J Pediatr Neuroradiol 2016; 05(04): 242-247
DOI: 10.1055/s-0036-1597689
Original Article
Georg Thieme Verlag KG Stuttgart • New York

Can Apparent Diffusion Coefficient Values Predict Time of Onset in Term Neonates with Hypoxic–Ischemic Injury?

Mohamed G. Eissawy
1  Radiology Department, Minia University Faculty of Medicine, Minia, Egypt
,
Mahmoud M. Higazi
1  Radiology Department, Minia University Faculty of Medicine, Minia, Egypt
,
Sheren E. Maher
1  Radiology Department, Minia University Faculty of Medicine, Minia, Egypt
2  Pediatric Department, Minia University Faculty of Medicine, Minia, Egypt
› Author Affiliations
Further Information

Publication History

17 July 2016

26 November 2016

Publication Date:
26 December 2016 (eFirst)

Abstract

Background Hypoxic–ischemic injury (HII) is a significant cause of neonatal morbidity and mortality. It had been postulated that apparent diffusion coefficient (ADC) abnormalities in term neonatal HII generally peak at 3 to 5 days after birth and subsequently “pseudonormalize” by the end of the first week. Thus, ADC values may provide a clue for timing of HII.

Objective In this study, we sought to assess whether ADC values can always predict time of hypoxic ischemic insult.

Methodology We prospectively analyzed 34 full-term neonates with suspected HII by diffusion-weighted (DW) magnetic resonance imaging (MRI) within 14 days after birth. DW images (DWIs) were assessed for areas of restricted diffusion at different locations that could be encountered in HII. ADC maps were generated and ADC values were calculated. Spearman correlation coefficient and receiver operating characteristic (ROC) curve analyses were performed.

Results The mean age of neonates at time of MRI was 8 (±4) days (range: 2–14 days). No significant correlation detected between ADC values and age of neonates at time of imaging (p = 0.183; R2 = 0.06). ROC curve analysis showed that ADC values could not discriminate between neonates who were imaged early (≤7 days) or later (p = 0.391; area under the curve = 0.633).

Conclusion ADC values may not be capable to accurately predict time of onset in term neonates with HII. ADC values should always be interpreted in combination with both conventional and DWIs, and each case should be individualized instead of generalization.