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Magnetic resonance imaging in preterm infants

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Abstract

MR imaging of the premature infant poses a number of challenges with regard to safety, sequence optimization and recognition of the normal appearances of the developing brain. In this paper we discuss these challenges, and review the common intracerebral abnormalities associated with premature birth. Although the outcome for very-low-birth-weight babies has improved over the last decade, there remains a significant risk of subsequent development of neurological disability. The relationship between MRI abnormalities and long-term outcome is considered.

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References

  1. Paneth N (1999) Classifying brain damage in preterm infants (editorial). J Pediatr 134:527–529

    Article  PubMed  CAS  Google Scholar 

  2. Inder TE, Warfield SK, Wang H, et al (2005) Abnormal cerebral structure is present at term in premature infants. Pediatrics 115:286–294

    Article  PubMed  Google Scholar 

  3. Levene MI, de Vries LS (2001) Neonatal intracranial haemorrhage; cerebral ischemic lesions. In: Levene MI, Chervenak FA, Whittle M (eds) Fetal and neonatal neurology and neurosurgery, 3rd edn. Churchill Livingstone, Edinburgh, pp 339–404

    Google Scholar 

  4. Wood NS, Marlow N, Costeloe K, et al (2000) Neurologic and developmental disability after extremely preterm birth. N Engl J Med 343:378–384

    Article  PubMed  CAS  Google Scholar 

  5. Trounce JQ, Fagan D, Levene MI (1986) Intraventricular haemorrhage and periventricular leukomalacia: ultrasound and autopsy correlation. Arch Dis Child 61:1203–1207

    PubMed  CAS  Google Scholar 

  6. Trounce JQ, Rutter N, Levene MI (1986) Periventricular leukomalacia and intraventricular haemorrhage in the preterm neonate. Arch Dis Child 61:1196–1202

    Article  PubMed  CAS  Google Scholar 

  7. Debillion T, N’Guyen S, Muet A, et al (2003) Limitations of ultrasonography for diagnosing white matter damage in preterm infants. Arch Dis Child Fetal Neonatal Ed 88:F275–F279

    Article  PubMed  Google Scholar 

  8. De-Vries LS, Van-Haaster I-L, Rademaker KJ, et al (2004) Ultrasound abnormalities preceding cerebral palsy in high-risk preterm infants. J Pediatr 144:815–820

    PubMed  Google Scholar 

  9. Volpe JJ (1997) Brain injury in the premature infant. Neuropathology, clinical aspects, pathogenesis, and prevention. Clin Perinatol 24:567–587

    PubMed  CAS  Google Scholar 

  10. Barkovich AJ, Sargent SK (1995) Profound asphyxia in the premature infant: imaging findings. AJNR 16:1837–1846

    PubMed  CAS  Google Scholar 

  11. Childs AM, Cornette L, Ramenghi LA, et al (2001) Magnetic resonance and cranial ultrasound characteristics of periventricular white matter abnormalities in newborn infants. Clin Radiol 56:647–655

    Article  PubMed  CAS  Google Scholar 

  12. Maalouf EF, Duggan PJ, Counsell SJ, et al (2001) Comparison of findings on cranial ultrasound and magnetic resonance imaging in preterm infants. Pediatrics 107:719–727

    Article  PubMed  CAS  Google Scholar 

  13. Inder TE, Anderson NJ, Spencer C, et al (2003) White matter injury in the premature infant: a comparison between serial cranial sonographic and MR findings at term. AJNR 24:805–809

    PubMed  Google Scholar 

  14. Kanal E, Borgstede JP, Barkovich AJ, et al (2004) American College of Radiology. white paper on MR safety: 2004 update and revisions. AJR 182:1111–1114

    PubMed  Google Scholar 

  15. Purdy IB, Wiley DJ (2003) Magnetic resonance imaging in the neonate. Neonatal Netw 22:9–18

    PubMed  Google Scholar 

  16. Rutherford MA (2002) Patient preparation, safety and hazards in imaging infants and children. In: Rutherford MA (ed) MRI of the neonatal brain, 1st edn. Saunders, Philadelphia, pp 3–15

    Google Scholar 

  17. Rutherford MA (2002) Imaging the preterm infant: practical issues. In: Rutherford MA (ed) MRI of the neonatal brain, 1st edn. Saunders, Philadelphia, pp 17–21

    Google Scholar 

  18. Whitby E, Griffiths PD, Lonneker-Lammers T, et al (2004) Ultrafast magnetic resonance imaging of the neonate in a magnetic resonance-compatible incubator with a built-in coil. Pediatrics 113:150–152

