Screening Cranial Imaging at Multiple Time Points Improves Cystic Periventricular Leukomalacia Detection.
OBJECTIVE
The aim of this study is to determine whether the cystic periventricular leukomalacia (cPVL) detection rate differs between imaging studies performed at different time points.


METHODS
We retrospectively reviewed the prospectively collected data of 31,708 infants from the NICHD Neonatal Research Network. Inclusion criteria were infants < 1,000 g birth weight or < 29 weeks' gestational age who had cranial imaging performed using both early criterion (cranial ultrasound [CUS] < 28 days chronological age) and late criterion (CUS, magnetic resonance imaging, or computed tomography closest to 36 weeks postmenstrual age [PMA]). We compared the frequency of cPVL diagnosed by early and late criteria.


RESULTS
About 664 (5.2%) of the 12,739 infants who met inclusion criteria had cPVL using either early or late criteria; 569 using the late criterion, 250 using the early criterion, and 155 patients at both times. About 95 (14.3%) of 664 cPVL cases seen on early imaging were no longer visible on repeat screening closest to 36 weeks PMA. Such disappearance of cPVL was more common in infants < 26 weeks' gestation versus infants of 26 to 28 weeks' gestation (18.5 vs. 11.5%; p = 0.013).


CONCLUSIONS
Cranial imaging at both < 28 days chronological age and closest to 36 weeks PMA improves cPVL detection, especially for more premature infants.
Department of Pediatrics, University of Michigan, Ann Arbor, Michigan.
Subrata
S
Sarkar
Department of Pediatrics, Wayne State University, Detroit, Michigan.
Seetha
S
Shankaran
Department of Pediatrics, Women and Infants' Hospital, Brown University, Providence, Rhode Island.
Abbot R
AR
Laptook
Department of Pediatrics, Wayne State University, Detroit, Michigan.
Beena G
BG
Sood
Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina.
Barbara
B
Do
Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia.
Barbara J
BJ
Stoll
Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
Krisa P
KP
Van Meurs
Department of Pediatrics, University of Iowa, Iowa City, Iowa.
Edward F
EF
Bell
Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, Maryland.
Abhik
A
Das
Department of Pediatrics, University of Michigan, Ann Arbor, Michigan.
John
J
Barks
D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D004453:Echoencephalography; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007234:Infant, Premature; D007969:Leukomalacia, Periventricular / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D015997:Neonatal Screening; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed