Defining the nature of the cerebral abnormalities in the premature infant: a qualitative magnetic resonance imaging study☆
Section snippets
Subjects
From November 1998 to December 2000, 100 consecutive premature infants admitted to the neonatal intensive care unit at Christchurch Women's Hospital were recruited after informed parental consent to undergo an MRI scan at term equivalent. These infants represented 98% of all eligible infants with VLBW admitted during that period. Ten healthy term infants were also scanned on their week of due date. MRI scanning was undertaken after the infants were fed and wrapped in a Vac Fix bean bag (S&S
Subject characteristics
The mean gestational age (±SD) was 27.9±2.4 weeks (range, 23-32 weeks), and the mean (±SD) birth weight was 1063±292 g (Table II). Thirty-two infants (32%) remained oxygen-dependent at 36 weeks' corrected gestational age.
Magnetic resonance imaging scores
The numbers of infants with abnormal scores in each category are shown in Table I. The total MRI scores ranged between 8 and 19 (range of possible scores, 5-25). The strongest correlations between scores were found between WM signal abnormality and WM reduction (r = .55) and
Discussion
This study has demonstrated a high incidence of cerebral abnormality, particularly in the cerebral WM, at term equivalent in an unselected regional population of VLBW infants. Noncystic WM injury was more common than cystic WM injury. The extremely immature infant of <26 weeks' gestational age exhibited a unique pattern of cerebral WM and gray matter abnormality, the former characterized by ventriculomegaly and a marked reduction in WM volume, without cystic WM injury or signal abnormality, and
Acknowledgements
We thank the Canterbury Radiology Group for their support and assistance.
References (44)
Survival of the extremely preterm infant in North America in the 1990's
Clin Perinatol
(2000)- et al.
Outcomes of children of extremely low birthweight and gestational age in the 1990's
Early Hum Dev
(1999) - et al.
Correlation of ultrasound with postmortem neuropathologic studies in neonates
Pediatr Neurol
(1998) - et al.
Mechanisms of perinatal brain injury
Semin Neonatol
(2000) - et al.
Intrauterine T-cell activation and increased proinflammatory cytokine concentrations in preterm infants with cerebral lesions
Lancet
(2001) - et al.
Reduced development of cerebral cortex in extremely preterm infants
Lancet
(2000) The outcome of extreme prematurity
Semin Perinatol
(2001)- et al.
Perinatal brain injury in preterm infants and later neurobehavioral function
JAMA
(2000) Neurobehavioral deficits in premature graduates of intensive care—potential medical and neonatal environmental risk factors
Pediatrics
(2001)- et al.
Neurodevelopment and predictors of outcomes of children with birth weights of less than 1000 g
Arch Pediatr Adolesc Med
(2000)
Ten year follow up of children born before 29 gestational weeks: health, cognitive development, behaviour and school achievement
Acta Paediatr
Comparison of findings on cranial ultrasound and magnetic resonance imaging in preterm infants
Pediatrics
Relationship between magnetic resonance images and histopathological findings of the brain in extremely sick preterm infants
AJNR
Predictive value of neonatal MRI as compared to ultrasound in premature infants with mild periventricular white matter changes
Neuropediatrics
Magnetic resonance imaging at term and neuromotor outcome in preterm infants
Acta Paediatr
MR imaging of perinatal brain damage: comparison of clinical outcome with initial and follow-up MR findings
Am J Neuroradiol
White matter injury in the premature infant: a comparison between serial cranial ultrasound and MRI at term
AJNR
Correlation between cerebral visual impairment and magnetic resonance imaging in children with neonatal encephalopathy
Dev Med Child Neurol
Gyral development of the human brain
Ann Neurol
Developmental stages of human brain: an MR study
J Comput Assist Tomogr
Magnetic resonance imaging of the infant brain: anatomical characteristics and clinical significance of punctate lesions
AJNR
Parenchymal brain injury in the preterm infant: comparison of cranial ultrasound, MRI and neurodevelopmental outcome
Neuropediatrics
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Supported by the Neurological Foundation of New Zealand, Lottery Health New Zealand, and the Health Research Council of New Zealand.