    Article  Google Scholar 

  19. American Academy of Pediatrics, Committee on Environmental Health (1997) Noise: a hazard for the fetus and newborn. Pediatrics 100:724–727

    Article  Google Scholar 

  20. Battin M, Maalouf EF, Counsell SJ, et al (1998) Physiological stability of preterm infants during magnetic resonance imaging. Early Hum Dev 52:101–110

    Article  PubMed  CAS  Google Scholar 

  21. Johnson MA, Pennock JM, Bydder GM, et al (1983) Clinical NMR imaging of the brain of children: normal and neurologic disease. AJR 141:1005–1018

    PubMed  CAS  Google Scholar 

  22. Counsell SJ, Kennea NL, Herlihy AH, et al (2003) T2 relaxation values in the developing brain. AJNR 24:1654–1660

    PubMed  Google Scholar 

  23. Jones RA, Palasis S, Grattan-Smith JD (2004) MRI of the neonatal brain: optimisation of spin-echo parameters. AJR 182:367–372

    PubMed  Google Scholar 

  24. Inder T, Huppi P, Zientara G, et al (1999) Early detection of periventricular leukomalacia by diffusion-weighted magnetic resonance imaging techniques. J Pediatr 134:631–634

    Article  PubMed  CAS  Google Scholar 

  25. Bozzao A, Di Paolo A, Mazzoleni C, et al (2003) Diffusion-weighted MR imaging in the early diagnosis of periventricular leukomalacia. Eur Radiol 13:1571–1576

    Article  PubMed  Google Scholar 

  26. Counsell SJ, Alsop JM, Harrison MC, et al (2003) Diffusion-weighted imaging of the brain in preterm infants with focal and diffuse white matter abnormality. Pediatrics 112:1–7

    Article  PubMed  Google Scholar 

  27. Childs AM, Ramenghi LA, Evans DJ, et al (1998) MR features of developing periventricular white matter in preterm infants: evidence of glial cell migration. AJNR 19:971–976

    PubMed  CAS  Google Scholar 

  28. Battin MR, Maalouf EF, Counsell SJ, et al (1998) Magnetic resonance imaging of the brain in preterm infants: visualisation of the germinal matrix, early myelination and cortical folding. Pediatrics 101:957–962

    Article  PubMed  CAS  Google Scholar 

  29. Evans DJ, Childs AM, Ramenghi LA, et al (1997) Magnetic resonance imaging of the brain of premature infants (letter). Lancet 349:1741

    Article  PubMed  Google Scholar 

  30. Counsell SJ, Rutherford MA, Cowan FM, et al (2002) Magnetic resonance imaging of the preterm brain injury. Arch Dis Child 88:F269–F274

    Google Scholar 

  31. McArdle CB, Richardson CJ, Nicholas DA, et al (1987) Developmental features of the neonatal brain: MR imaging. Radiology 162:223–229

    PubMed  CAS  Google Scholar 

  32. Barkovich AJ, Kjos BO, Jackson DE, et al (1988) Normal maturation of the neonatal and infant brain: MR imaging at 1.5 T. Radiology 166:173–180

    PubMed  CAS  Google Scholar 

  33. Barkovich JA (2000) Normal development of the neonatal and infant brain, skull, and spine. In: Barkovich JA (ed) Pediatric neuroimaging, 3rd edn. Lippincott Williams & Wilkins, Philadelphia, pp 13–69

    Google Scholar 

  34. Childs AM, Ramenghi LA, Cornette L, et al (2001) Cerebral maturation in premature infants: quantitative assessment using MR imaging. AJNR 22:1577–1582

    PubMed  CAS  Google Scholar 

  35. van der Knapp MS, Wezel-Meijler G, Barth PG, et al (1996) Normal gyration and sulcation in preterm and term neonates: appearance on MR images. Radiology 200:389–396

    PubMed  Google Scholar 

  36. De Vries LS, Eken P, Groenendaal F, et al (1993) Correlation between the degree of periventricular leukomalacia diagnosed using cranial ultrasound and MRI later in infancy in children with cerebral palsy. Neuropediatrics 24:263–268

    PubMed  Google Scholar 

  37. Roelants-van Rijn A, Groeendaal F, Beek FJ, et al (2001) Parenchymal brain injury in the preterm infant: comparison of cranial ultrasound, MRI and neurodevelopmental outcome. Neuropediatrics 32:80–89

    Article  PubMed  CAS  Google Scholar 

  38. Cornette LG, Tanner, SF, Ramenghi LA, et al (2002) Magnetic resonance imaging of the infant brain: anatomical characteristics and clinical significance of punctate lesions. Arch Dis Child Fetal Neonatal Ed 86:F171–F177

