Perinatal asphyxia: MR findings in the first 10 days.

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.