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AJNR - American Journal of Neuroradiology

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Differentiating Normal Myelination from Hypoxic-Ischemic Encephalopathy on T1-Weighted MR Images: A New Approach

L. Liauw^a, I.H. Palm-Meinders^a, J. van der Grond^a, L.M. Leijser^a, S. le Cessie^b, L.A.E.M. Laan^c, B.C. Heeres^a, M.A. van Buchem^a and G. van Wezel-Meijler^d

^a Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
^b Department of Medical Statistics and Bio-Informatics, Leiden University Medical Center, Leiden, the Netherlands
^c Department of Neurology Leiden University Medical Center, Leiden, the Netherlands
^d Department of Neonatology, Leiden University Medical Center, Leiden, the Netherlands

View larger version (30K): [in this window] [in a new window]   Fig 1. Mean total SI scores of all structures on T1-weighted images. There is a statistically significant difference in mean total SI scores between controls and HIE infants for PP, PC, PLIC, and CR.

View larger version (5K): [in this window] [in a new window]   Fig 2. A, Flow chart comprising all infants. B, Flow chart comprising infants with ages at imaging of 28 days or younger.

View larger version (102K): [in this window] [in a new window]   Fig 3. Term-born infant with a closed bifid spine. T1-weighted image (TR/TE, 550/14; signals acquired, 2; matrix, 205 x 256; section thickness, 5 mm; section gap, 0.5 mm; FOV, 16 cm) of the infant from the control group at 2 days of age. The image shows higher SI in the PLIC than in the PP. The flow chart predicted the infant to come from the control group.

View larger version (86K): [in this window] [in a new window]   Fig 4. Term-born infant with a small dimple at the back and without neurologic symptoms. T1-weighted image (TR/TE, 640/16; signals acquired, 2; matrix, 205 x 256; section thickness, 5 mm; section gap, 0.5 mm; FOV, 16 cm) of the infant from the control group at 8 days of age. The image shows higher SI in the CR than in the PC. The flow chart predicted the infant to come from the control group.

View larger version (127K): [in this window] [in a new window]   Fig 5. An infant born at a gestational age of 40+4 weeks with cesarean delivery for fetal distress who had an Apgar score of 0–4–5. Resuscitation was required, and there were no brain stem reflexes. T1-weighted image (TR/TE, 550/14; signals acquired, 2; matrix, 205 x 256; section thickness, 5 mm; section gap, 0.5 mm; FOV, 16 cm) of the infant from the HIE group at 3 days of age. The image shows higher SI in the PP than in the PLIC and abnormal SI in the lateral thalami. The flow chart predicted the infant to come from the HIE group.

View larger version (127K): [in this window] [in a new window]   Fig 6. Term-born infant of a mother with solutio placentae. T1-weighted image (TR/TE, 550/14; signals acquired, 2; matrix, 205 x 256; section thickness, 5 mm; section gap, 0.5 mm; FOV, 16 cm) of the infant from the HIE group at 10 days of age. The image shows higher SI in the PC than in the CR. T1-weighted imaging also showed (not shown here) equal SI in the PP and the PLIC. The flow chart predicted the infant to come from the HIE group.