Hill Ann,  Hirsig Leslie,  Yazdani Milad,  Collins Heather,  Jenkins Dorothea

Final Pr. ID: Poster #: SCI-015

MRS is the best prognostic indicator for hypoxic-ischemic encephalopathy (HIE) but is difficult to obtain early after injury. We investigated whether cerebral blood flow measures of resistive indices (RI) and time average maximum velocities (TAMx) shortly after birth would relate to later degree of neural injury by MRI in hypothermic HIE newborns. We predicted that abnormally high/low blood flow would be associated with poor outcomes. Read More

Authors:  Hill Ann , Hirsig Leslie , Yazdani Milad , Collins Heather , Jenkins Dorothea

Keywords:  Cerebral Blood Flow, Hypoxic Ischemic Encephalopathy (HIE), Magnetic Resonance Spectroscopy (MRS)

Iordanou James,  Kelsch Ryan

Final Pr. ID: Poster #: EDU-077

Hypoxic ischemic encephalopathy (HIE) is one of the most common causes of neurological injury in neonates. Given the variability of clinical manifestations, ranging from normal neurological outcomes to profound neurocognitive impairment or death, precise characterization is critical in prognostication. Evaluation is made more challenging by the unique morphologic features of the neonatal brain which constantly evolve as the nervous system matures. With this in mind, the timing of disease and duration of insult can produce characteristic imaging patterns. The timing of imaging is also crucial, as typical patterns may become occult or obscure in the subacute/chronic setting. Unexplained signal abnormalities seen in the neonate may also be erroneously attributed to HIE, when in fact another underlying disease process may be the etiology. The goal after viewing this exhibit is to have a clear and concise pattern based approach for the diagnosis and prognostication of HIE while highlighting important differentials that may mimic this disease.

The exhibit will review the most common morphologic patterns of hypoxic ischemic encephalopathy in neonates with perinatal HIE using sample brain MRI and ultrasound studies from our institution over the last 3 years. Initially focus will be placed on discussing subtypes and mechanisms of classic HIE based on the severity of the insult and duration of ischemia (mild/moderate acute, mild/moderate prolonged, severe acute, and severe prolonged). Characteristic schematic and imaging examples will be provided for each category. Additionally, for each pattern of injury several alternative diagnoses will be discussed which can mimic HIE in the term neonate, and imaging examples will be provided. The potential mimics will include developmental, vascular, infectious, metabolic, and congenital etiologies.

Understanding the variable patterns of HIE is paramount in providing both an accurate report and aiding in prognostication. Equally important is knowing and considering differential diagnoses for common mimics of HIE, which may dramatically alter management. Read More

Authors:  Iordanou James , Kelsch Ryan

Keywords:  Hypoxic Ischemic Encephalopathy (HIE), Neonatal Outcomes, MRI Brain

Le Phong,  Leschied Jessica,  Ledbetter Karyn

Final Pr. ID: Poster #: EDU-014

Hypoxic ischemic encephalopathy occurs in up to 1.5-2.5 per 1,000 live births in developed countries and can result in major neurologic deficits and mortality in the neonatal population. Currently, treatments are supportive and include moderate hypothermia which has demonstrated a significant reduction in disability and mortality in patients with moderate hypoxic ischemic encephalopathy. Despite improved mortality, morbidity in this patient population remains high with residual neurological deficits. This review will illustrate the patterns of brain injury as well as the imaging findings of neonatal hypoxic ischemic injury on ultrasound, CT, and MRI to assist with diagnosis and prognosis.
By completion of this exhibit, the learner will:
1. Review the anatomy of the neonatal brain on multiple modalities include ultrasound, CT, and MRI.
2. Be familiar with the patterns of brain injury in neonates.
3. Be able to identify the sonographic, CT, and MRI findings of neonatal hypoxic ischemic encephalopathy.
4. Understand the treatments and prognosis for neonatal hypoxic encephalopathy. Read More

Authors:  Le Phong , Leschied Jessica , Ledbetter Karyn

Keywords:  HIE

Vyas Rutvi,  Morton Sarah,  Nunes Deivid,  Song Yanan,  Grant Ellen,  Ou Yangming

Final Pr. ID: Paper #: 119

Hypoxic Ischemic Encephalopathy (HIE) occurs in 1-6/1000 livebirths often leading to death or neurological disability. Neonatal brain magnetic resonance imaging (MRI) is used to assess severity of brain injury and provide prognostic information in the newborn period. However, 20-50% HIE patients do not have early abnormal MRI findings detected by qualitative neuroradiologic evaluation and yet have adverse outcomes evident by 2 years of age. Our aim was to investigate whether quantitative MRI analysis can find subtle abnormalities that help improve prognostication and reduce the incidence of falsely reassuring neonatal MRI among infants with HIE. Read More

Authors:  Vyas Rutvi , Morton Sarah , Nunes Deivid , Song Yanan , Grant Ellen , Ou Yangming

Keywords:  HIE, neonates, Quantitative MRI