Early cranial ultrasound lesions predict microcephaly at age 2 years in preterm infants.
To assess how well early ultrasound lesions in preterm newborns predict reduced head circumference at 2 years, the investigators followed 923 children born before the 28th week of gestation who were not microcephalic at birth. Six percent of children who had a normal ultrasound scan were microcephalic compared with 15% to 20% who had intraventricular hemorrhage, an echolucent lesion, or ventriculomegaly. The odds ratios (95% confidence intervals) for microcephaly associated with different ultrasound images were intraventricular hemorrhage, 1.5 (0.8-3.0); ventriculomegaly, 3.3 (1.8-6.0); an echodense lesion, 1.6 (0.7-3.5); and an echolucent lesion, 3.1 (1.5-6.2). Ventriculomegaly and an echolucent lesion had very similar low positive predictive values (24% and 27%, respectively) and high negative predictive values (91% and 90%, respectively) for microcephaly. Ventriculomegaly had a higher sensitivity for microcephaly than did an echolucent lesion (24% vs 16%, respectively). Focal white-matter lesion (echolucent lesion) and diffuse white-matter damage (ventriculomegaly) predict an increased risk of microcephaly.
Krishnamoorthy
Kalpathy S
KS
Department of Neurology/Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, Harvard Medical School, Harvard University, Boston, Massachusetts, USA. KKrishnamoorthy@Partners.org
Kuban
Karl C K
KC
O'Shea
T Michael
TM
Westra
Sjirk J
SJ
Allred
Elizabeth N
EN
Leviton
Alan
A
D001921:Brain / Q000473:pathology; D002508:Cephalometry; D002675:Child, Preschool; D004453:Echoencephalography; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007969:Leukomalacia, Periventricular / Q000000981:diagnostic imaging* / Q000473:pathology; D008831:Microcephaly / Q000000981:diagnostic imaging* / Q000473:pathology; D016017:Odds Ratio; D011237:Predictive Value of Tests