Article Figures & Data
Figures
- FIG 1.
A, The gestational age of the infants considered when evaluating the myelination of the PLIC. In the coronal T1-weighted image, the myelination of the PLIC was considered as age-appropriate for a near-term infant (35 weeks of gestation) and was scored as normal. B, The gestational age of the infants was considered when evaluating the peak of the NAA. In 1H-MR spectroscopy (TE = 30 ms), the peak NAA was considered as age-appropriate for a near-term infant (35 weeks of gestation) and was scored as normal. C, The lesion that had involvement of both the WM and cortex was scored individually only for the principal area. In axial DWI, the diffusion restriction in the cortex and its location were scored as focal (1 lobe) and unilateral (score of 2). The WM involvement was scored individually as focal and unilateral (score of 2). D, The extension of signal abnormality (involving 1 lobe or >1 lobe) was scored on the basis of the primary area of injury. In axial ADC mapping, the diffusion restriction in the WM was scored as focal (score of 1) because only the frontal lobe was involved and the location was scored as bilateral (score of 2).
- FIG 2.
The frequency distribution of the total score in the full cohort.
- FIG 3.
The severity of brain injury based on the total score for each subject in the first (A) and second epochs (B).
Tables
Full Cohort (n = 252) Gestational age (wk) 39 (38–40) Birth weight (g) 3180 (2830–3544) Sex (% of males) 145 (57.5%) Inborn 166 (65.9%) Apgar at 1 min 2 (1–4) Apgar at 5 min 6 (5–7) Apgar at 10 min 7 (6–8) UA pH 7.04 (6.94–7.12) UA BD (mmol/L) 11.7 (8.5–14.3) UA lactate (mmol/L) 8.9 (6.4–10.4) UV pH 7.13 (7.02–7.23) UV BD (mmol/L) 10.1 (6.9–12.9) UV lactate (mmol/L) 7.3 (5.6–9.2) Postnatal pH 7.24 (7.15–7.30) Postnatal BD (mmol/L) 9.2 (6.2–12.9) Postnatal lactate (mmol/L) 7.9 (4.9–11.2) Stage of HIE Mild HIE 124/234 (53.0%) Moderate HIE 105/234 (44.9%) Severe HIE 5/234 (2.1%) Note:—BD indicates base deficit; UA, umbilical artery; UV, umbilical vein.
↵a Nonparametric data are presented as median with interquartile range. The stage of HIE was based on the modified Sarnat stage. The Sarnat stage was available for 234 infants.
Before Adjustment (n = 20) After Adjustment (n = 20) ICC 95% CI ICC 95% CI Gray matter 0.95 0.86–0.98 0.95 0.88–0.98 GM with 1H-MR spectroscopy 0.95 0.82–0.98 0.96 0.89–0.98 WM/cortex 0.97 0.91–0.99 0.98 0.96–0.99 Cerebellum 0.95 0.88–0.98 1.00 – Additional 0.86 0.62–0.94 0.66 0.14–0.87 Total score 0.96 0.89–0.99 0.96 0.89–0.98 Note:— GM indicates Gray Matter; ICC, intraclass correlation coefficient; WM, white matter; ‐, not applicable (NA).
↵a The ICC with a 2-way random-effects model was calculated to assess the interrater variability between 2 experienced readers.
Severity of Brain Injury Before Adjustment (n = 20) After Adjustment (n = 20) Reader 1 Reader 2 P Value Reader 1 Reader 2 P Value Normal (≤4) (No.) (%) 10 (50%) 12 (60%) .50 8 (40%) 9 (45%) 1.00 Mild (5–10) (No.) (%) 1 (5%) 3 (15%) .63 6 (30%) 3 (15%) .25 Moderate (11–15) (No.) (%) 5 (25%) 2 (10%) .25 1 (5%) 3 (15%) .50 Severe (>15) (No.) (%) 4 (20%) 3 (15%) 1.00 5 (25%) 5 (25%) 1.00 ↵a A McNemar test was administered to determine whether there was a difference in the proportion of the severity of the brain injury between the 2 readers.
