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• Clinical Article •
Value of 3D arterial spin labeling in early diagnosis and prognostic grouping of full-term neonatal hypoxic-ischemic encephalopathy
LIU Chang  JI Haixia  TIAN Yanghua  HOU Weishu  YIN Dawei  DENG Kexue 

Cite this article as: LIU C, JI H X, TIAN Y H, et al. Value of 3D arterial spin labeling in early diagnosis and prognostic grouping of full-term neonatal hypoxic-ischemic encephalopathy[J]. Chin J Magn Reson Imaging, 2023, 14(1): 61-66, 76. DOI:10.12015/issn.1674-8034.2023.01.011.


[Abstract] Objective To investigate the value of 3D arterial spin labeling (3D ASL) perfusion imaging and diffusion weighted imaging (DWI) for the early diagnosis of hypoxic-ischemic encephalopathy (HIE) in term neonates and the predictive value of 3D ASL for patient prognosis.Materials and Methods A total of 40 cases of full-term neonates clinically diagnosed with HIE in our hospital from December 2017 to May 2022 and 40 control group were selected. All HIE neonates were divided into favourable outcome and adverse outcome groups according to their prognosis,and all subjects underwent 3D ASL and DWI simultaneously to compare cerebral blood flow (CBF) and apparent diffusion coefficient (ADC) in each region of interest and analyze the agreement. The areas of interest included bilateral basal ganglia, thalamus, and frontal white matter, and the final average was bilaterally taken.To investigate the correlation between CBF value of HIE in neonates and Neonatal Behavioral Neurological Assessment (NBNA), the relationship between early changes of CBF value and prognosis of neonates with HIE.Results (1) The CBF values of basal ganglia and thalamus in the poor prognosis group were higher than those in the good prognosis group, and the difference was statistically significant (P＜0.001); (2) The area under the ROC curve for CBF values was 0.973, and the specificity and sensitivity of CBF values were 90.2% and 97.5%; the area under the receiver operating characteristic (ROC) curve for ADC values was 0.881, and the sensitivity and specificity were 82.5% and 92.7%; (3) CBF values in the basal ganglia and thalamus were highly correlated with NBNA scores (r=-0.8196, P＜0.001; r=-0.8504, P＜0.001).Conclusions ASL findings within 3 days after birth in full-term neonates were highly correlated with NBNA scores. It can diagnose HIE early and predict the outcome of functional brain damage with better diagnostic efficacy than DWI.
[Keywords] neonatus；hypoxic ischemia encephalopathy；magnetic resonance imaging；diffusion weighted imaging；arterial spin labeling；cerebral blood flow；neonatal behavioral neurological assessment；prognosis；early diagnosis；prediction

LIU Chang1   JI Haixia2   TIAN Yanghua2   HOU Weishu3   YIN Dawei1   DENG Kexue1*  

1 Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230031, China

2 Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China

3 Department of Radiology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China

Corresponding author: Deng KX, E-mail: dengkexue-anhui@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS National Natural Science Found of China (No. 32071054); Natural Science Foundation of Anhui Province (No. 2008085QH381).
Received  2022-07-28
Accepted  2022-11-10
DOI: 10.12015/issn.1674-8034.2023.01.011
Cite this article as: LIU C, JI H X, TIAN Y H, et al. Value of 3D arterial spin labeling in early diagnosis and prognostic grouping of full-term neonatal hypoxic-ischemic encephalopathy[J]. Chin J Magn Reson Imaging, 2023, 14(1): 61-66, 76. DOI:10.12015/issn.1674-8034.2023.01.011.

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