Abnormal white matter appearance on term FLAIR predicts neuro-developmental outcome at 6 years old following preterm birth.
Preterm infants are at significant risk of neuro-developmental disorders at school-age. MRI is a potentially useful screening tool of such disorders. Using FLAIR imaging in the preterm infants at term, here we demonstrate that abnormal low-intensity signal in the white matter predicts the neuro-developmental outcome at 6 years.


METHODS
Clinical factors associated with white matter appearance on MRI obtained at term were investigated in 210 preterm infants.


RESULTS
Low-intensity signal on FLAIR imaging was commonly observed (69%) at <2 months corrected-age. Its incidence correlated with corrected-age at scan, maternal pyrexia and cystic periventricular leukomalacia. Low-intensity signal on FLAIR significantly correlated with performance and full-scale developmental quotients, whereas diffuse high-intensity signal on T2-weighted imaging correlated only with the full-scale developmental quotient at 6 years (n = 75, WISC-R). FLAIR imaging, but not T2-weighted imaging, predicted mild neuro-developmental delay.


CONCLUSIONS
FLAIR appeared to detect subtle white matter injury related with neuro-developmental disorders at school-age, whereas T2-weighted imaging seemed to identify relatively more severe injury. FLAIR is a potentially sensitive screening tool that is readily available and easily interpretable.
Iwata
Sachiko
S
Department of Pediatrics and Child Health, Center for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011 Japan.
Iwata
Osuke
O
Bainbridge
Alan
A
Nakamura
Tomohiko
T
Kihara
Hideki
H
Hizume
Eriko
E
Sugiura
Masatoshi
M
Tamura
Masanori
M
Matsuishi
Toyojiro
T
D000704:Analysis of Variance; D001921:Brain / Q000473:pathology*; D002648:Child; D003627:Data Interpretation, Statistical; D002658:Developmental Disabilities / Q000473:pathology* / Q000523:psychology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D016017:Odds Ratio; D011379:Prognosis