RT Journal Article
SR Electronic
T1 MRI Findings at Term-Corrected Age and Neurodevelopmental Outcomes in a Large Cohort of Very Preterm Infants
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1509
OP 1516
DO 10.3174/ajnr.A6666
VO 41
IS 8
A1 S. Arulkumaran
A1 N. Tusor
A1 A. Chew
A1 S. Falconer
A1 N. Kennea
A1 P. Nongena
A1 J.V. Hajnal
A1 S.J. Counsell
A1 M.A. Rutherford
A1 A.D. Edwards
YR 2020
UL http://www.ajnr.org/content/41/8/1509.abstract
AB BACKGROUND AND PURPOSE: Brain MR imaging at term-equivalent age is a useful tool to define brain injury in preterm infants. We report pragmatic clinical radiological assessment of images from a large unselected cohort of preterm infants imaged at term and document the spectrum and frequency of acquired brain lesions and their relation to outcomes at 20 months.MATERIALS AND METHODS: Infants born at <33 weeks’ gestation were recruited from South and North West London neonatal units and imaged in a single center at 3T at term-equivalent age. At 20 months’ corrected age, they were invited for neurodevelopmental assessment. The frequency of acquired brain lesions and the sensitivity, specificity, and negative and positive predictive values for motor, cognitive, and language outcomes were calculated, and corpus callosal thinning and ventricular dilation were qualitatively assessed.RESULTS: Five hundred four infants underwent 3T MR imaging at term-equivalent age; 477 attended for assessment. Seventy-six percent of infants had acquired lesions, which included periventricular leukomalacia, hemorrhagic parenchymal infarction, germinal matrix–intraventricular hemorrhage, punctate white matter lesions, cerebellar hemorrhage, and subependymal cysts. All infants with periventricular leukomalacia, and 60% of those with hemorrhagic parenchymal infarction had abnormal motor outcomes. Routine 3T MR imaging of the brain at term-equivalent age in an unselected preterm population that demonstrates no focal lesion is 45% sensitive and 61% specific for normal neurodevelopment at 20 months and 17% sensitive and 94% specific for a normal motor outcome.CONCLUSIONS: Acquired brain lesions are common in preterm infants routinely imaged at term-equivalent age, but not all predict an adverse neurodevelopmental outcome.BSID-IIIBayley Scales of Infant Development, Version IIIGMFCSGross Motor Function Classification SystemGMH–IVHgerminal matrix hemorrhage–intraventricular hemorrhageHPIhemorrhagic parenchymal infarctionIMDindex of multiple deprivationM-CHATModified Checklist for Autism in ToddlersPLICposterior limb of the internal capsulePMApostmenstrual agePVLperiventricular leukomalaciaPWMLpunctate white matter lesions TEAterm-equivalent age