Cerebral MRI of very low birth weight children at 6 years of age compared with the findings at 1 year.
BACKGROUND
We have previously reported the results of cerebral MRI examinations in an unselected year cohort of very low birth weight (VLBW) infants at one year of corrected age. Twenty-one (78 %) of 27 infants had abnormal myelination, mainly in the central occipital white matter (COWM) and in the centrum semiovale (CS), seen on T2-weighted images. Twelve infants had irregular and dilated lateral ventricles. We speculated whether these findings indicated perinatal periventricular leukomalacia (PVL). Only two infants had completely normal MRI at age 1 year.


OBJECTIVE
To determine whether the abnormal myelination seen at 1 year of age, was still present, either as delayed myelination or as gliosis caused by perinatal PVL.


METHODS
In the present study, we report the results of follow-up cerebral MRI in 20 of these infants at 6 years of age.


RESULTS
Most of the children with MRI deviations at 1 year still had abnormalities at 6 years. Abnormal myelination in the central occipital white matter combined with abnormalities in the CS or with ventricular dilatation at age 1 year, presented as gliosis in 12 of 13 children at 6 years of age. Abnormalities solely in the COWM at age 1 year had normalised in two of five children and persisted as delayed myelination in three at age 6 years. Gliotic changes in periventricular white matter were found in 12 of 20 children (60 %). Areas most affected were the CS (11 children) and the COWM (9 children). Delayed myelination in COWM was found in six children (30 %), combined with gliosis in CS in three children. Twelve infants had ventricular dilatation both at 1 and 6 years of age.


CONCLUSIONS
The MRI correlates of PVL, i. e. gliosis and ventricular dilatation, are common findings on cerebral MRI at 6 years of age in VLBW infants.
Skranes
J S
JS
Department of Pediatrics and Neonatal Medicine, University Hospital of Trondheim, Norway.
Nilsen
G
G
Smevik
O
O
Vik
T
T
Brubakk
A M
AM
D001921:Brain / Q000473:pathology*; D002648:Child; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007969:Leukomalacia, Periventricular / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D013997:Time Factors