Neonatal brain MRI: how reliable is the radiologist's eye?
BACKGROUND
White matter (WM) analysis in neonatal brain magnetic resonance imaging (MRI) is challenging, as demonstrated by the issue of diffuse excessive high signal intensity (DEHSI). We evaluated the reliability of the radiologist's eye in this context.


METHODS
Three experienced observers graded the WM signal intensity on axial T2-weighted 1.5T images from 60 different premature newborns on 2 occasions 4 weeks apart with a semi-quantitative classification under identical viewing conditions.


RESULTS
The intra- and inter-observer correlation coefficients were fair to moderate (Fleiss' kappa between 0.21 and 0.60).


CONCLUSIONS
This is a serious limitation of which we need to be aware, as it can lead to contradictory conclusions in the challenging context of term-equivalent age brain MRI in premature infants. These results highlight the need for a semiautomatic tool to help in objectively analyzing MRI signal intensity in the neonatal brain.
Pediatric Radiology, A. Trousseau Hospital APHP, 26 avenue du Dr Arnold Netter, 75012, Paris, France. baptistemorelaphp@gmail.com.|LTCI, CNRS, Télécom ParisTech, Université Paris-Saclay, Paris, France. baptistemorelaphp@gmail.com.
B
B
Morel
INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Reproduction and Child Development, F-94807, Villejuif, France.
G
G
Antoni
INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Reproduction and Child Development, F-94807, Villejuif, France.
J P
JP
Teglas
LTCI, CNRS, Télécom ParisTech, Université Paris-Saclay, Paris, France.
I
I
Bloch
Faculty of Medicine, Paris Sud University, Pediatric Radiology Department Bicêtre Hospital APHP, Paris, France.
C
C
Adamsbaum
D001921:Brain / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D015588:Observer Variation; D018743:Perinatal Care / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D066127:White Matter / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*
DEHSI; Neonatal brain MRI; Signal analysis