Marta Muresan

Yes. Cerebral US is a good marker. Please read my artile about it.Sorry for the late response. PREDICTIVE VALUE OF CRANIAL ULTRASOUND IN HIPOXIC ISCHEMIC NEONATAL ENCEPHALOPATY Marta Muresan*, *Clinica Obstetrica Ginecologie II, "Dominic Stanca" Cluj-Napoca- sectia Nou-Nascuti Abstract: The relation of neonatal US abnormalities to neurologic outcome was examined in a prospectively followed cohort of 42 neonates with hipoxic-ischemic neonatal encephalopaty (HI-NE). The study group had consisted of 30 asphyxiated neonate with abnormal ultrasonograms and their neurological outcome was compared to the outcome of 12 asphyxiated infants without US abnormalities (control group). We used van Wezel Meijler`s score system to grade the intensity of parenchymal echogenicity. The results shown that the frequency of abnormal outcome in the study group (83%) was significantly different (for p<0,01) than that in patients with normal US scans (8%). US examination had a high sensitivity (94%), specificity (92%), 85% accuracy and 83% positive predictive value for neurologic outcome in infants with HI-NE. A high positive predicting value of bad prognosis had severe, generalized diffuse PHYE (sever brain edema) (90%), hyperechogenicity in BGTL, in the brainstem and in the subcortical region (100%). Less frequent abnormal outcome was predicted by parenchymal echodensities (76%) than by cystic lesions (86%), and by ventricle size (70%) compared with parenchymal abnormalities (79%), differences were significant (p<0,05). We describe a new pattern of hypoxic-ischemic US abnormality, periventricular pseudocyst, which appears in severe asphyxiated term infants, in the area of previous hyperechogenicity of external angle of lateral ventricles and had a poor outcome. Highest degree of echogenicity of parenchyma carried the highest predictive value for neurologic impairment (gr.2 intensity PHYE 90% versus 64% gr.2 PHYE). We conclude that US could identify the risk of abnormal neurologic development in infants with HI-NE, with high sensitivity and specificity. Grading of parenchymal hyperechogenicity could serve as a prognostic criterion in HI-NE as well as the location and extension of echodensities.