title: Routine Magnetic Resonance Imaging at Term-Equivalent Age Detects Brain Injury in 25% of a Contemporary Cohort of Very Preterm Infants.
abstract: BACKGROUND
  In recent years, significant investigation has been undertaken by means of magnetic resonance imaging (MRI) in an attempt to identify preterm infants at risk for adverse outcome. The primary objective is to provide a comprehensive characterization of cerebral injury detected by conventional MRI at term-equivalent age in an unselected, consecutive, contemporary cohort of preterm infants born <32 gestational weeks. Secondly, this study aims to identify risk factors for the different injury types in this population.
  
  
  METHODS
  Data for all preterm infants born <32 gestational weeks and admitted to Innsbruck Medical University Hospital were prospectively collected (October 2010 to December 2015). Cerebral MRI was evaluated retrospectively using a validated scoring system that incorporates intraventricular haemorrhage (IVH), white matter disease (WMD) and cerebellar haemorrhage (CBH).
  
  
  RESULTS
  300 infants were included in the study. MRI showed 24.7% of all infants to have some form of brain injury. The most common injury type was IVH (16.0%). WMD and CBH were seen in 10.0% and 8.0%. The prevalence of common neonatal risk factors was greater within the group of infants with CBH. In particular indicators for respiratory disease were observed more often: longer ventilation duration, more frequent need for supplemental oxygen at day 28, higher rates of hydrocortisone treatment. Catecholamine treatment was the only neonatal risk factor that was overrepresented in infants with WMD.
  
  
  CONCLUSIONS
  Cerebral MRI at term-equivalent age, as addition to cranial ultrasound, detected brain injury in 25% of preterm survivors. The diagnosis of IVH was already made by neonatal ultrasound in most cases. In contrast, only a minority of the CBH and none of the non-cystic WMD have been detected prior to MRI. Decreasing gestational age and neonatal complications involved with immaturity have been identified as risk factors for CBH, whereas WMD was found in relatively mature infants with circulatory disturbances.
authors.affiliation: Department of Paediatrics II, Neonatology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Vera
authors.identifier: http://orcid.org/0000-0001-6638-8624
authors.initials: V
authors.lastname: Neubauer
authors.affiliation: Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Tanja
authors.initials: T
authors.lastname: Djurdjevic
authors.affiliation: Department of Paediatrics II, Neonatology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Elke
authors.initials: E
authors.lastname: Griesmaier
authors.affiliation: Department of Paediatrics II, Neonatology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Marlene
authors.initials: M
authors.lastname: Biermayr
authors.affiliation: Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria.|Neuroimaging Core Facility, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Elke Ruth
authors.initials: ER
authors.lastname: Gizewski
authors.affiliation: Department of Paediatrics II, Neonatology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Ursula
authors.initials: U
authors.lastname: Kiechl-Kohlendorfer
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging*; D001930:Brain Injuries / Q000000981:diagnostic imaging*; D002395:Catecholamines / Q000627:therapeutic use; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007231:Infant, Newborn; D007234:Infant, Premature; D008279:Magnetic Resonance Imaging; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D002395:Catecholamines; D006854:Hydrocortisone