PhD Scientific Days 2017

Oral Presentations: Neurosciences

Prognostic performance of proton magnetic resonance spectroscopy metabolite ratios in the first 96 hours of life in asphyxiated neonates

Előadó neve

Dr. Barta, Hajnalka

Előadó munkahelye

1st Department of Pediatrics, Semmelweis University

Előadó telefonszáma

+36704063039

Előadó e-mail címe

hajnalka.barta.md@gmail.com

Az előadás címe

Prognostic performance of proton magnetic resonance spectroscopy metabolite ratios in the first 96 hours of life in asphyxiated neonates

Szerző(k) neve és munkahelye

Hajnalka Barta1
1 1st Department of Pediatrics, Semmelweis University

Szekció

Oral Presentations: Neurosciences

Data of the presenter

Doctoral School: Clinical Medicine
Program: Prevention of Chronic Diseases in Childhood
Supervisor: Miklós Szabó
E-mail address: hajnalka.barta.md@gmail.com

Text of the abstract

Introduction: Neonatal hypoxic-ischemic encephalopathy (HIE) can lead to neurodevelopmental impairment, raising a need for early prognostic tools to guide therapy. Prognostic value of proton magnetic resonance spectroscopy (HMRS) performed between 5-30 days of life has been extensively studied, although few studies focus on earlier periods.
Aims: to determine the prognostic performance of HMRS during the first 96 hours of life.
Method: 55 consecutive hypothermia-treated HIE neonates were examined by HMRS at three echo-times (TE=35, 144, 288 ms) between 6-96 hours of age, depending of clinical stability. Patients were divided into favorable (n=38) and unfavorable (n=17) outcome groups based on Bayley II MDI and PDI scores (≥70 vs. <70 or death, respectively) assessed at 18-26 months of age. Associations between 36 routinely measured metabolite ratios (MROs) and outcome were studied. Prognostic performance of MROs was evaluated by ROC analysis. Age-dependent changes of MROs in whole patient population were also assessed.
Results: 6 MROs showed significant difference between outcome groups after correction for multiple testing (p<0.0014). ROC analysis revealed that Myo-inositol/N-Acetyl-Aspartate (TE=35 ms) gives best prediction for outcome with 85.71% sensitivity and 91.30% specificity. Assessment of age-dependency showed that 4 of 6 MROs stay constant during first 96 hours of life, all containing Myo-inositol.
Conclusion: Our findings suggest that during first 96 hours of life HMRS could be a useful prognostic tool in predicting the outcome of asphyxiated neonates. Myo-inositol/N-Acetyl-Aspartate ratio was found to be the best and age-independent predictor.

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Előadó

1041

Authors (legacy)

Hajnalka Barta1
1 1st Department of Pediatrics, Semmelweis University