title: Neurodevelopmental outcomes in preterm infants: comparison of infants with and without diffuse excessive high signal intensity on MR images at near-term-equivalent age.
abstract: OBJECTIVE
  To compare the neurodevelopmental outcomes between preterm infants with diffuse excessive high signal intensity (DEHSI) and those without DEHSI on magnetic resonance (MR) images, in association with other white matter lesions.
  
  
  METHODS
  This retrospective study was approved by the institutional review board, and requirement to obtain informed consent was waived. High-risk preterm infants (n = 126) who underwent screening brain MR imaging at near-term-equivalent age were classified into two groups according to the presence of DEHSI. Bayley Scales of Infant Development-II, presence of cerebral palsy, and neurosensory impairment between 18 and 24 months of age were compared between the two groups. The associations of MR findings of other white matter lesions (cystic encephalomalacia, punctate lesions, loss of volume, ventricular dilatation, and delayed myelination) and subsequent outcomes were also analyzed. Outcome data were evaluated by using exact logistic regression analyses and Fisher exact test.
  
  
  RESULTS
  DEHSI was present in 75% (95 of 126) of infants. Subsequent neurodevelopmental outcomes did not differ significantly between the two groups. Severe motor delay and cerebral palsy were more common in infants with both DEHSI and other white matter lesions as compared with infants with normal white matter (P = .001 and P < .001, respectively). Among other white matter lesions, cystic encephalomalacia (odds ratio, 19.6; 95% confidence interval: 1.3, 333.3) and punctate lesions (odds ratio, 90.9; 95% confidence interval: 6.4, 1000) were significant predictors of cerebral palsy.
  
  
  CONCLUSIONS
  Although the incidence of DEHSI was high (75%) in preterm infants at near-term-equivalent age MR imaging, DEHSI was not predictive of following adverse outcomes. Cystic encephalomalacia and punctate lesions were more significant predictors of cerebral palsy.
authors.affiliation: Department of Radiology, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Tae Yeon
authors.initials: TY
authors.lastname: Jeon
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Kim
authors.forename: So-Young
authors.initials: SY
authors.lastname: Yoo
authors.forename: Hong
authors.initials: H
authors.lastname: Eo
authors.forename: Jeong-Yi
authors.initials: JY
authors.lastname: Kwon
authors.forename: Jeehun
authors.initials: J
authors.lastname: Lee
authors.forename: Munhyang
authors.initials: M
authors.lastname: Lee
authors.forename: Yun Sil
authors.initials: YS
authors.lastname: Chang
authors.forename: Won Soon
authors.initials: WS
authors.lastname: Park
mesh_terms: D000704:Analysis of Variance; D001921:Brain / Q000254:growth & development*; D001927:Brain Diseases / Q000175:diagnosis*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012189:Retrospective Studies