Abstract
Background and aims: Deep grey matter lactate/N-acetylaspartate (Lac/NAA) peak area ratio on proton magnetic resonance spectroscopy (1H MRS) is the best predictor of neurological outcome following neonatal encephalopathy (NE). We evaluated the prognostic accuracy following therapeutic hypothermia (TH).
Methods: We performed magnetic resonance imaging (MRI) in consecutive term babies with NE, over a 3 year period before and after introduction of TH. Death or severe neurodisability (BSID 3) at 12 months was considered as an unfavourable outcome.
Results: Of 28 babies studied, 11 babies received TH. The median (range) age at MRI was 10 (5,12) days. Thalamic Lac/NAA (>0.29) had 100% sensitivity and specificity for predicting adverse outcome in both normothermic babies and cooled infants (Table 1). The mean (SD) Lac/NAA was high in infants who had unfavorable outcome (Figure 1)
Conclusions: The prognostic accuracy of 1H MRS deep gray matter Lac/NAA peak area ratios is unaltered by TH.
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Chandrasekaran, M., Thayyil, S., Bainbridge, A. et al. Prognostic Accuracy of Thalamic Proton Magnetic Resonance Spectroscopy Following Therapeutic Hypothermia in Neonatal Encephalopathy. Pediatr Res 70 (Suppl 5), 161 (2011). https://doi.org/10.1038/pr.2011.386
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DOI: https://doi.org/10.1038/pr.2011.386