Comparison of fractional anisotropy and apparent diffusion coefficient among hypoxic ischemic encephalopathy stages 1, 2, and 3 and with nonasphyxiated newborns in 18 areas of brain

Supriya Kushwah; Ashok Kumar; Ashish Verma; Sriparna Basu; Ashutosh Kumar

doi:10.4103/ijri.IJRI_384_16

Indian Journal of Radiology and Imaging, Table of Contents

CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2017; 27(04): 447-456
DOI: 10.4103/ijri.IJRI_384_16

Neuro/Head & Neck

Comparison of fractional anisotropy and apparent diffusion coefficient among hypoxic ischemic encephalopathy stages 1, 2, and 3 and with nonasphyxiated newborns in 18 areas of brain

Authors

Supriya Kushwah

Department of Paediatrics, Yenepoya Medical College, Mangalore, Karnataka, India
Ashok Kumar

Department of Paediatrics, Institute of Medical Sciences, Varanasi, Uttar Pradesh, India
Ashish Verma

Department of Paediatrics, Institute of Medical Sciences, Varanasi, Uttar Pradesh, India
Sriparna Basu

Department of Paediatrics, Institute of Medical Sciences, Varanasi, Uttar Pradesh, India
Ashutosh Kumar

Department of Anaesthesia, KMC, Mangalore, Karnataka, India

Abstract

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Abstract

Purpose: To determine the area and extent of injury in hypoxic encephalopathy stages by diffusion tensor imaging (DTI) using parameters apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values and their comparison with controls without any evidence of asphyxia. To correlate the outcome of hypoxia severity clinically and significant changes on DTI parameter. Materials and Methods: DTI was done in 50 cases at median age of 12 and 20 controls at median age of 7 days. FA and apparent diffusion coefficient (ADC) were measured in several regions of interest (ROI). Continuous variables were analyzed using Student's t-test. Categorical variables were compared by Fisher's exact test. Comparison among multiple groups was done using analysis of variance (ANOVA) and post hoc Bonferroni test. Results: Abnormalities were more easily and accurately determined in ROI with the help of FA and ADC values. When compared with controls FA values were significantly decreased and ADC values were significantly increased in cases, in ROI including both right and left side of thalamus, basal ganglia, posterior limb of internal capsule, cerebral peduncle, corticospinal tracts, frontal, parietal, temporal, occipital with P value < 0.05. The extent of injury was maximum in stage-III. There was no significant difference among males and females. Conclusion: Compared to conventional magnetic resonance imaging (MRI), the evaluation of FA and ADC values using DTI can determine the extent and severity of injury in hypoxic encephalopathy. It can be used for early determination of brain injury in these patients.

Keywords

Apparent diffusion coefficient - diffusion tensor imaging - fractional anisotropy - hypoxic ischemic encephalopathy

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References

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