{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T17:49:03Z","timestamp":1792259343206,"version":"4.4.0"},"reference-count":35,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2016,7,24]]},"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Previous studies have demonstrated the association of abnormalities on diffusion-weighted MRI (DW-MRI) and proton magnetic resonance spectroscopy (<jats:sup>1<\/jats:sup>H-MRS) in infants with perinatal asphyxia. The use of therapeutic hypothermia might change this association.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To study the association between DW-MRI and <jats:sup>1<\/jats:sup>H-MRS and outcome after perinatal asphyxia and therapeutic hypothermia in infants with a gestational age of \u226536\u2005weeks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients and methods<\/jats:title>\n                  <jats:p>Infants with perinatal asphyxia and therapeutic hypothermia (n=88) were included when an MR examination was performed within 7\u2005days after birth. Apparent diffusion coefficient (ADC) values of the basal ganglia and thalamus were calculated, as were lactate\/N-acetylaspartate (LAC\/NAA) and N-acetylaspartate\/choline (NAA\/Cho) ratios. Death or an abnormal neurodevelopment at \u226524\u2005months was considered an adverse outcome. Receiver operating characteristic analysis was performed to determine cut-off levels.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 88 infants, 22 died and 7 had an adverse neurodevelopmental outcome. In infants with an adverse outcome, ADC values of the basal ganglia and thalamus were significantly lower, and Lac\/NAA ratios were significantly higher than in infants with a normal outcome. Areas under the curve of ADC of the basal ganglia, thalami and Lac\/NAA ratio were 0.89, 0.88 and 0.87, respectively. NAA\/Cho ratios were in this cohort not associated with outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>During and after therapeutic hypothermia, low ADC values and high Lac\/NAA ratios of the basal ganglia and thalamus are associated with an adverse outcome in infants with perinatal asphyxia.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/archdischild-2016-310514","type":"journal-article","created":{"date-parts":[[2016,8,23]],"date-time":"2016-08-23T22:29:44Z","timestamp":1471991384000},"page":"F147-F152","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":69,"title":["MRI and spectroscopy in (near) term neonates with perinatal asphyxia and therapeutic hypothermia"],"prefix":"10.1136","volume":"102","author":[{"given":"Thomas","family":"Alderliesten","sequence":"first","affiliation":[{"name":"Department of Neonatology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda S","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liza","family":"Staats","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid C","family":"van Haastert","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Weeke","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon J N L","family":"Benders","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corine","family":"Koopman-Esseboom","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floris","family":"Groenendaal","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,8,23]]},"reference":[{"key":"2025090513294879000_102.2.F147.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12658-X"},{"key":"2025090513294879000_102.2.F147.2","doi-asserted-by":"crossref","unstructured":"Jacobs SE , Berg M , Hunt R , et al . Cooling for newborns with hypoxic ischaemic encephalopathy. Cochrane Database Syst Rev 2013;(1):CD003311. doi:10.1002\/14651858.CD003311.pub3","DOI":"10.1002\/14651858.CD003311.pub3"},{"key":"2025090513294879000_102.2.F147.3","doi-asserted-by":"publisher","DOI":"10.1159\/000348823"},{"key":"2025090513294879000_102.2.F147.4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0038504"},{"key":"2025090513294879000_102.2.F147.5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0083742"},{"key":"2025090513294879000_102.2.F147.6","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70295-9"},{"key":"2025090513294879000_102.2.F147.7","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-010-0674-9"},{"key":"2025090513294879000_102.2.F147.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2004.12.026"},{"key":"2025090513294879000_102.2.F147.9","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-0222"},{"key":"2025090513294879000_102.2.F147.10","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2253011797"},{"key":"2025090513294879000_102.2.F147.11","first-page":"533","article-title":"MR imaging, MR spectroscopy, and diffusion tensor imaging of sequential studies in neonates with encephalopathy","volume":"27","author":"Barkovich","year":"2006","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025090513294879000_102.2.F147.12","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.209.1.9769812"},{"key":"2025090513294879000_102.2.F147.13","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199402000-00004"},{"key":"2025090513294879000_102.2.F147.14","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-1046"},{"key":"2025090513294879000_102.2.F147.15","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.11110213"},{"key":"2025090513294879000_102.2.F147.16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0123230"},{"key":"2025090513294879000_102.2.F147.17","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-2938"},{"key":"2025090513294879000_102.2.F147.18","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318253d589"},{"key":"2025090513294879000_102.2.F147.19","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1976.00500100030012"},{"key":"2025090513294879000_102.2.F147.20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1997.tb08581.x"},{"key":"2025090513294879000_102.2.F147.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.05.013"},{"key":"2025090513294879000_102.2.F147.22","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0136"},{"key":"2025090513294879000_102.2.F147.23","doi-asserted-by":"publisher","DOI":"10.1136\/adc.67.7_Spec_No.846"},{"key":"2025090513294879000_102.2.F147.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2014.12.011"},{"key":"2025090513294879000_102.2.F147.25","doi-asserted-by":"publisher","DOI":"10.1055\/s-2003-39599"},{"key":"2025090513294879000_102.2.F147.26","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1318"},{"key":"2025090513294879000_102.2.F147.27","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1177\/0271678X15607881","article-title":"The effects of therapeutic hypothermia on cerebral metabolism in neonates with hypoxic-ischemic encephalopathy: an in vivo 1H-MR spectroscopy study","volume":"36","author":"Wisnowski","year":"2015","journal-title":"J Cereb Blood Flow Metab"},{"key":"2025090513294879000_102.2.F147.28","doi-asserted-by":"publisher","DOI":"10.1017\/S0012162299000973"},{"key":"2025090513294879000_102.2.F147.29","first-page":"203","article-title":"Increased detectibility of alpha brain glutamate\/glutamine in neonatal hypoxic-ischemic encephalopathy","volume":"21","author":"Pu","year":"2000","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025090513294879000_102.2.F147.30","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199809000-00007"},{"key":"2025090513294879000_102.2.F147.31","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199607000-00002"},{"key":"2025090513294879000_102.2.F147.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2007.06.003"},{"key":"2025090513294879000_102.2.F147.33","doi-asserted-by":"publisher","DOI":"10.1002\/ana.10365"},{"key":"2025090513294879000_102.2.F147.34","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1111\/j.1651-2227.2009.01528.x","article-title":"Using diffusion MRI for measuring the temperature of cerebrospinal fluid within the lateral ventricles","volume":"99","author":"Kozak","year":"2010","journal-title":"Acta Paediatr"},{"key":"2025090513294879000_102.2.F147.35","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2014-306550"}],"container-title":["Archives of Disease in Childhood - Fetal and Neonatal Edition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/archdischild-2016-310514","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T20:29:55Z","timestamp":1757104195000},"score":1,"resource":{"primary":{"URL":"https:\/\/fn.bmj.com\/lookup\/doi\/10.1136\/archdischild-2016-310514"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8,23]]},"references-count":35,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2017,2,16]]},"published-print":{"date-parts":[[2017,3]]}},"alternative-id":["10.1136\/archdischild-2016-310514"],"URL":"https:\/\/doi.org\/10.1136\/archdischild-2016-310514","relation":{},"ISSN":["1359-2998","1468-2052"],"issn-type":[{"value":"1359-2998","type":"print"},{"value":"1468-2052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,8,23]]}}}