Association between Early Basal Ganglia and Thalami Perfusion Assessed by Color Doppler Ultrasonography and Brain Injury in Infants with Hypoxic-Ischemic Encephalopathy: A Prospective Cohort Study

To evaluate associations between neurologic outcomes and early measurements of basal ganglia (BG) and thalamic (Th) perfusion using color Doppler ultrasonography (CDUS) in infants with hypoxic-ischemic encephalopathy (HIE). Prospective study of infants with mild (n = 18), moderate (n = 17), and seve...

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Vydáno v:The Journal of pediatrics Ročník 271; s. 114086
Hlavní autoři: Faingold, Ricardo, Prempunpong, Chatchay, Garfinkle, Jarred, St Martin, Christine, Menegotto, Flavia, Boyle, Rose, Aguilera, Jean Marc, Nguyen, Kim-Anh, Sant’Anna, Guilherme M.
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Elsevier Inc 01.08.2024
Témata:
brain perfusion
neonatal encephalopathy
neurodevelopmental impairment
CDUS
neurodevelopmental impairment
BG
HIE
MRI
CBF
EEG
HUS
brain perfusion
ROI
POCUS
AUC
BGW
Th
neonatal encephalopathy
RI
NIRS
GMFCS
ISSN:0022-3476, 1097-6833, 1097-6833
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Shrnutí:To evaluate associations between neurologic outcomes and early measurements of basal ganglia (BG) and thalamic (Th) perfusion using color Doppler ultrasonography (CDUS) in infants with hypoxic-ischemic encephalopathy (HIE). Prospective study of infants with mild (n = 18), moderate (n = 17), and severe HIE (n = 14) and controls (n = 17). Infants with moderate-severe HIE received therapeutic hypothermia (TH). CDUS was performed at 24-36 hours and brain magnetic resonance imaging (MRI) at a median of 10 days. Development was followed through 2.5-5 years. The primary outcome was the association between BG and Th perfusion and brain MRI injury. Secondary analyses focused on associations between perfusion measurements and admission neurologic examinations, MRI scores in infants treated with TH, and motor and sensory disability, or death. An exploratory analysis assessed the accuracy of BG and Th perfusion to predict brain MRI injury in infants treated with TH. Increased BG and Th perfusion on CDUS was observed in infants with severe MRI scores and those with significant motor and neurosensory disability or death through 2.5-5 years (P < .05). Infants with severe HIE showed increased BG and Th perfusion (P < .005) compared with infants with moderate HIE. No differences were identified between the between the control and mild HIE groups. Th perfusion ≥0.237 cm/second (Area under the curve of 0.824) correctly classified 80% of infants with severe MRI scores. Early dynamic CDUS of the BG and Th is a potential biomarker of severe brain injury in infants with HIE and may be a useful adjunct to currently used assessments.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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content type line 23
ISSN:0022-3476
1097-6833
1097-6833
DOI:10.1016/j.jpeds.2024.114086