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Quantitative Apparent Diffusion Coefficient Measurements in Term Neonates for Early Detection of Hypoxic-Ischemic Brain Injury: Initial Experience¹

¹ From the Section of Neuroradiology, University of Pennsylvania Medical Center, Ground Floor, Founders Building, 3400 Spruce St, Philadelphia, PA 19104 (R.L.W.); and the Children’s Hospital of Philadelphia, Pa (R.A.Z., R.C., J.H.H.). Received December 28, 1999; revision requested February 8, 2000; revision received June 29; accepted August 1. Supported in part by National Institutes of Health training grant T32 CA 7478. Address correspondence to R.L.W. (e-mail: wolf@oasis.rad.upenn.edu).

PURPOSE: To determine the utility of using quantitative apparent diffusion coefficient (ADC) values as an objective means of early detection of brain injury caused by hypoxic-ischemic encephalopathy (HIE) in term neonates.

MATERIALS AND METHODS: Conventional images, diffusion-weighted images, ADC maps, and clinical charts from 13 term neonates clinically suspected of having HIE were retrospectively reviewed. Four term neonates without HIE served as control subjects. ADC values were calculated in predefined regions in patients and compared with those in control subjects. A Student t test was performed for each region to compare patients and control subjects.

RESULTS: Abnormalities were more easily detected on diffusion-weighted images and ADC maps, compared with conventional images. ADC values in patients with HIE were significantly different from those of control subjects in the posterior limb of the internal capsule, corona radiata, posterior frontal white matter, and parietal white matter bilaterally.

CONCLUSION: Evaluation of ADC maps can improve conspicuity of hypoxic-ischemic injury in the acute and/or subacute setting (within 12 days of insult), and calculation of ADC values can provide an objective measure of hypoxic-ischemic injury.

Index terms: Brain, ischemia, 10.591 • Hypoxia • Magnetic resonance (MR), diffusion study, 10.121411, 10.121413, 10.121416, 10.121417, 10.12144 • Magnetic resonance (MR), in infants and children

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