Predictive accuracy of duplex sonography vs. MRI in grading of neonatal hypoxic encephalopathy

Background: To evaluate the diagnostic accuracy of Doppler in neonates with hypoxic-ischemic encephalopathy (HIE) in correlation with MRI. Materials & Methods: During the period September 2017 to October 2019, term neonates with clinical evidence of HIE who underwent MRI were enrolled for the study. Two-dimensional duplex and color Doppler ultrasound were performed, resistive index of the middle cerebral artery was documented, and findings were correlated with MRI. Results: Of 40 consecutive neonates (29 boys and 11girls), 29 neonates with mild-moderate HIE, 7 neonates had severe HIE and 4 were normal. Accuracy of Duplex ultrasound in mild HIE is limited, however in neonates with moderate hypoxia the predictive accuracy of duplex scan as 77%, with 100% accuracy in all neonates with severe HIE. All neonates with severe HIE had increased resistance index of cerebral arteries. Conclusion: Duplex ultrasound can be used as a point of care tool not only in diagnosis of HIE, but also as a tool distinguish the grades of HIE thus aid in prognostication.