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- Title
Non-Sedated Rapid Volumetric Proton Density MRI Predicts Neonatal Brachial Plexus Birth Palsy Functional Outcome.
- Authors
Shen, Peter Y.; Nidecker, Anna E.; Neufeld, Ethan A.; Lee, Paul S.; James, Michelle A.; Bauer, Andrea S.
- Abstract
<bold>Background and Purpose: </bold>The current prognostic biomarker of functional outcome in brachial plexus birth palsy is serial clinical examination throughout the first 6 months of age. This can delay surgical treatment and prolong parental anxiety in neonates who will recover spontaneously. A potentially superior biomarker is a volumetric proton density MRI performed at clinical presentation and within the first 12 weeks of life, providing a high spatial and contrast resolution examination in 4 minutes.<bold>Methods: </bold>Nine neonates ranging in age from 4 to 9 weeks who presented with brachial plexus birth palsy were enrolled. All subjects underwent non-sedated 3 Tesla MRI with Cube Proton Density MRI sequence at the same time as their initial clinical visit. Serial clinical examinations were conducted at routine 4 week intervals and the functional performance scores were recorded. MRI findings were divided into pre-ganglionic and post-ganglionic injuries and a radiological scoring system (Shriners Radiological Score) was developed for this study.<bold>Results: </bold>Proton Density MRI was able to differentiate between pre-ganglionic and post-ganglionic injuries. Radiological scores (Shriners Radiological Score) correlated better with functional performance at 6 months of age (P = .022) than the initial clinical examinations (Active Movement Scale P = .213 and Toronto P = .320).<bold>Conclusions: </bold>Rapid non-sedated volumetric Cube Proton Density MRI protocol performed at initial clinical presentation can accurately grade severity of brachial plexus birth palsy injury and predict functional performance at 6 months of age.
- Subjects
BRACHIAL plexus diseases; MAGNETIC resonance imaging of the brain; PARALYSIS; NEONATAL diseases; BIOMARKERS; DIAGNOSIS; BIRTH injuries; MAGNETIC resonance imaging; PROGNOSIS; TREATMENT effectiveness; BRACHIAL plexus neuropathies
- Publication
Journal of Neuroimaging, 2017, Vol 27, Issue 2, p248
- ISSN
1051-2284
- Publication type
journal article
- DOI
10.1111/jon.12389