Prognostic value of Cranial Ultrasound combined with Serum Neuron-Specific Enolase and Creatine Kinase-MB Isoenzyme Measurement in Neonatal Hypoxic-Ischemic Encephalopathy

Abstract

Objectives: To investigate the prognostic value of cranial ultrasound combined with serum neuron-specific enolase (NSE) and creatine kinase isoenzyme-MB (CK-MB) levels for evaluating clinical outcomes in neonates with hypoxic-ischemic encephalopathy (HIE).

Methodology: A retrospective study was conducted using clinical data from 126 children with HIE admitted to Xi’an Fourth Hospital from November 2024 to December 2025 (study group). Clinical data from 126 healthy newborns were used as the control group. All the subjects underwent cranial ultrasound and NSE and CK-MB detection. Cranial ultrasound parameters and NSE and CK-MB levels were recorded, correlations among the indicators were analyzed, and the value of each indicator for predicting HIE prognosis was evaluated.

Results: The peak systolic velocity (Vs) (t=18.508; P<0.001) and peak diastolic velocity (Vd) (t=22.741; P<0.001) were lower in the study group than in the control group, whereas the cerebral parenchymal echo intensity (t=26.068; P<0.001), lateral ventricle width (t=34.343; P<0.001), NSE level (t=35.618; P<0.001), and CK-MB level (t=30.276; P<0.001) were greater. Poor prognosis was associated with significantly lower Vs and Vd and greater cerebral parenchymal echo intensity, lateral ventricle width, and NSE and CK-MB levels (P<0.001). NSE and CK-MB levels in the study group were negatively correlated with Vs (r=-0.625, P<0.001; r=-0.483, P<0.001) and Vd (r=-0.568, P<0.001; r=-0.516, P<0.001) and positively correlated with cerebral parenchymal echo intensity (r=0.602, P<0.001; r=0.459, P<0.001) and lateral ventricle width (r=0.535, P<0.001; r=0.528, P<0.001). Combined detection showed the highest sensitivity and accuracy for predicting poor prognosis among the evaluated diagnostic methods.

Conclusion: The combination of cranial ultrasound parameters and serum NSE and CK-MB levels is a potential prognostic indicator of HIE.