Amide proton transfer and apparent diffusion coefficient analysis reveal susceptibility of brain regions to neonatal hypoxic-ischemic encephalopathy.

ABSTRACT

Purpose: To identify brain regions affected by Hypoxic-Ischemic Encephalopathy (HIE) in neonates using Amide Proton Transfer (APT) imaging and Apparent Diffusion Coefficient (ADC). Materials and methods: Twenty neonates were divided into HIE and control groups. All neonates were undergoing MRI, including APT and DWI. Imaging analysis was performed using SPM12. The independent-samples t-test was used to analyze the difference in APTw values and ADC values between the mild HIE neonates and the control group. The receiver operating characteristic (ROC) curves were established to assess the diagnostic values of APTw and ADC values in different brain regions for HIE. Pearson's correlation analysis was used to analyze the correlation between APTw values and ADC values for each region. Results: APTw values were significantly higher in 26 regions of the HIE group. ADC values were lower in the right anterior temporal lobe and higher in bilateral Subthalamic nucleus in HIE. The APTw values of 22 regions showed very high area under the curve (AUC), whereas the AUC of ADC values in right anterior temporal lobe and right subthalamic nucleus were both 0.802. Notably, the right anterior temporal lobe exhibited significant differences in both APTw and ADC values between the HIE and control groups, additionally, APTw value was significant positive correlated with ADC values in right anterior temporal lobe. Conclusion: APTw and ADC are effective in detecting HIE, with APTw being more sensitive. The right anterior temporal lobe is particularly affected by HIE, with significant changes in APTw and ADC values and a positive correlation between them. This suggests that temporal lobe damage may be critical in the long-term neurological consequences of HIE.