Cerebral Pulsed Arterial Spin Labeling Perfusion Weighted Imaging Predicts Language and Motor Outcomes in Neonatal Hypoxic-Ischemic Encephalopathy

Frontiers in Pediatrics

article

Qiang Zheng¹  Michael A. Padula²  Sara B. Demauro²  John Flibotte²  Eric C. Eichenwald²  John A. Detre³  Raymond Wang Sze²  Hao Huang²  Misun Hwang²  Juan Sebastian Martin-Saavedra²  Sandra Saade-Lemus²  Arastoo Vossough²  Giulio Zuccoli²  Fabrício Guimarães Gonçalves²  Colbey W. Freeman³  Minhui Ouyang²  Varun Singh⁴ 

[1] Yantai University;Children's Hospital of Philadelphia, United States;University of Pennsylvania, United States;Thomas Jefferson University, United States

关键词: arterial spin labeling;    hypoxic ischemic encephalopathy;    neonate;    perfusion imaging;    perfusion weighted imaging (PWI);   

DOI  :  10.3389/fped.2020.576489

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Rationale and Objectives: To compare cerebral pulsed arterial spin labeling (PASL) perfusion among controls, hypoxic ischemic encephalopathy (HIE) neonates with normal conventional MRI(HIE/MRI⊕), and HIE neonates with abnormal conventional MRI(HIE/MRI⊖). To create a predictive machine learning model of neurodevelopmental outcomes using cerebral PASL perfusion. Materials and Methods: A total of 73 full-term neonates were evaluated. The cerebral perfusion values were compared by permutation test to identify brain regions with significant perfusion changes among 18 controls, 40 HIE/MRI⊖ patients, and 15 HIE/MRI⊕ patients. A machine learning model was developed to predict neurodevelopmental outcomes using the averaged perfusion in those identified brain regions. Results: Significantly decreased PASL perfusion in HIE/MRI⊖ group, when compared with controls, were found in the anterior corona radiata, caudate, superior frontal gyrus, precentral gyrus. Both significantly increased and decreased cerebral perfusion changes were detected in HIE/MRI⊕ group, when compared with HIE/MRI⊖ group. There were no significant perfusion differences in the cerebellum, brainstem and deep structures of thalamus, putamen, and globus pallidus among the three groups. The machine learning model demonstrated significant correlation ( p < 0.05) in predicting language( r = 0.48) and motor( r = 0.57) outcomes in HIE/MRI⊖ patients, and predicting language( r = 0.76), and motor( r = 0.53) outcomes in an additional group combining HIE/MRI⊖ and HIE/MRI⊕. Conclusion: Perfusion MRI can play an essential role in detecting HIE regardless of findings on conventional MRI and predicting language and motor outcomes in HIE survivors. The perfusion changes may also reveal important insights into the reperfusion response and intrinsic autoregulatory mechanisms. Our results suggest that perfusion imaging may be a useful adjunct to conventional MRI in the evaluation of HIE in clinical practice.

【 授权许可】

CC BY