Neonatal neuroimaging after repair of congenital diaphragmatic hernia and long-term neurodevelopmental outcome

作     者：Julia Kate Gunn-Charlton Alice C Burnett Stephanie Malarbi Margaret M Moran Esther A Hutchinson Susan Greaves Rod W Hunt 

作者机构：Newborn Intensive CareThe Royal Children’s HospitalMelbourneVictoriaAustralia Neonatal Research GroupMurdoch Children’s Research InstituteMelbourneVictoriaAustralia Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia Victorian Infant Brain Studies(VIBeS)GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia Department of Occupational TherapyThe Royal Children’s HospitalMelbourneVictoriaAustralia 

出 版 物：《World Journal of Pediatric Surgery》 (世界小儿外科杂志（英文）)

年 卷 期：2019年第2卷第3期

页      面：2-8页

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

基　　金：Royal Children's Hospital Foundation  Melbourne Australia 

主　　题：hernia routine maturity 

摘      要：Objective Previous outcome reports of congenital diaphragmatic hernia(CDH)have described neuroimaging anomalies and neurodevelopmental ***,the link between imaging and outcome has not been *** aimed to determine whether routine postoperative neonatal neuroimaging in infants with CDH detects later neurodevelopmental *** In a prospective cohort study within a clinical service in The Royal Children’s Hospital Newborn Intensive *** ultrasound was performed in 81 children and MRI in 57 children who subsequently underwent neurodevelopmental follow-up after surgery for *** scans were analyzed using a scoring system designed to identify injury,maturation and volume *** assessment occurred at 2 years(48)and neurocognitive assessment at 5 years(26)and/or 8 years(27).Brain imaging scores corrected for gestational age at scan time were correlated with outcome measures,adjusting for known clinical *** Clinically significant findings were identified on MRI of 16(28%)*** scores were in the normal range for all domains assessed at each *** impairment was seen in 23%at 2 years and verbal intellectual impairment in 25%at 8 *** cognitive scores were lower in 2-year-old children with white matter injury on MRI(p=0.03).Mean motor scores were lower in 2-year-old children with brain immaturity(p=0.01).Associations between MRI and 5-year and 8-year assessments were no longer significant when adjusting for known clinical *** Neuroimaging abnormalities were associated with worse neurodevelopment at 2 years,but not with later neurocognitive outcomes,after accounting for clinical risk factors.