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@article{Montaldo:2015:10.1016/j.ejpn.2015.07.006,
author = {Montaldo, P and Chaban, B and Lally, PJ and Sebire, NJ and Taylor, AM and Thayyil, S},
doi = {10.1016/j.ejpn.2015.07.006},
journal = {European Journal of Paediatric Neurology},
pages = {665--671},
title = {Quantification of ante-mortem hypoxic ischemic brain injury by post-mortem cerebral magnetic resonance imaging in neonatal encephalopathy},
url = {http://dx.doi.org/10.1016/j.ejpn.2015.07.006},
volume = {19},
year = {2015}
}

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TY  - JOUR
AB  - Post-mortem (PM) magnetic resonance imaging (MRI) is increasingly used as an alternative to conventional autopsy in babies dying from neonatal encephalopathy. However, the confounding effect of post-mortem changes on the detection of ante-mortem ischemic injury is unclear. We examined whether quantitative MR measurements can accurately distinguish ante-mortem ischemic brain injury from artifacts using post-mortem MRI.Methods:We compared PM brain MRI (1.5 T Siemens, Avanto) in 7 infants who died with neonatal encephalopathy (NE) of presumed hypoxic-ischemic origin with 7 newborn infants who had sudden unexplained neonatal death (SUND controls) without evidence of hypoxic-ischemic brain injury at autopsy. We measured apparent diffusion coefficients (ADCs), T1-weighted signal intensity ratios (SIRs) compared to vitreous humor and T2 relaxation times from 19 predefined brain areas typically involved in neonatal encephalopathy.Results:There were no differences in mean ADC values, SIRs on T1-weighted images or T2 relaxation times in any of the 19 predefined brain areas between NE and SUND infants. All MRI images showed loss of cortical gray/white matter differentiation, loss of the normal high signal intensity (SI) in the posterior limb of the internal capsule on T1-weighted images, and high white matter SI on T2-weighted images.Conclusion:Normal post-mortem changes may be easily mistaken for ante-mortem ischemic injury, and current PM MRI quantitative assessment cannot reliably distinguish these. These findings may have important implications for appropriate interpretation of PM imaging findings, especially in medico-legal practice.
AU  - Montaldo,P
AU  - Chaban,B
AU  - Lally,PJ
AU  - Sebire,NJ
AU  - Taylor,AM
AU  - Thayyil,S
DO  - 10.1016/j.ejpn.2015.07.006
EP  - 671
PY  - 2015///
SN  - 1090-3798
SP  - 665
TI  - Quantification of ante-mortem hypoxic ischemic brain injury by post-mortem cerebral magnetic resonance imaging in neonatal encephalopathy
T2  - European Journal of Paediatric Neurology
UR  - http://dx.doi.org/10.1016/j.ejpn.2015.07.006
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000363346400008&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
VL  - 19
ER  -

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