Journal of Developmental Medicine(Electronic Version)  2018, Vol. 6 Issue (4): 225-230 DOI: 10.3969/j.issn.2095-5340.2018.04.007 |
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| Research of magnetic resonance imaging and neurological prognosis in asphyxiated neonates |
| HUA Guo-wei，YU Min， JIANG Kai-hua, ZHENG Ai-bin, LI Hong-xin
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1 (1.Department of Neonatology,the Affiliated Changzhou Children’s Hospital of Nantong University, Jiangsu, Changzhou 213003, China;2.Medical School of Nantong University, Jiangsu, Nantong 226001, China)
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Abstract 【Abstract】 Objective To study the correlation about magnetic resonance imaging (MRI) findings and
relevant clinical data and neurological prognosis of asphyxiated neonates. Methods From January 2013 to December 2015, the full-term newborns with asphyxia were admitted to the neonatology department of
the Affiliated Changzhou Children's Hospital of Nantong University, and totally 46 cases with complete
data were studied. All the neonates were conducted by MRI examination at the age of 6~14 days and their
clinical data were collected. Mental development index (MDI) and psychomotive development index (PDI)
were calculated at the age of 12 months according to children's developmental center of China (CDCC).
The statistical analysis was carried out by t test, χ2 test or Fisher exact probability method. Results
The severe asphyxia group were higher (all P ﹤ 0.05) than the mild asphyxia group in the proportion
of abnormal CDCC scores of severe asphyxia group and mild asphyxia group［66.7% (16/24) vs 22.7%
(5/22)］, the proportion of abnormal MRI ［79.2% (19/24) vs 36.4% (8/22)］, the rate of abnormal basal
ganglia/thalamus ［45.8% (11/24) vs 9.1% (2/22)］ and the incidence of hypoxic-ischemic encephalopathy
(HIE) ［91.7% (22/24) vs 22.7% (5/22)］ . In the 27 cases of neonates with abnormal MRI results, 13
cases were abnormal basal ganglia/thalamus and 14 cases were normal basal ganglia/thalamus. The basal
ganglia/thalamus abnormal group were higher (all P ﹤ 0.05) than the normal basal ganglia/thalamus
in the incidence of abnormal both in PDI and MDI ［61.5% (8/13) vs 7.1% (1/14)］, the duration of
convulsions ［(96.3±24.9) vs (67.8 ± 18.6) hours］; the abnormal basal ganglia/thalamus were lower
than the basal ganglia/thalamus normal group (all P ﹤ 0.05) in the 5 minutes Apgar score ［(3.6 ± 2.1)
vs (5.2 ± 1.9) scores］ and the umbilical cord blood pH value ［(6.91±0.21) vs (7.06±0.18)］ . CDCC
score of abnormal group were higher than the normal group in the abnormal MRI rate ［(85.7%(18/21)
vs 16.0% (4/25)］ and the duration of convulsions ［(76.1±49.9) vs (39.9±34.1) hours］; CDCC score
of abnormal group were lower than the CDCC score normal group(all P ﹤ 0.05) in the 5 minutes Apgar
score ［(5.1±2.9) vs (6.6±2.1) scores］, the umbilical cord blood pH value ［(6.92±0.29) vs (7.05±0.21)］
and the rate of good follow-up compliance ［28.6% (6/21) vs 60.0% (15/25)］. Conclusions MRI
examination has some value in the evaluation of neurological prognosis in asphyxiated neonates. It is more
likely to cause motor dysfunction if the injured sites are in basal ganglia/thalamus area. The neurological
symptoms and MRI findings should be paid attention in neonates with asphyxiation and the early
intervention in high-risk neonates should be strengthened.
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Received: 03 April 2018
Published: 20 November 2018
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