American Journal of Neuroradiology, Vol 16, Issue 4 685-692, Copyright © 1995 by American Society of Neuroradiology
ARTICLES |
Patterns and implications of MR contrast enhancement in perinatal asphyxia: a preliminary report
KD Westmark, AJ Barkovich, A Sola, D Ferriero and JC Partridge
Department of Neuroradiology, University of California, San Francisco 94143-0628, USA.
PURPOSE: To determine the presence and location of MR contrast enhancement in infants with perinatal asphyxia and to evaluate the utility of enhancement in assessing extent of brain damage. METHODS: Precontrast and postcontrast MR examinations within the first 10 days of life were evaluated in 10 infants with suspected hypoxic-ischemic birth injury. Findings were correlated with clinical birth history and short-term neurologic follow-up. RESULTS: All four infants with MR signal abnormalities and contrast enhancement in the basal ganglia and brain stem had early seizures and profound neurologic deficits at early follow-up. Two infants had abnormal scans but no contrast enhancement; one with MR signal abnormality within the basal ganglia is neurologically healthy at 10-month follow-up, whereas the other, in status epilepticus at the time of imaging at age 2 days, died. Two infants with minimal parasagittal subcortical white matter enhancement had no early seizure activity and only mild developmental delay at early follow-up. Two infants with normal precontrast and postcontrast MR had no early seizures and remain healthy at early follow-up, despite initial clinical parameters similar to more severely injured infants. CONCLUSION: Although the number of patients is small, our results indicate that the presence of contrast enhancement in asphyxiated neonates may indicate more severe brain damage and, hence, a poorer prognosis.
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