RT Journal Article
SR Electronic
T1 Cerebral Maturation in Premature Infants: Quantitative Assessment Using MR Imaging
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1577
OP 1582
VO 22
IS 8
A1 Anne-Marie Childs
A1 Luca A. Ramenghi
A1 Luc Cornette
A1 Steven F. Tanner
A1 Rosemary J. Arthur
A1 Delia Martinez
A1 Malcolm I. Levene
YR 2001
UL http://www.ajnr.org/content/22/8/1577.abstract
AB BACKGROUND AND PURPOSE: The assessment of whether brain development is at an appropriate level for age has become an integral part of clinical MR reporting, although few studies have quantitatively defined the developmental changes occurring in premature infants. We have developed a simple scoring system to assess four parameters of cerebral maturation—myelination, cortical folding, glial cell migration, and germinal matrix distribution—to determine the total maturation score (TMS). The aim of this study was to validate this scoring system in a large population of preterm infants across a range of gestational ages.METHODS: A retrospective analysis was conducted of MR images acquired over a 3-year period with an identical imaging protocol. Infants born more than 14 days before the imaging examination and those with a clinical or radiologic history suggestive of neuroabnormality were excluded from the study. The TMS was derived by consensus. Interobserver agreement was evaluated by using the Bland-Altman plot.RESULTS: Images from 134 infants (23–41 weeks' gestational age) were evaluated. The TMS was significantly related to the postmenstrual age of the infant, with the mean TMS for each age group increasing with advancing postmenstrual age. Interobserver agreement was found to be high (mean difference in score = 0.07, SD = 0.56).CONCLUSION: This scoring system provides a standardized method for assessing cerebral maturation in the premature infant. The TMS is easy to calculate from standard MR images, is reproducible, and can help detect changes occurring within a postnatal age of a few weeks.