Purpose or Case Report: Insult to developing neonatal brain can significantly impair motor, cognitive, language and behavioral functions. MR imaging is an indispensable investigation for the evaluation of neonatal encephalopathy due to its high sensitivity, specificity and prognostic utility. MRI with its recent advancements can yield valuable information on morphology, neuronal connectivity, structural and functional architecture of gray and white matter.
Methods & Materials: We intend to present and discuss the optimization of neonatal brain imaging, challenges in acquisition and interpretation and the spectrum of findings in various encephalopathies. Spectrum includes a total of 40 neonates who underwent MR imaging on a 3T MR system.
Results: Neonatal brain has higher concentration of water and lower concentrations of proteins and lipids impacting the tissue contrast on imaging which requires specific parameter optimization. Moreover, edema resulting from neuronal injury tends to be subtle due to the inherent T2W hyperintensity of the white matter. Causes of neonatal encephalopathy include hypoxic ischemic injury (HII), metabolic causes like bilirubin encephalopathy and hypoglycemia, congenital and acquired infections, birth trauma and inborn errors of metabolism. Of 40 neonates, 29 had HII out of which 4 had co existing sepsis. Among the remaining 11 neonates, 4 had infective encephalopathy, 4 had acute bilirubin encephalopathy, 2 had hypoglycemic encephalopathy, and 2 had encephalopathy secondary to inborn errors of metabolism.
Conclusions: Recognizing the morphology, patterns and topographic distribution of signal abnormalities on MR imaging plays an imperative role in the diagnosis and prognostication of various causes of neonatal encephalopathy. Diffusion weighting and MR spectroscopy are of significant additive value.