Comparing 3T T1-weighted sequences in identifying hyperintense punctate lesions in preterm neonates.
OBJECTIVE
The loss of contrast on T1-weighted MR images at 3T may affect the detection of hyperintense punctate lesions indicative of periventricular leukomalacia in preterm neonates. The aim of the present study was to determine which 3T T1-weighted sequence identified the highest number of hyperintense punctate lesions and to explore the relationship between the number of hyperintense punctate lesions and clinical outcome.


METHODS
The presence of hyperintense punctate lesions was retrospectively evaluated in 200 consecutive preterm neonates on 4 axial T1-weighted sequences: 3-mm inversion recovery and spin-echo and 1- and 3-mm reformatted 3D-fast-field echo. Statistically significant differences in the number of hyperintense punctate lesions were evaluated by using a linear mixed-model analysis. Logistic regression analysis was used to assess the relation between the number of hyperintense punctate lesions and neuromotor outcome at 3 months.


RESULTS
Thirty-one neonates had at least 1 hyperintense punctate lesion indicative of periventricular leukomalacia in at least 1 of the 4 sequences. The 1-mm axial reformatted 3D-fast-field echo sequence identified the greatest number of hyperintense punctate lesions (P < .001). No statistically significant differences were found among the 3-mm T1-weighted sequences. The greater number of hyperintense punctate lesions detected by the 1-mm reformatted T1 3D-fast-field echo sequence in the central region of the brain was associated with a worse clinical outcome.


CONCLUSIONS
At 3T, the 1-mm axial reformatted T1 3D-fast-field echo sequence identified the greatest number of hyperintense punctate lesions in the central region of preterm neonate brains, and this number was associated with neuromotor outcome.
From the Radiology Unit (D.T., V.P., A.R.C., M.C.) ITAB-Institute of Advanced Biomedical Technologies (D.T., V.P., A.T., M.C.).
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Tortora
From the Radiology Unit (D.T., V.P., A.R.C., M.C.) ITAB-Institute of Advanced Biomedical Technologies (D.T., V.P., A.T., M.C.).
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Panara
Ophthalmology Clinic (P.A.M.).
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Mattei
From the Radiology Unit (D.T., V.P., A.R.C., M.C.) ITAB-Institute of Advanced Biomedical Technologies (D.T., V.P., A.T., M.C.) Department of Neuroscience and Imaging (A.T., A.R.C., M.C.), University "G. d'Annunzio" of Chieti, Chieti, Italy.
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Tartaro
Neonatology and Neonatal Intensive Care Unit (R.S., S.D.), University Hospital of Chieti, Chieti, Italy.
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Salomone
Neonatology and Neonatal Intensive Care Unit (R.S., S.D.), University Hospital of Chieti, Chieti, Italy.
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Domizio
From the Radiology Unit (D.T., V.P., A.R.C., M.C.) Department of Neuroscience and Imaging (A.T., A.R.C., M.C.), University "G. d'Annunzio" of Chieti, Chieti, Italy.
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Cotroneo
From the Radiology Unit (D.T., V.P., A.R.C., M.C.) ITAB-Institute of Advanced Biomedical Technologies (D.T., V.P., A.T., M.C.) Department of Neuroscience and Imaging (A.T., A.R.C., M.C.), University "G. d'Annunzio" of Chieti, Chieti, Italy. caulo@unich.it.
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Caulo
D001921:Brain / Q000473:pathology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007969:Leukomalacia, Periventricular / Q000473:pathology*; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012189:Retrospective Studies