Ces radiol. 2016, 70(3):149-157 | DOI: 10.55095/CesRadiol2016/023

Hypoxic-ischemic encephalopathy in newborns - MRI diagnosisReview article

Lenka Bakaj Zbrožková¹, Jan Hálek^2,3, Kamila Michálková¹, Miroslav Heřman¹

¹ Radiologická klinika FN a LF UP, Olomouc

² Novorozenecké oddělení FN a LF UP, Olomouc

³ Dětská klinika FN a LF UP, Olomouc

Hypoxic-ischemic encephalopathy (HIE) is an important cause of morbidity and mortality in term newborns. The precise pattern of CNS injury depends mainly on the severity of asphyxia and time of it's duration and also on the degree of brain maturation. Neonatal encephalopathy has been graded by modified Sarnat score. The only therapeutic method, which provably improve the prognosis in newborns with HIE, is hypothermia (cooling). The diagnosis is based on a clinical history, laboratory findings, electroencephalographic investigation and imaging methods. From last mentioned the magnetic resonance imaging has the highest sensitivity and specificity. In severe hypoxia we can find lesions mostly in the basal ganglia, thalami and capsula interna. Pathological lesions in hippocampi, perirolandic regions, corticospinal tract, sensomotor cortex and brain stem can also be found. Moderate hypoperfusion leads to the symmetric parasagittal hemispheric infarcts. Mild hypoperfusion causes damage of the cortex, most often around sulcus centralis, interhemispheric fissura and insula, which is accompanied by changes in the adjacent subcortical white matter.
Brain magnetic resonance imaging in newborns with HIE can affect the indication of the other diagnostic investigations and therapeutical interventions and predict the prognosis of the disease.

Keywords: hypoxic-ischemic encephalopathy, magnetic resonance imaging, newborn

Grants and funding:

Práce byla podpořena grantem UP: IGA_LF_2016_004 a RVO: LF UP 61989592.

Accepted: September 15, 2016; Published: September 1, 2016  Show citation