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Four Major Signs Can Be Used To Facilitate Diagnosis of Hypoxia in Children NEW YORK -- January 15, 2009 -- There are 4 major signs that can be used to facilitate a diagnosis of hypoxia in children, according to a review published in the January issue of the American Journal of Roentgenology. A child who potentially suffers from hypoxia can be evaluated using a specific set of signs, according to lead author Ralph Heinz, Department of Radiology, Duke University School of Medicine, Durham, North Carolina. The signs are (1) increased signal intensity in the basal ganglia on T1-weighted images, (2) increased signal intensity in the thalamus on T1-weighted images, (3) absent or decreased signal intensity in the posterior limb of the internal capsule on T-1 weighted images, and (4) restricted water diffusion on diffusion-weighted images. The authors also discuss the signs that help to distinguish total, severe hypoxia from partial, prolonged hypoxia. In additions to the 4 major signs, 2 additional findings of cerebral injury may be seen. "The first is that of profound global injury involving both the gray matter and the white matter, a finding that is much less common than any of the focal injury patterns outlined previously," the authors wrote. "The second additional finding is that of parasagittal gray and white matter injury, which is characterised by the presence of bilateral cortical and subcortical white matter necrosis in the parasagittal area, often extending into the parietooccipital areas of the brain." "These signs can be used as a checklist to help radiologists assess the possibility of hypoxia in the newborn. It can be used as a cookbook or summary on how to approach a problem that has not always been handled well in the past," said Dr. Heinz. "Many general radiologists and some neuroradiologists do not have a lot of experience reading paediatric films. We have used the most valuable conclusions of others as well as our own observations and tried to present them in summary fashion. Our goal was to make it easy for people who are not experienced to grasp it in the short form." SOURCE: American Roentgen Ray Society E-mail this page to a friend or colleague! To print, use this version