Pediatric radiology · 2015
Comparison of early and late MRI in neonatal hypoxic-ischemic encephalopathy using three assessment methods.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Charon Valérie, Proisy Maïa, Ferré Jean-Christophe, Bruneau Bertrand, Tréguier Catherine, Beuchée Alain, Chauvel Jennifer, Rozel Céline
Аннотация
BACKGROUND: There is no consensus on the optimum timing of MRI in neonates with hypoxic-ischemic encephalopathy treated with hypothermia. Reliable early imaging assessment might help managing treatment.
OBJECTIVE: To assess non-random differences between early and late MRI that might influence intensive-care decisions.
MATERIALS AND METHODS: This single-center retrospective study included all asphyxiated term neonates eligible for hypothermia treatment November 2009-July 2012. MRI scans were systematically performed at day 4 (early MRI) and day 11 of life as part of routine protocol. Two experienced pediatric radiologists reviewed both scans according to three assessment methods: a pattern classification, a scoring system and a simplified classification. Agreement between early and late imaging findings was assessed using Cohen's kappa coefficients.
RESULTS: Thirty-three neonates were included. Interobserver agreement was excellent. Early MRI detected all severe injuries. Agreement between early and late MRI was excellent for the simplified classification (κ = 0.82), good for the pattern classification (κ = 0.64), and good to excellent for 3 scores out of 4 in the scoring system (κ = 0.70-0.89).
CONCLUSION: Early MRI may provide valuable information about brain injury to help parents and neonatologists in intensive-care decisions at the end of hypothermia treatment.
OBJECTIVE: To assess non-random differences between early and late MRI that might influence intensive-care decisions.
MATERIALS AND METHODS: This single-center retrospective study included all asphyxiated term neonates eligible for hypothermia treatment November 2009-July 2012. MRI scans were systematically performed at day 4 (early MRI) and day 11 of life as part of routine protocol. Two experienced pediatric radiologists reviewed both scans according to three assessment methods: a pattern classification, a scoring system and a simplified classification. Agreement between early and late imaging findings was assessed using Cohen's kappa coefficients.
RESULTS: Thirty-three neonates were included. Interobserver agreement was excellent. Early MRI detected all severe injuries. Agreement between early and late MRI was excellent for the simplified classification (κ = 0.82), good for the pattern classification (κ = 0.64), and good to excellent for 3 scores out of 4 in the scoring system (κ = 0.70-0.89).
CONCLUSION: Early MRI may provide valuable information about brain injury to help parents and neonatologists in intensive-care decisions at the end of hypothermia treatment.