suspected hypoxic- ischemic injury. Echoplanar DW imaging was performed with the diffusion gradient in the slice-select direction: b value, 1200 sec/mm2; matrix, 128 x 128, interpolated to 256 x 256. Four scans (4 sec per scan) were obtained and averaged to optimize the signal-to-noise ratio. Most patients were not sedated (n = 19). Abnormalities seen on DW imaging were correlated with clinical findings at short-term follow-up 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 sequelae in 12 (86{\%}) of 14 patients with DW images with normal findings. Echoplanar DW images revealed a greater extent of and a larger number of abnormalities 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 short-term neurologic prognosis in these patients.",
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N2 - OBJECTIVE. Our objective was to examine the effectiveness of echoplanar diffusion-weighted (DW) imaging in detecting CNS ischemia in neonates and infants and to determine how well the imaging findings using this technique correlate 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 clinically defined cohort of 26 consecutive neonates and infants with suspected hypoxic- ischemic injury. Echoplanar DW imaging was performed with the diffusion gradient in the slice-select direction: b value, 1200 sec/mm2; matrix, 128 x 128, interpolated to 256 x 256. Four scans (4 sec per scan) were obtained and averaged to optimize the signal-to-noise ratio. Most patients were not sedated (n = 19). Abnormalities seen on DW imaging were correlated with clinical findings at short-term follow-up 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 sequelae in 12 (86%) of 14 patients with DW images with normal findings. Echoplanar DW images revealed a greater extent of and a larger number of abnormalities 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 short-term neurologic prognosis in these patients.

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