Magnetic resonance imaging in neonatal hypoxic-ischemic brain injury

Abstract

Nowadays many advanced MR imaging techniques are available for detection of hypoxic-ischemic brain injury in young infants. In tertiary referral centres and large children__s hospitals, these techniques are used on a regular basis. However, a considerable proportion of young infants with hypoxic-ischemic brain injury are imaged in primary and secondary care centres where experience with these advanced techniques is limited. Consequently, cranial ultrasonography and the conventional MR imaging techniques, such as T1- and T2-weighted imaging remain the mainstay of neonatal neuroimaging today. The purpose of this thesis was to study diagnostic and predictive MR imaging features of hypoxic-ischemic brain injury in young infants. We focused on T1-, T2-, and diffusion-weighted imaging, since these are applied on a large scale in primary and secondary centres. It may be anticipated that in the future, the use of these techniques will increase as experience with these techniques increases and access to MR imaging machines becomes more widespread. To identify all cases of neonatal hypoxic-ischemic brain injury and for optimal outcome prediction, a combination of diagnostic modalities is mandatory. For the diagnosis and outcome prediction of hypoxic-ischemic brain injury in young infants, clinical assessment, neuroimaging (cranial ultrasonography and MR imaging), and EEG are complementary.