title: Serial cranial ultrasonography or early MRI for detecting preterm brain injury?
abstract: OBJECTIVE
  To investigate detection ability and feasibility of serial cranial ultrasonography (CUS) and early MRI in preterm brain injury.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Level III neonatal intensive care unit.
  
  
  METHODS
  307 infants, born below 29 weeks of gestation.
  
  
  METHODS
  Serial CUS and MRI were performed according to standard clinical protocol. In case of instability, MRI was postponed or cancelled. Brain images were assessed by independent experts and compared between modalities.
  
  
  METHODS
  Presence of preterm brain injury on either CUS or MRI and discrepant imaging findings on CUS and MRI.
  
  
  RESULTS
  Serial CUS was performed in all infants; early MRI was often postponed (n=59) or cancelled (n=126). Injury was found in 146 infants (47.6%). Clinical characteristics differed significantly between groups that were subdivided according to timing of MRI. 61 discrepant imaging findings were found. MRI was superior in identifying cerebellar haemorrhage; CUS in detection of acute intraventricular haemorrhage, perforator stroke and cerebral sinovenous thrombosis.
  
  
  CONCLUSIONS
  Advanced serial CUS seems highly effective in diagnosing preterm brain injury, but may miss cerebellar abnormalities. Although MRI does identify these lesions, feasibility is limited. Improved safety, better availability and tailored procedures are essential for MRI to increase its value in clinical care.
authors: Division of Neonatology, Department of Pediatrics, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Annemarie
authors: A
authors: Plaisier
authors: Division of Neonatology, Department of Pediatrics, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands.
authors: Marlou M A
authors: MM
authors: Raets
authors: Division of Neonatology, Department of Pediatrics, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands.
authors: Ginette M
authors: GM
authors: Ecury-Goossen
authors: Division of Neonatology, Department of Pediatrics, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands Department of Pediatrics, Koningin Paola Children's Hospital, Antwerp, Belgium.
authors: Paul
authors: P
authors: Govaert
authors: Division of Neonatology, Department of Pediatrics, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Monique
authors: M
authors: Feijen-Roon
authors: Division of Neonatology, Department of Pediatrics, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands.
authors: Irwin K M
authors: IK
authors: Reiss
authors: Division of Neonatology, Department of Pediatrics, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands Division of Pediatric Neurology, Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Liesbeth S
authors: LS
authors: Smit
authors: Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Maarten H
authors: MH
authors: Lequin
authors: Division of Neonatology, Department of Pediatrics, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Jeroen
authors: J
authors: Dudink
mesh_terms: D001921:Brain / Q000473:pathology; D001930:Brain Injuries / Q000175:diagnosis / Q000209:etiology; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology; D015331:Cohort Studies; D003951:Diagnostic Errors / Q000517:prevention & control*; D004453:Echoencephalography / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009426:Netherlands; D011446:Prospective Studies; D058996:Quality Improvement; D015203:Reproducibility of Results
keywords: Imaging; Neonatology; Neurology