Purpose: To determine whether one can detect hypoxic-ischemic brain injury by MR in the first 10 days of life and to identify patterns of injury in affected neonates.
Methods: Standard T1- and T2-weighted MR sequences that were performed in the first 10 days of life in 20 patients who suffered hypoxia/ischemia in the intrapartum or neonatal periods were reviewed retrospectively. Images were evaluated for patterns of signal changes.
Results: Four patients had normal findings and were clinically healthy. The remaining 16 patients were divided into four groups based on pattern of injury: (a) primarily deep gray matter involvement; (b) primarily cortical involvement; (c) primarily periventricular white matter injury; and (d) mixed injury pattern. Two patients had appearances that suggested prepartum injury. T1 shortening was seen in injured tissue as early as 3 days after injury. T2 shortening did not appear until 6 or 7 days after injury.
Conclusion: MR can show brain damage in asphyxiated neonates during the first 10 days of life and shows early appearances of several patterns of brain injury.