title: Prognostic value of gradient echo T2* sequences for brain MR imaging in preterm infants.
abstract: BACKGROUND
  Gradient echo T2*-W sequences are more sensitive than T2-W spin-echo sequences for detecting hemorrhages in the brain.
  
  
  OBJECTIVE
  The aim of this study is to correlate presence of hemosiderin deposits in the brain of very preterm infants (gestational age <32 weeks) detected by T2*-W gradient echo MRI to white matter injury and neurodevelopmental outcome at 2 years.
  
  
  METHODS
  In 101 preterm infants, presence and location of hemosiderin were assessed on T2*-W gradient echo MRI performed around term-equivalent age (range: 40-60 weeks). White matter injury was defined as the presence of >6 non-hemorrhagic punctate white matter lesions (PWML), cysts and/or ventricular dilatation. Six infants with post-hemorrhagic ventricular dilatation detected by US in the neonatal period were excluded. Infants were seen for follow-up at 2 years. Univariate and regression analysis assessed the relation between presence and location of hemosiderin, white matter injury and neurodevelopmental outcome.
  
  
  RESULTS
  In 38/95 (40%) of the infants, hemosiderin was detected. Twenty percent (19/95) of the infants were lost to follow-up. There was a correlation between hemosiderin in the ventricular wall with >6 PWML (P < 0.001) and cysts (P < 0.001) at term-equivalent age, and with a lower psychomotor development index (PDI) (P=0.02) at 2 years. After correcting for known confounders (gestational age, gender, intrauterine growth retardation and white matter injury), the correlation with PDI was no longer significant.
  
  
  CONCLUSIONS
  The clinical importance of detecting small hemosiderin deposits is limited as there is no independent association with neurodevelopmental outcome.
authors.affiliation: Department of Radiology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands, f.t.wiggers-de_bruine@lumc.nl.
authors.forename: Francisca T
authors.initials: FT
authors.lastname: de Bruïne
authors.forename: Sylke J
authors.initials: SJ
authors.lastname: Steggerda
authors.forename: Annette A
authors.initials: AA
authors.lastname: van den Berg-Huysmans
authors.forename: Lara M
authors.initials: LM
authors.lastname: Leijser
authors.forename: Monique
authors.initials: M
authors.lastname: Rijken
authors.forename: Mark A
authors.initials: MA
authors.lastname: van Buchem
authors.forename: Gerda
authors.initials: G
authors.lastname: van Wezel-Meijler
authors.forename: Jeroen
authors.initials: J
authors.lastname: van der Grond
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D001921:Brain / Q000378:metabolism* / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000378:metabolism*; D005260:Female; D006485:Hemosiderin / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014018:Tissue Distribution
chemical_list: D015415:Biomarkers; D006485:Hemosiderin