Predictive Value of MRI in Hypoxic-Ischemic Encephalopathy Treated with Therapeutic Hypothermia.

ADC HIE MRI ROC curve early biomarker hypoxic-ischemic encephalopathy perinatal asphyxia prognostic parameter van Rooij

Journal

Children (Basel, Switzerland)
ISSN: 2227-9067
Titre abrégé: Children (Basel)
Pays: Switzerland
ID NLM: 101648936

Informations de publication

Date de publication:
25 Feb 2023
Historique:
received: 28 12 2022
revised: 16 02 2023
accepted: 23 02 2023
medline: 30 3 2023
entrez: 29 3 2023
pubmed: 30 3 2023
Statut: epublish

Résumé

Hypoxic-ischemic encephalopathy (HIE) is a severe pathology, and no unique predictive biomarker has been identified. Our aims are to identify associations of perinatal and outcome parameters with morphological anomalies and ADC values from MRI. The secondary aims are to define a predictive ADC threshold value and detect ADC value fluctuations between MRIs acquired within 7 days (MR0) and at 1 year (MR1) of birth in relation to perinatal and outcome parameters. Fifty-one term children affected by moderate HIE treated with hypothermia and undergoing MRI0 and MRI1 were recruited. Brain MRIs were evaluated through the van Rooij score, while ADC maps were co-registered on a standardized cerebral surface, on which 29 ROIs were drawn. Statistical analysis was performed in Matlab, with the statistical significance value at 0.05. ADC0 < ADC1 in the left and right thalami, left and right frontal white matter, right visual cortex, and the left dentate nucleus of children showing abnormal perinatal and neurodevelopmental parameters. At ROC analysis, the best prognostic ADC cut-off value was 1.535 mm ADC values could be used as prognostic biomarkers to predict children's neurodevelopmental outcomes. Further studies are needed to address these crucial topics and validate our results. Early and multidisciplinary perinatal evaluation and the subsequent re-assessment of children are pivotal to identify physical and neuropsychological disorders to guarantee early and tailored therapy.

Sections du résumé

BACKGROUND BACKGROUND
Hypoxic-ischemic encephalopathy (HIE) is a severe pathology, and no unique predictive biomarker has been identified. Our aims are to identify associations of perinatal and outcome parameters with morphological anomalies and ADC values from MRI. The secondary aims are to define a predictive ADC threshold value and detect ADC value fluctuations between MRIs acquired within 7 days (MR0) and at 1 year (MR1) of birth in relation to perinatal and outcome parameters.
METHODS METHODS
Fifty-one term children affected by moderate HIE treated with hypothermia and undergoing MRI0 and MRI1 were recruited. Brain MRIs were evaluated through the van Rooij score, while ADC maps were co-registered on a standardized cerebral surface, on which 29 ROIs were drawn. Statistical analysis was performed in Matlab, with the statistical significance value at 0.05.
RESULTS RESULTS
ADC0 < ADC1 in the left and right thalami, left and right frontal white matter, right visual cortex, and the left dentate nucleus of children showing abnormal perinatal and neurodevelopmental parameters. At ROC analysis, the best prognostic ADC cut-off value was 1.535 mm
CONCLUSIONS CONCLUSIONS
ADC values could be used as prognostic biomarkers to predict children's neurodevelopmental outcomes. Further studies are needed to address these crucial topics and validate our results. Early and multidisciplinary perinatal evaluation and the subsequent re-assessment of children are pivotal to identify physical and neuropsychological disorders to guarantee early and tailored therapy.

Identifiants

pubmed: 36980004
pii: children10030446
doi: 10.3390/children10030446
pmc: PMC10047577
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Alessia Guarnera (A)

Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital IRCCS, Piazza Sant'Onofrio, 4, 00165 Rome, Italy.
Neuroradiology Unit, NESMOS Department Sant'Andrea Hospital, La Sapienza University, Via di Grottarossa, 1035-1039, 00189 Rome, Italy.

Giulia Lucignani (G)

Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital IRCCS, Piazza Sant'Onofrio, 4, 00165 Rome, Italy.

Chiara Parrillo (C)

Medical Physics Unit, Risk Management Enterprise, Bambino Gesù Children's Hospital IRCCS, Piazza Sant'Onofrio, 4, 00165 Rome, Italy.

Maria Camilla Rossi-Espagnet (MC)

Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital IRCCS, Piazza Sant'Onofrio, 4, 00165 Rome, Italy.

Chiara Carducci (C)

Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital IRCCS, Piazza Sant'Onofrio, 4, 00165 Rome, Italy.

Giulia Moltoni (G)

Neuroradiology Unit, NESMOS Department Sant'Andrea Hospital, La Sapienza University, Via di Grottarossa, 1035-1039, 00189 Rome, Italy.

Immacolata Savarese (I)

Neonatal Intensive Care Unit, Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165 Rome, Italy.

Francesca Campi (F)

Neonatal Intensive Care Unit, Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165 Rome, Italy.

Andrea Dotta (A)

Neonatal Intensive Care Unit, Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165 Rome, Italy.

Francesco Milo (F)

Unit of Clinical Psychology, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165 Rome, Italy.

Simona Cappelletti (S)

Unit of Clinical Psychology, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165 Rome, Italy.

Teresa Capitello Grimaldi (T)

Unit of Clinical Psychology, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165 Rome, Italy.

Carlo Gandolfo (C)

Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital IRCCS, Piazza Sant'Onofrio, 4, 00165 Rome, Italy.

Antonio Napolitano (A)

Medical Physics Unit, Risk Management Enterprise, Bambino Gesù Children's Hospital IRCCS, Piazza Sant'Onofrio, 4, 00165 Rome, Italy.

Daniela Longo (D)

Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital IRCCS, Piazza Sant'Onofrio, 4, 00165 Rome, Italy.

Classifications MeSH