Magnetic resonance imaging versus transcranial ultrasound in early identification of cerebral injuries in neonatal encephalopathy

Abstract

Objective: Neonatal encephalopathy (NE) is a condition that causes significant morbidity and mortality to the infant. The diagnosis and severity of NE rely heavily on clinical presentation and imaging findings. The present study was planned to assess the role of MRI and Transcranial ultrasound (TCUS) in the early identification of cerebral injuries in NE. Patients and methods: Our study enrolled 38 newborns presented with NE. Brain MRI and TCUS were carried out for each case and their results were compared. Results: MRI was positive in 33 cases. Findings at MRI supported hypoxic-ischemic encephalopathy as an etiology in 25 neonates, and other etiologies included metabolic disorders in 2, congenital neonatal infection in 1, 2 cases of neonatal stroke, congenital brain anomalies in 2 neonates and cerebral venous sinus thrombosis in 1. The overall diagnostic accuracy of TCUS compared to MRI was 78.9%, while the overall sensitivity and specificity were 81.8% and 60% respectively. Conclusion: TCUS is an effective screening tool in detecting the etiology of NE in suspected cases; it is sometimes crucial in critically sick neonates; however, early MRI is mandatory as it can detect precisely the extent of brain injury compared with TCUS alone.

Keywords

• Neonatal encephalopathy
• Hypoxic–ischemic encephalopathy
• HIE
• MRI
• Transcranial ultrasound