Early diffusion-weighted MRI and 1H-Magnetic Resonance Spectroscopy in asphyxiated full-term neonates.

Aim: To assess the predictive value of early MRI and proton MR spectroscopy (1H-MRS), 11 full-term neonates with severe perinatal asphyxia were studied within 48 h after birth. Methods: T1- and T2-weighted MRI, diffusion-weighted MRI (DW-MRI), apparent diffusion coefficient of water (ADC) of the basal ganglia and parietal white matter, as well as 1H-MRS of the basal ganglia were performed in a 1.5-Tesla magnetic field. Neurodevelopment was assessed in the survivors for at least 24 months. Results: Nine of the 11 neonates had a poor outcome (7 died, 2 developed cerebral palsy). All examinations were normal in the 2 neonates with a good outcome. T1- and T2-weighted MRI were abnormal in 7, DWI was abnormal in 7, ADC was abnormal in 5, and elevated lactate/N-acetylaspartate ratios using 1H-MRS were seen in 7 of the 9 neonates with a poor outcome. None of these 9 had completely normal MRI or 1H-MRS findings. Conclusions: Using a combination of T1- and T2-weighted MRI, DW-MRI, ADC measurements and 1H-MRS within 48 h after severe perinatal asphyxia, no abnormalities were seen with any of these techniques in both neonates with a good outcome.