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Precise neonatal arterial ischemic stroke classification with a three-dimensional map of the arterial territories of the neonatal brain
Pediatric Research ( IF 3.1 ) Pub Date : 2019-12-13 , DOI: 10.1038/s41390-019-0724-x
Christian Núñez 1, 2 , Gemma Arca 3, 4, 5, 6 , Thais Agut 1, 6, 7 , Christian Stephan-Otto 1, 2, 8 , Alfredo García-Alix 1, 5, 6, 7
Affiliation  

Introduction Data regarding neonatal arterial ischemic stroke (NAIS) topography are still sparse and inaccurate. Despite the importance of locating NAIS to predict the long-term outcome of neonates, a map of arterial territories is not yet available. Our aim was therefore to generate the first three-dimensional map of arterial territories of the neonatal brain (ATNB) and test its usefulness. Methods Three-dimensional time-of-flight magnetic resonance angiography images were acquired from four neonates without NAIS. Arteries were semi-automatically segmented to build a symmetric arterial template. This allowed us to delineate the volumetric extension of each arterial territory, giving rise to the ATNB map, which is publicly available. Its applicability was tested on a sample of 34 neonates with NAIS. Results After applying the ATNB map to the neonatal sample, the posterior trunk of the middle cerebral artery, followed by its anterior trunk, were identified as the most affected arterial territories. When comparing the results obtained employing the map with the original diagnoses made during the standard clinical evaluation of NAIS, major diagnostic errors were found in 18% of cases. Conclusion The ATNB map has been proven useful to precisely identify the arterial territories affected by an NAIS, as well as to increase the accuracy of clinical diagnoses.

中文翻译:

精确的新生儿动脉缺血性卒中分类,带有新生儿大脑动脉区域的三维图

简介 关于新生儿动脉缺血性卒中 (NAIS) 地形的数据仍然稀少且不准确。尽管定位 NAIS 对预测新生儿的长期结果很重要,但目前还没有动脉区域图。因此,我们的目标是生成第一个新生儿大脑动脉区域 (ATNB) 的三维地图并测试其实用性。方法 采集 4 名未行 NAIS 新生儿的三维飞行时间磁共振血管造影图像。动脉被半自动分割以建立一个对称的动脉模板。这使我们能够描绘每个动脉区域的体积延伸,从而产生公开可用的 ATNB 地图。对 34 名患有 NAIS 的新生儿样本测试了其适用性。结果将 ATNB 图应用于新生儿样本后,大脑中动脉的后干,其次是前干,被确定为受影响最严重的动脉区域。将使用地图获得的结果与 NAIS 标准临床评估期间做出的原始诊断进行比较时,发现 18% 的病例存在重大诊断错误。结论 ATNB 图已被证明可用于精确识别受 NAIS 影响的动脉区域,并提高临床诊断的准确性。在 18% 的案例中发现了重大诊断错误。结论 ATNB 图已被证明可用于精确识别受 NAIS 影响的动脉区域,并提高临床诊断的准确性。在 18% 的案例中发现了重大诊断错误。结论 ATNB 图已被证明可用于精确识别受 NAIS 影响的动脉区域,并提高临床诊断的准确性。
更新日期:2019-12-13
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