TOPLINE

MRI performed during therapeutic hypothermia (TH) in neonates with hypoxic-ischemic encephalopathy (HIE) showed 95% concordance with MRI obtained 11 days after birth in identifying both the pattern and severity of brain injury, supporting its use for early clinical decision-making and family counseling.

METHODOLOGY

• Researchers retrospectively analyzed data collected prospectively from 114 newborns with HIE who were admitted at a tertiary ICU between 2008 and 2023 and underwent TH.
• Researchers compared concordance in terms of injury pattern and severity between MRI scans taken at two timepoints: during TH (at a median age of 2 days) and after completion of TH (at a median age of 11 days).

TAKEAWAY

• A total of 58% of newborns had detectable brain injury on MRI performed during TH.
• MRI performed during TH showed 95% concordance with later MRI in assessing the pattern and severity of brain injury in newborns with HIE.

IN PRACTICE

"Early MRI during TH may support timely prognostication, family counseling and enrollment in clinical trials. However, follow-up MRI remains important in selected cases, particularly with severe illness or discordant imaging and clinical findings. These results support a broader use of early MRIs during TH in appropriately equipped centers and lay the foundation for future studies linking early imaging to long-term neurodevelopmental outcomes," the authors wrote.

SOURCE

The study was led by Florence Dolan and Valerie Biran, MD, McGill University, Montreal, Canada. It was published online on September 3 in The Journal of Pediatrics.

LIMITATIONS

The study was limited by its single-center design leading to potential survivor and selection bias, reliance on routine clinical readings without formal inter-rater reliability assessment, low power to assess the evolution of injury, possible effect of diffusion pseudonormalization on some late scans, and lack of direct long-term neurodevelopmental follow-up.

DISCLOSURES

One author reported receiving grants from the Canadian Institutes of Health Research Project, Brain Canada Platform, Courtois Foundation, as well as the William Dawson Scholar Award. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.