PEDIATRICS Vol. 87 No. 4 April 1991, pp. 431-438
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Prospective Observations of 100 High-Risk Neonates by High-Field (1.5 Tesla) Magnetic Resonance Imaging of the Central Nervous System II. Lesions Associated With Hypoxic-Ischemic Encephalopathy

Susan E. Keeney MD1, Eugene W. Adcock MD1, and Craig B. McArdle MD1

1 From the Departments of Pediatrics and Radiology, University of Texas Medical School at Houston

One hundred neonates determined prospectively to be at risk for neurologic handicap underwent magnetic resonance imaging with a high-field (1.5 T) imager. Thirty-three demonstrated a total of 37 lesions consistent with hypoxic-ischemic encephalopathy, including periventricular leukomalacia (n = 12), basal ganglia hemorrhage (n = 5), multicystic encephalomalacia (n = 5), and focal parenchymal hemorrhage (n = 15). Diagnoses by ultrasonography and computed tomography were compared with those by magnetic resonance imaging in 29 and 17 infants, respectively. Ultrasonography agreed more frequently with magnetic resonance imaging than did computed tomography. Ultrasonography detected 79% of lesions demonstrated by magnetic resonance imaging whereas computed tomography detected only 41%. Periventricular leukomalacia was seen most often in preterm infants, basal ganglia hemorrhage and multicystic encephalomalacia primarily occurred in term infants, and focal parenchymal hemorrhage occurred at all gestational ages. Basal ganglia hemorrhage and multicystic encephalomalacia were strongly associated with histories of perinatal asphyxia, seizures, and early abnormal neurologic status. All infants with basal ganglia hemorrhage (5/5) and multicystic encephalomalacia (5/5) and the majority with periventricular leukomalacia (9/12) and focal parenchymal hemorrhages (9/15) had developmental abnormalities at discharge.

Key Words: magnetic resonance imaging • hypoxicischemic encephalopathy • periventricular leukomalacia • basal ganglia hemorrhage • multicystic encephalomalacia • parenchymal hemorrhages

Submitted on June 19, 1989
Accepted on November 1, 1990




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