The correlation between apparent diffusion coefficient and neonatal behavioral neurological assessment in hypoxic ischemic encephalopathy / 中华放射学杂志

ABSTRACT

Objective To explore the correlation between apparent diffusion coefficient(ADC)and neonatal behavioral neurological assessment(NBNA) of newborns with hypoxic ischemic encephalopathy (HIE),and to evaluate ADC in the early diagnosis of HIE from the imaging perspective. Method One hundred and nine neonates aged 0—7 days with HIE underwent conventional MRI and DWI. According to HIE grading standards, there were 43 neonates in the mild group, 38 in the moderate group, 28 in the severe group, and meanwhile 24 normal neonates with the same ages were selected as the control group. All cases were assessed with NBNA, and ADC values of bilateral frontal white matter, parietal white matter, periventricular white matter, posterior limb of the internal capsule(PLIC), ventral lateral nucleus of thalamus, lenticular nucleus, splenium of the corpus callosum, brainstem were measured. ADC values of different groups were compared by analysis of variance, and the correlations between ADC values of all ROIs and NBNA were analyzed by Pearson correlation. Results Except lenticular nucleus and the brainstem, ADC values of frontal white matter, parietal white matter, periventricular white matter and PLIC, ventral lateral nucleus of thalamus, splenium of the corpus callosum were decreased in the mild, moderate, severe group. In the mild, moderate, and severe group, the ADC values of frontal deep white matter were(1.82± 0.33)× 10-3,(1.77 ± 0.34)× 10-3 and(1.62 ± 0.31)× 10-3 mm2/s,while they were(1.81 ± 0.34)× 10-3,(1.79 ± 0.27)× 10-3 and(1.72 ± 0.31)× 10-3 mm2/s for the parietal deep white matter,(1.27 ± 0.15)× 10-3,(1.23 ± 0.12)× 10-3 and(1.15 ± 0.17)× 10-3 mm2/s for the periventricular white matter,(1.08 ± 0.09)× 10-3,(0.97 ± 0.07)×10-3 and(0.84±0.06)×10-3 mm2/s for the PLIC,(1.13±0.07)×10-3 ,(1.08±0.13)×10-3 and(1.00± 0.13)× 10-3 mm2/s for the ventral lateral nucleus of thalamus,(1.27 ± 0.22)× 10-3,(1.18 ± 0.16)× 10-3 and (1.00 ± 0.23)× 10-3 mm2/s for the splenium of the corpus callosum. There were statistically significant differences between the 3 groups (F=61.27,16.27, 23.26, 72.70, 26.73, 66.09,all P<0.05). In the mild, modreate and severe group, NBNA were(36.8 ± 1.4) in the mild group,(33.5 ± 1.6) in the moderate,and (29.3 ± 2.6) in the severe group. There was positive correlation between ADC values of frontal white matter, parietal white matter, periventricular white matter and PLIC, ventral lateral nucleus of thalamus, splenium of the corpus callosum and NBNA scores(r=0.60,0.49,0.54,0.67,0.56,0.65,all P<0.05). Conclusions There are correlations between ADC values of the related ROIs of HIE and NBNA scores. Combining two aspects might diagnose the brain injury of HIE more accurately and objectively.