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.
Keywords: Hypoxic ischemic injury, neonatal low birth weight, MRI, ultrasound, germinal matrix hemorrhage, hydrocephalus.
Graphical Abstract