Neonatal Hypoxic-ischemic Encephalopathy: Detection with Diffusion-weighted MR Imaging
Kirsten P. N. Forbesa,
James G. Pipea and
Roger Birda
a From the Division of Neuroradiology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W Thomas Rd, Phoenix, AZ 85013. Address reprint requests to Kirsten Forbes, MRCP, FRCR.
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FIG 1. Subject 4: watershed ischemia.
A, T1-weighted image shows hypointensity bilaterally in the anterior and posterior watershed areas.
B, T2-weighted image shows hyperintensity in the same areas, suggesting edema.
C, Anisotropic diffusion-weighted image (z gradient) shows corresponding signal hyperintensity.
D, Isotropic ADC map confirms a decrease in water diffusion with hypointensity in all watershed regions, most prominently seen in left posterior watershed area.
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FIG 2. Subject 10: deep gray matter ischemia.
A and B, T1-weighted (A) and T2-weighted (B) images show hyperintensity in the thalami and lentiform nuclei.
C and D, Anisotropic diffusion-weighted image (z gradient) (C) and isotropic ADC map (D) confirm normal water diffusion.
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FIG 3. Cortical injuries: correlation between image timing and ADC changes. The age of each subject with cortical ischemic damage is shown. ADC changes within the ischemic region were calculated using normal published values (16), with error bars shown (SD). All subjects except case 12 (day 11) had a significant decrease in ADC values
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FIG 4. Thalamic injuries: correlation between image timing and ADC changes. The age of each subject with thalamic ischemic damage is shown. Four imaging studies show a significant decrease in ADC: subjects 5 (day 2); 12 (days 4 and 11), and 13 (day 9)
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