Modified Barkovich Neonatal Hypoxic-Ischemic Encephalopathy MRI Classification (HIE-MRI) Imaging Score

Watershed Area	Imaging Findings	Score
Normal		0
Mild	Single or focal white matter injury	1
Mild	Anterior or posterior white matter injury (including periventricular white matter injury)	2
Moderate	Anterior or posterior watershed area cortical and white matter injury	3
Severe	Abnormal signals in anterior and posterior watershed areas (including unclear gray-white matter boundaries)	4
Severe	More extensive abnormalities (including indistinguishable gray-white matter)	5

Basal Ganglia/Thalamus	Imaging Findings	Score
Normal		0
Mild	Focal, mild signal abnormalities, usually in the ventrolateral nucleus of the thalamus and/or posterior putamen	1
Moderate	Signal abnormalities in the thalamus and lentiform nucleus	2
Moderate	Signal abnormalities in the thalamus, lentiform nucleus, and Rolandic area	3
Severe	More extensive involvement	4

Posterior Limb of Internal Capsule	Imaging Findings	Score
Normal		0
Blurred	Reduced or asymmetric signal intensity	1
Abnormal	Loss, inversion, or abnormal signals on T1 and/or T2	2

Brainstem/Diencephalon	Imaging Findings	Score
Normal		0
Moderate	Loss of anatomical details, clear distinction between anterior and posterior pons, focal signal abnormalities, mild asymmetry	1
Severe	Extensive signal abnormalities, abnormal myelination, significant asymmetry, atrophy	2