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Neonatal encephalopathy: a prospective comparison of head US and MRI

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Abstract

Background

Head US, the cornerstone neuroimaging modality in neonates, is believed to be less sensitive than MRI for detecting hypoxic ischemic injury (HII). Most reports comparing these modalities are retrospective and have a long interval between the exams.

Objective

To prospectively characterize the range of abnormalities found in US examinations performed within 2 h of brain MRI in encephalopathic neonates.

Materials and methods

A total of 76 consecutive exams met our inclusion criteria. Diagnostic performance of the US images was prospectively compared with MRI.

Results

MRI was considered positive for HII in 53 neonates. Of the remaining 23, MRI was negative for HII in 9, showed white matter abnormalities unrelated to HII in 8, and was inconclusive in 6. Of the 70 neonates with conclusive examinations, the US exam was regarded as positive in 67. Diagnostic accuracy of US was 95.7%.

Conclusion

Our study demonstrates that US should still be regarded as a screening test in neonates. US is more sensitive for the detection of injury than previously reported, and more attention should be paid to proper US technique. MRI shows disease more extensively and should be accomplished as early as possible.

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Author information

Author notes

  1. Monica Epelman

    Present address: Children’s Hospital of Philadelphia, Philadelphia, PA, USA

  2. Christian J. Kellenberger

    Present address: Department of Diagnostic Imaging, University Children’s Hospital, Zürich, Switzerland

  3. Osnat Konen

    Present address: Imaging Department, Schneider Children’s Medical Center, Tel Aviv University, Tel Aviv, Israel

Authors and Affiliations

  1. Department of Diagnostic Imaging, Hospital for Sick Children, 555 University Ave, Toronto, Canada, M5G 1X8

    Monica Epelman, Alan Daneman, Christian J. Kellenberger, Osnat Konen & Susan Blaser

  2. Division of Neonatology, Hospital for Sick Children, Toronto, Canada

    Abdul Aziz & Hilary Whyte

  3. Department of Public Health Sciences, University of Toronto, Toronto, Canada

    Rahim Moineddin

Authors
  1. Monica Epelman
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  2. Alan Daneman
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  3. Christian J. Kellenberger
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  4. Abdul Aziz
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  5. Osnat Konen
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  6. Rahim Moineddin
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  7. Hilary Whyte
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  8. Susan Blaser
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Corresponding author

Correspondence to Alan Daneman.

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Epelman, M., Daneman, A., Kellenberger, C.J. et al. Neonatal encephalopathy: a prospective comparison of head US and MRI. Pediatr Radiol 40, 1640–1650 (2010). https://doi.org/10.1007/s00247-010-1634-6

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  • DOI: https://doi.org/10.1007/s00247-010-1634-6

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