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Abstract #0254

Prognostic Significance of Combined Diffusion Weighted Imaging & Magnetic Resonance Spectroscopy in Neonates with Hypoxic Ischemic Injury

Eva-Maria Ratai1, Jason M. Johnson2, Bindu Setty2, Joseph Chou3, Kalpathy Krishnamoorthy4, Paul Caruso2, P Ellen Grant5

1Radiology, A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital , Charlestown, MA, United States; 2Radiology, Massachusetts General Hospital, United States; 3Pediatric Medical Services / Neonatal ICU, Massachusetts General Hospital, United States; 4Pediatric Neurology, Massachusetts General Hospital, United States; 5Radiology, Childrens Hospital Boston, United States

The goal of this study was to investigate the prognostic values of ADC and MRS in neonatal hypoxic ischemic injury within 5 days of life. Eight of 17 patients died before discharge from the hospital and nine had unfavorable outcome including severe developmental delay. Low concentrations of N-acetylaspartate, choline, creatine and low ADC values in the basal ganglia were predictive of poor outcome. High glutamate/glutamine levels were also associated with poor outcome. Spearman Rank analysis between ADC and spectroscopic markers revealed significant correlations between ADC and choline as well as ADC and N-Acetylaspartate. No correlation with lactate was found.

Keywords

absolute affect approximately assessment association basal best better bold cause cell cells characteristic child choline classified combined concentrations consistent context continues correlate correlated correlation cortex days death decrease delay delayed denominator detection determine developmental died diffusion disorder early elevated emerged evidence exam except excessive excluded favorable focuses furthermore ganglia general glutamate goal gradient hand highlighted highly home hospital ideal identified immediate important indicating infection influence inherited injury insult interestingly killed lack lactate lies life likely malformations maria marker markers medical metabolic mild moderate morbidity mortality necrosis needed neonatal neonates nerve neurology none normalization occipital outcome outcomes package parietal pathological patients peak pediatric placed poor potential potentially pour predict prediction predictive prior processes prognosis prognostic pseudo radiology rank rapidly receiver relationship reliable reported reporting retrospective retrospectively revealed search seizure separation severe severity software spectroscopic spectroscopy starting statistical stores studies survival suspected table term therapy timing transl uncertain unfavorable versus weeks white yield