Understanding brain injury and neurodevelopmental disabilities in the preterm infant: the evolving role of advanced magnetic resonance imaging

The high incidence of neurodevelopmental disability in premature infants requires continued efforts at understanding the underlying microstructural changes in the brain that cause this perturbation in normal development. Magnetic resonance imaging (MRI) methods offer great potential to fulfill this need. Serial MR imaging and the application of newer analysis techniques, such as diffusion tensor imaging (DTI), volumetric MR analysis, cortical surface analysis, functional connectivity MRI (fcMRI) and diffusion tractography, provide important insights into the trajectory of brain development in the premature infant and the impact of injury on this developmental trajectory. While some of these imaging techniques are currently available in the research setting only, other measures, such as DTI and brain metric measures can be used clinically. MR imaging also has an enormous potential to be used as a surrogate, short-term outcome measure in clinical studies evaluating new therapeutic interventions of neuroprotection of the developing brain. In this article, we review the current status of these advanced MR imaging techniques.