Title:Intracranial Imaging of Preterm Infants with Suspected Hypoxic Ischemic
Encephalopathy: Comparing MRI and Ultrasound
Volume: 19
Issue: 2
Author(s): Simon S. Ho*, Yujia Zhou and Dhanashree Rajderkar
Affiliation:
- Department of Radiology, College of Medicine, University of Florida, Gainesville FL, USA
Keywords:
Hypoxic ischemic injury, neonatal low birth weight, MRI, ultrasound, germinal matrix hemorrhage, hydrocephalus.
Abstract:
Aims: We correlate ultrasound, MRI, and clinical findings in neonates with suspected
hypoxic ischemic injury.
Background: Recent advances in neuroimaging have led to improved detection of subtle insults associated
with neurodevelopmental outcomes, beyond more historically described lesions such as
large hemorrhages and hydrocephalus.
Objective: In this study, we compare cranial ultrasound to MRI for the evaluation of suspected HIE
in preterm infants.
Methods: 147 premature infant patients with paired ultrasound and MRI exams were retrospectively
analyzed to compare imaging finding accuracy and clinical value.
Result: We confirm that ultrasound is highly sensitive and specific for hydrocephalus, ventricular
prominence, and gross structural abnormalities. Ultrasound is not a substitute for MRI in cases of
small hemorrhages or white matter injury, however, certain US findings were associated with Apgar
score and MRI sequelae of HIE.
Conclusion: Choosing between ultrasound and MRI for preterm neonates at risk for intracranial abnormalities
based on their strengths can reduce cost and maximize clinical utility. MRI provides a
highly sensitive identification of subtle brain injury, yet ultrasound is correlated with the peripartum
clinical picture as measured by Apgar score.
