Preprint Article Version 1 This version not peer reviewed

Diffusion-Weighted MRI and Urinary Activin-A are Correlated with the Degree of Hypoxic Ischemic Encephalopathy in Neonates

Version 1 : Received: 25 March 2017 / Approved: 28 March 2017 / Online: 28 March 2017 (03:07:20 CEST)

How to cite: Maher, S.; Abdelazim, M.; Eissawy, M.; Higazi, M.; Okaily, N. Diffusion-Weighted MRI and Urinary Activin-A are Correlated with the Degree of Hypoxic Ischemic Encephalopathy in Neonates. Preprints 2017, 2017030207 (doi: 10.20944/preprints201703.0207.v1). Maher, S.; Abdelazim, M.; Eissawy, M.; Higazi, M.; Okaily, N. Diffusion-Weighted MRI and Urinary Activin-A are Correlated with the Degree of Hypoxic Ischemic Encephalopathy in Neonates. Preprints 2017, 2017030207 (doi: 10.20944/preprints201703.0207.v1).

Abstract

Background: Early identification and prevention of hypoxic ischemic encephalopathy (HIE) may reduce neonatal mortality and morbidity. Objective: We aimed to correlate between urinary Activin-A and MRI (conventional and Diffusion-weighted) and the severity of HIE in full-term neonates. Methods: Forty-five full-term neonates with HIE admitted to NICU and 15 normal neonates were enrolled into the study. The concentration of urinary Activin-A was determined using enzyme immunoassay kits and MRI were done. Correlations between urinary Activin-A and MRI with the degree of HIE were done. Results: Urinary Activin-A levels were significantly higher in neonates with HIE than controls (P<0.001). It was positively correlated with the clinical grading of HIE and a cutoff value of 0.08µg/l on day-1 after birth had a sensitivity of 98.6% and specificity of 97.1% for prediction of HIE. DW-MRI detected HIE with a high sensitivity (85%) compared to the low sensitivity of conventional MRI (35%). An ADC value of ≤ 0.8 was the best sensitivity-specificity cutoff point for detecting severe ischemic injury. DW-MRI imaging was positively correlated with Urinary Activin-A and both of them were positively correlated with the clinical grades of HIE (P < 0.001). Conclusions: DW-MRI imaging is correlated well with urinary Activin-A in full-term neonates with HIE and both of them are correlated with the degree of HIE. Early determination of urinary Activin-A combined with DW-MRI imaging can early detect HIE and its severity in full-term neonates with HIE.

Subject Areas

Activin-A; HIE; MRI; apparent diffusion coefficient; neonates

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