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PS-112 Ischaemic Neonatal Stroke Classification With A 3d Map Of The Arterial Territories Of The Infant Brain
  1. C Stephan-Otto1,
  2. G Arca-Diaz2,
  3. T Agut2,
  4. A Garcia-Alix2
  1. 1Unitat de Recerca, Parc Sanitari Sant Joan de Deu FSJD – UB – CIBERSAM, Barcelona, Spain
  2. 2Neonatology, Agrupacion Sanitaria Sant Joan de Deu – Hospital Clinic – UB, Barcelona, Spain

Abstract

Background and aim Prognosis of neonatal Arterial Ischaemic Stroke (AIS) seems to depend strongly on early MRI findings, while standard neurological examination provides limited prognostic value. The extent of a lesion as well as the brain areas involved appear to be the main outcome indicators. Moreover, classification according to arterial irrigation regions has proven useful. We aim to provide a tool for systematic vascular classification by means of a segmented 3D map with standard neonatal dimensions.

Methods A T1 structural MR image as well as a TOF angiography were deformed into a standardised neonatal brain. Brain structures and main arteries were then identified in this brain, and the corresponding arterial territories delineated with the help of published arterial region maps for adults. The standardised brain was then manually segmented, under supervision of three experts, and assembled into a 3-dimensional map.

Results Reliability of the resulting 3D map was assessed by automatically classifying a series of previously diagnosed AIS. Arterial region attribution mistakes were detected in radiology reports in some cases, supporting the need of this kind of tool. A test sample of 25 AIS with heterogeneous distribution and sizes was used to validate the original segmentation. Only minor corrections to territory boundaries were necessary.

Conclusions We propose a systematic method to characterise AIS location and extent in neonates by means of a standard template of arterial territories. Its effectiveness in the assessment of stroke outcome is left as a future research endeavour with an independent, larger sample.

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