Detecting silent lesions in hypoxic-ischemic encephalopathy using submillimeter isotropic resolution diffusion MRI

Motivation: MRI is crucial for the diagnosis and prognosis of hypoxic-ischemic encephalopathy (HIE). High-resolution imaging benefits the detection of subtle lesions. However, neonates may not tolerate lengthy scans . Goal(s): To obtain ultrahigh resolution brain diffusion-weighted MR images(DWIs) within a feasible time frame to detect lesions invisible on images acquired using standard clinical protocols. Approach: One b=0 volume and six DWI volumes at submillimeter isotropic resolution (0.86×0.86×0.86 mm3) were acquired using the Generalized SLIce Dithered Enhanced Resolution Simultaneous MultiSlice (gSlider-SMS) sequence, in addition to standard protocols. Results: Ischemic lesions and cytotoxic edema invisible on standard clinical images were found on submillimeter resolution diffusion MRI data. Impact: Submillimeter isotropic resolution diffusion MR images show lesions invisible on standard clinical images, which helps diagnose HIE earlier and more accurately for timely and appropriate treatment, as well as provides new biomarkers for accurate HIE staging.