Early MRI features and their prognosis value in neonatal cerebral infarction

HE Si-ping; WANG Hai; XU He-ping; CHEN Hua; WANG Sheng; LUO Wei-hua

Journal of China Clinic Medical Imaging ›› 2015, Vol. 26 ›› Issue (3) : 157-161.

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Early MRI features and their prognosis value in neonatal cerebral infarction

HE Si-ping, WANG Hai, XU He-ping, CHEN Hua, WANG Sheng, LUO Wei-hua

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Abstract

Objective: To investigate the early MRI features of arterial ischemic stroke in middle cerebral artery(MCA) in full term neonate and evaluate their prognostic value in motor function. Methods: Early MRI appearances and clinical follow-up records of motor developments from birth to 1 year in 26 full term neonates with MCA ischemic strokes were retrospectively analyzed. All patients underwent conventional MRI and DWI examination by Siemens Avanto 1.5 Tesla scanner. SWI sequence was added in 6 cases. Correlation between MR findings and motor prognosis was assessed by Fisher exact test. Results: Among all the 26 cases, 12 had mixed infarctions, and 14 had superficial infarctions. Conventional MRI showed big patchy slight hypointensity on T1WI and slight hyperintensity on T2WI in the affected areas with poor differentiation of grey and white matter. Cortical necrosis was found in 6 cases. DWI showed hyperintense lesions and reduced ADC in the infarction. The delineation of the lesions was better in DWI than routine MRI. The corticospinal tract was involved in 16 cases (mixed infarctions in 12 cases, superficial infarctions in 4 cases), thalamus was involved in 14 cases, and corpus callosum was involved in 6 cases. Mixed infarctions(P＜0.05) and corticospinal tract involvement(P＜0.05) were highly predictive of hemiplegia. Conclusion: Cortical necrosis and involvement of corticospinal tract, thalamus and corpus callosum may be presented in the early MCA ischemic stroke in full term neonates. DWI can show the infarction and involvement areas, and estimate the prognosis at the early stage.

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Infarction / middle cerebral artery / Infant / newborn / Magnetic resonance imaging

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HE Si-ping;WANG Hai;XU He-ping;CHEN Hua;WANG Sheng;LUO Wei-hua. Early MRI features and their prognosis value in neonatal cerebral infarction[J]. Journal of China Clinic Medical Imaging. 2015, 26(3): 157-161