    Article  PubMed  CAS  Google Scholar 

  39. Ernst M, Baryonic A (1995) Magnetic resonance imaging in perinatal asphyxia. Arch Dis Child Fetal Neonatal Ed 72:F62–F70

    Article  PubMed  Google Scholar 

  40. Sie LT, Hart AA, van Hoof J, et al (2005) Predictive value of neonatal MRI with respect to late MRI findings and clinical outcome. A study in infants with periventricular densities on neonatal ultrasound. Neuropediatrics 36:78–89

    Article  PubMed  CAS  Google Scholar 

  41. Maalouf EF, Duggan PJ, Rutherford MA, et al (1999) Magnetic resonance imaging of the brain in a cohort of extremely preterm infants. J Pediatr 135:351–357

    Article  PubMed  CAS  Google Scholar 

  42. Inder T, Scott JW, Mogridge NB, et al (2003) Defining the nature of the cerebral abnormalities in the premature infant: a qualitative magnetic resonance imaging study. J Pediatr 143:171–179

    Article  PubMed  Google Scholar 

  43. Kennea NL, Rutherford MA, Counsell SJ, et al (2002) Brain injury in extremely preterm infants at birth and at term corrected age using magnetic resonance imaging. Pediatr Res 51S:2559

    Google Scholar 

  44. Miall LS, Cornette LG, Tanner SF, et al (2003) Posterior fossa abnormalities seen on magnetic resonance brain imaging in a cohort of newborn infants. J Perinatol 23:396–403

    Article  PubMed  Google Scholar 

  45. Merrill JD, Piecuch RE, Fell SC, et al (1998) A new pattern of cerebellar hemorrhages in preterm infants. Pediatrics 102:e62

    Article  PubMed  CAS  Google Scholar 

  46. Taylor GA (1998) Recent advances in neonatal cranial ultrasound and Doppler techniques. Clin Perinatol 24:677–689

    Google Scholar 

  47. Whitby EH, Griffiths PD, Rutter S, et al (2004) Frequency and natural history of subdural haemorrhages in babies and relation to obstetric factors. Lancet 363:846–851

    Article  PubMed  CAS  Google Scholar 

  48. Valkama AM, Pääkko EL, Vainionpää LK, et al (2000) Magnetic resonance imaging at term and neuromotor outcome in preterm infants. Acta Paediatr 89:348–355

    Article  PubMed  CAS  Google Scholar 

  49. Aida N, Nishimura G, Hachiya Y, et al (1998) MR imaging of perinatal brain damage: comparison of clinical outcome with initial and follow-up MR findings. AJNR 19:1909–1921

    PubMed  CAS  Google Scholar 

  50. de Vries LS, Dubowitz MS, Pennock JM, et al (1989) Cystic leukomalacia: correlation of cranial ultrasound, magnetic resonance imaging and clinical findings in sequential studies. Clin Radiol 40:158–166

    Article  PubMed  Google Scholar 

  51. Kuban KC (1998) White matter disease of prematurity, periventricular leukomalacia, and ischemic lesions. Dev Med Child Neurol 40:571–573

    Article  PubMed  CAS  Google Scholar 

  52. Takashima S, Mito T, Ando Y (1986) Pathogenesis of periventricular white matter hemorrhage in preterm infants. Brain Dev 8:25–30

    PubMed  CAS  Google Scholar 

  53. Volpe JJ (1995) Intracranial haemorrhage: germinal matrix-intraventricular haemorrhage of the premature infants. Ischemic encephalopathy. In: Volpe JJ (ed) Neurology of the newborn, 3rd edn. Saunders, Philadelphia, pp 211–372, 403–465

    Google Scholar 

  54. Huppi PS, Murphy B, Maier SE, et al (2001) Microstructural brain development after perinatal cerebral white matter injury assessed by diffusion tensor magnetic resonance imaging. Pediatrics 107:455–460

    Article  PubMed  CAS  Google Scholar 

  55. Cooke RW, Abernethy LJ (1999) Cranial magnetic resonance imaging and school performance in very low birth weight infants in adolescence. Arch Dis Child Fetal Neonatal Ed 81:F116–F121

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

I wish to thank Professor M. Levene, Dr. L. Cornette, Dr. L. Miall, Dr. A.-M. Childs and Dr. L. Ramenghi for their participation, active support and advice in our “Neonatal MRI research team”, and the continuing efforts of our MRI radiographers and physicists in providing us with an excellent neonatal MRI service.

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Correspondence to Rosemary Arthur.

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Arthur, R. Magnetic resonance imaging in preterm infants. Pediatr Radiol 36, 593–607 (2006). https://doi.org/10.1007/s00247-006-0154-x

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