Magnetic Resonance Imaging versus Proton Magnetic Resonance Spectroscopy in Neonatal Hypoxic Ischemic Encephalopathy in Egyptian Population: Pilot study

Ossama Y Mansour*, Doaa Hanfy, Sameh Fathy and Rania E Mohammed,

Background: Hypoxic-ischemic encephalopathy (HIE) is a serious condition that results of critical failure of the intrapartum gas exchange and may lead to a signifi cant damage in the central nervous system.

Objective: to elucidate the role of brain magnetic resonance imaging (MRI) versus Proton magnetic resonance spectroscopy (1H-MRS) in the diagnosis and evaluating the severity of HIE in full-term Egyptian neonates

Design: 49-months observational controlled study.

Setting: Pediatric neurology and Radiology Departments, Alexandria University Hospital       

 Patients and Methods: Thirty full-term neonates in the fi rst two weeks with HIE (Sarnat staging) were included (18 males and 12 females), with exclusion of those with congenital brain malformation and/ or
perinatal infection in addition to 15 age- and sex- matched healthy controls. All patients and controls were
examined with brain MRI and 1H-MRS.

Results: In neonates with HIE, the percent of agreement between clinical staging, and MRI grading
was 66.67 while it was 76.67 regarding 1H-MRS grading. The sensitivity for MRI was 66.67%, specifi city
was 75%, accuracy was 77.78%, PPV was 80% and NPV was 75%. Meanwhile, the sensitivity for 1H-MRS
was 92%, specifi city was 75%, accuracy was 84.44%, PPV was 82.14% and NPV was 88.24%.

Conclusion: 1H-MRS detected more percent of agreement, true positive and less false negative cases
than MRI. Despite the equal specifi city between them, still 1H-MRS got more sensitivity, accuracy, PPV
and NPV than MRI i.e. when we have to choose early and single investigation it is recommended to choose
1H-MRS.

Keywords: Full-term; Neonates; Hypoxic-ischemic encephalopathy; MRI; 1H-MRS

Published on: Aug 30, 2017 Pages: 43-50

Full Text PDF Full Text HTML DOI: 10.17352/jnnsd.000020
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