Comparing brain white matter on sequential cranial ultrasound and MRI in very preterm infants.
BACKGROUND
Periventricular white matter (WM) echodensities, frequently seen in preterm infants, can be associated with suboptimal neurodevelopment. Major WM injury is well detected on cranial ultrasound (cUS). cUS seems less sensitive for diffuse or more subtle WM injury. Our aim was to assess the value of cUS and magnetic resonance imaging (MRI) for evaluating WM changes and the predictive value of cUS and/or MRI findings for neurodevelopmental outcome in very preterm infants with normal to severely abnormal WM on sequential high-quality cUS.


METHODS
Very preterm infants (<32 weeks) who had sequential cUS and one MRI within the first three postnatal months were included. Periventricular WM on cUS and MRI was compared and correlated with neurodevelopmental outcome at 2 years corrected age.


RESULTS
Forty preterm infants were studied; outcome data were available in 32. WM changes on sequential cUS were predictive of WM changes on MRI. Severely abnormal WM on cUS/MRI was predictive of adverse outcome, and normal-mildly abnormal WM of favorable outcome. Moderately abnormal WM on cUS/MRI was associated with variable outcome. Additional MRI slightly increased the predictive value of cUS in severe WM changes.


CONCLUSIONS
Sequential cUS in preterm infants is reliable for detecting WM changes and predicting favorable and severely abnormal outcome. Conventional and diffusion-weighted MRI sequences before term equivalent age in very preterm infants, suggested on cUS to have mild to moderately abnormal WM, do not seem to be warranted.
Leijser
Lara M
LM
Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, RC Leiden, the Netherlands.
Liauw
Lishya
L
Veen
Sylvia
S
de Boer
Inge P
IP
Walther
Frans J
FJ
van Wezel-Meijler
Gerda
G
D001921:Brain / Q000254:growth & development* / Q000473:pathology* / Q000503:physiopathology; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D004453:Echoencephalography; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D011237:Predictive Value of Tests; D011597:Psychomotor Performance / Q000502:physiology; D012189:Retrospective Studies; D012720:Severity of Illness Index