MR spectroscopy, S100B protein and NSE analysis as early predictors of hypoxic ishaemic encephalopathy

Abstract

Aim of workThe aim of this work is to assess S100B protein, neuron specific enolase and magnetic resonance spectroscopy as biochemical and imaging findings in neonatal hypoxic ischemic encephalopathy. MethodsThis prospective study on 30 full-term neonates suffering from HIE who were attendants of the Neonatology Unit of Pediatric Department and Radiodiagnosis Department of Tanta University Hospital. Duration of the study extended from June 2010 to June 2012. ResultsThirty patients (16 males and 14 females), HIE group classification according to Lac/Cr ratio in MRS to three groups: Groups – group I: where Lac/Cr<0.5, group II: where Lac/Cr 0.5–1.5 and group III: where Lac/Cr>1.5.1HMRS group I contained 17 patients (15 patients were present in Sarnat stage I and two patients were present in Sarnat stage II). Group II contained nine patients (all patients were present in Sarnat stage II). Group III contained four patients (all patients were present in Sarnat stage III).Serum level of S100B protein and NSE were significantly higher in the HIE group than control group also serum level of S100B protein and NSE in HIE stage III was significantly higher than control, HIE stage I and stage II. Conclusion1HMRS is a useful tool for evaluating the severity and prognosis of HIE noninvasively. Higher lactate/Cr ratio in basal ganglia and thalamus predict the poor prognosis of neonates.Serum level of S100B protein and NSE has an important meaning in adjuvant diagnosing and ruling out diagnosis of early HIE and prognosis of birth asphyxia.