Proton Spectroscopy and Diffusion Imaging on the First Day of Life after Perinatal Asphyxia: Preliminary Report

BACKGROUND AND PURPOSE: MR techniques have proved useful in assessing brain in-jury from perinatal asphyxia when the injury is subacute or chronic. Recent advances in un-derstanding the molecular mechanisms of brain injury have made medical intervention plau-sible, creating a need for assessment of the brain within the first few hours of life. We report the results of early (first 24 hours after birth) MR imaging in seven patients, including proton MR spectroscopy in six. METHODS: MR studies were performed within the first 24 hours of life in seven consecutive patients who were encephalopathic after complicated deliveries. Standard T1-, T2-, and dif-fusion-weighted sequences were performed in all patients; single-voxel MR spectroscopy was performed in two locations in six of the seven patients. Follow-up MR studies were performed in four patients at ages 7, 8, 9, and 15 days, respectively. RESULTS: T1-weighted images were normal in all seven patients. T2-weighted images were normal in three patients and showed T2 prolongation in the basal ganglia or white matter in the other four. Diffusion images showed small abnormalities in the lateral thalami or internal capsules in all seven patients. Comparison with clinical course in all seven patients and wit