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Pediatr."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to evaluate cerebral amide proton transfer signal intensity (SI) among controls, hypoxic\u2013ischemic encephalopathy (HIE) neonates with normal conventional magnetic resonance imaging (HIE\/MRI\u2212) findings, and HIE neonates with abnormal conventional MRI (HIE\/MRI+) findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty neonates diagnosed with neonatal HIE and sixteen normal neonates were evaluated. All neonates underwent conventional MRI scans and APT imaging. Cerebral APT SIs were compared to identify cerebral regions with significant APT changes among sixteen controls, thirteen HIE\/MRI\u2212 patients, and twenty\u2013seven HIE\/MRI+ patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significantly increased APT SIs were observed in the HIE\/MRI\u2212 group compared with controls, in the left insula, right occipital lobe, left cingulate gyrus (posterior part), and corpus callosum. Significantly increased APT SIs were found in the HIE\/MRI+ group compared with controls, in the right anterior temporal lobe (medial part), anterior parts of the right parahippocampal and ambient gyri, left superior temporal gyrus (middle part), left insula, left cingulate gyrus (posterior part), and right lentiform nucleus. No significant APT SI differences were observed in the cerebellum and brainstem among the three groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Amide proton transfer imaging plays an important role in detecting hypoxic\u2013ischemic encephalopathy regardless of conventional MRI findings. Changes in APT signal intensity may provide important insights into the characterization of the cerebral internal environment. This study suggests that APT imaging could be used as a complement to conventional MRI in the detection of hypoxic\u2013ischemic encephalopathy in clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2022.996949","type":"journal-article","created":{"date-parts":[[2022,11,11]],"date-time":"2022-11-11T06:42:30Z","timestamp":1668148950000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Application of amide proton transfer imaging for the diagnosis of neonatal hypoxic\u2013ischemic encephalopathy"],"prefix":"10.3389","volume":"10","author":[{"given":"Sijin","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xilong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingjie","family":"Mei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kan","family":"Deng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiao","family":"Xue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoyan","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yikai","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1001\/jamapediatrics.2014.3269","article-title":"Hypoxic\u2013ischemic encephalopathy: a review for the clinician","volume":"169","author":"Douglas-Escobar","year":"2015","journal-title":"JAMA Pediatr"},{"key":"B2","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1186\/s12887-021-02737-6","article-title":"Neonatal hypoxic\u2013ischemic encephalopathy diagnosis and treatment: a national survey in China","volume":"21","author":"Wang","year":"2021","journal-title":"BMC Pediatr"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2085","DOI":"10.1056\/NEJMoa1112066","article-title":"Childhood outcomes after hypothermia for neonatal encephalopathy","volume":"366","author":"Shankaran","year":"2012","journal-title":"N Engl J Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1550","DOI":"10.1001\/jama.2017.14972","article-title":"Effect of therapeutic hypothermia initiated after 6\u2005h of age on death or disability among newborns with hypoxic\u2013ischemic encephalopathy: a randomized clinical trial","volume":"318","author":"Laptook","year":"2017","journal-title":"JAMA"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4103\/1817-1745.205646","article-title":"Neonatal hypoxic\u2013ischemic encephalopathy: a radiological review","volume":"12","author":"Bano","year":"2017","journal-title":"J Pediatr Neurosci"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1747","DOI":"10.21037\/qims.2019.10.03","article-title":"Chemical exchange saturation transfer magnetic resonance imaging and its main and potential applications in pre-clinical and clinical studies","volume":"9","author":"Dou","year":"2019","journal-title":"Quant Imaging Med Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1002\/jmri.26645","article-title":"Apt-weighted mri: techniques, current neuro applications, and challenging issues","volume":"50","author":"Zhou","year":"2019","journal-title":"J Magn Reson Imaging"},{"key":"B8","doi-asserted-by":"publisher","first-page":"108620","DOI":"10.1016\/j.ejrad.2019.07.021","article-title":"Early identification of neonatal mild hypoxic\u2013ischemic encephalopathy by amide proton transfer magnetic resonance imaging: a pilot study","volume":"119","author":"Chen","year":"2019","journal-title":"Eur J Radiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"696","DOI":"10.1001\/archneur.1976.00500100030012","article-title":"Neonatal encephalopathy following fetal distress. 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