Early pattern recognition in severe perinatal asphyxia: a prospective MRI study

Neuroradiology. 1993;35(6):437-42. doi: 10.1007/BF00602824.


On the basis of MRI examinations in 88 neonates and infants with perinatal asphyxia, we defined 6 different patterns on T2-weighted images: pattern A--scattered hyperintensity of both hemispheres of the telencephalon with blurred border zones between cortex and white matter, indicating diffuse brain injury; pattern B--parasagittal hyperintensity extending into the corona radiata, corresponding to the watershed zones; pattern C--hyper- and hypointense lesions in thalamus and basal ganglia, which relate to haemorrhagic necrosis or iron deposition in these areas; pattern D--periventricular hyperintensity, mainly along the lateral ventricles, i.e. periventricular leukomalacia (PVL), originating from the matrix zone; pattern E--small multifocal lesions varying from hyper--to hypointense, interpreted as necrosis and haemorrhage; pattern F--periventricular centrifugal hypointense stripes in the centrum semiovale and deep white matter of the frontal and occipital lobes. Contrast was effectively inverted on T1-weighted images. Patterns A, B and C were found in 17%, 25% and 37% of patients, and patterns D, E and F in 19%, 17% and 35%, respectively. In 49 patients a combination of patterns was observed, but 30% of the initial images were normal. At follow-up, persistent abnormalities were seen in all children with patterns A and D, but in only 52% of those with pattern C. Myelination was retarded most often in patients with diffuse brain injury and PVL (patterns A and D).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asphyxia Neonatorum / diagnosis*
  • Brain / pathology
  • Brain Damage, Chronic / diagnosis*
  • Cerebral Hemorrhage / diagnosis
  • Female
  • Follow-Up Studies
  • Humans
  • Hypoxia, Brain / diagnosis*
  • Infant, Newborn
  • Infant, Premature, Diseases / diagnosis*
  • Leukomalacia, Periventricular / diagnosis
  • Magnetic Resonance Imaging*
  • Male
  • Pregnancy
  • Prospective Studies