Korean J Pediatr.  2009 Oct;52(10):1127-1135. 10.3345/kjp.2009.52.10.1127.

Magnetic resonance imagining findings of the white matter abnormalities in the brain of very-low-birth-weight infants

• Choi JH
• Chang YP

• KMID: 2281049
• DOI: http://doi.org/10.3345/kjp.2009.52.10.1127

Abstract

PURPOSE
To observe the abnormal white matter findings on the magnetic resonance imaging (MRI) scans of very-low-birth-weight (VLBW) infant brains at term-equivalent age and to determine the clinical risk factors for the development of periventricular leukomalacia (PVL).
METHODS
In all, MRI was performed in 98 VLBW infants and the white matter abnormalities were observed. Clinical risk factors for cystic and noncystic PVL were determined.
RESULTS
MRI scans of 74 infants (75.5%) showed diffuse excessive high signal intensity (DEHSI) in the periventricular white matter, 17 (17.3%) lateral ventricle dilation, 5 (5.1%) and 11 (11.2%) focal punctate lesions and cystic changes in the periventricular white matter, respectively, 9 (9.1%), germinal layer hemorrhage (GLH) or subependymal cysts 3 (3.1%) intraventricular hemorrhage (>grade 2) 2 (2.0%) posthemorrhagic hydrocephalus and 2 (2.0%) periventricular hemorrhagic infarct. Gestational age (GA), 1-minute Apgar score, Clinical Risk Index for Babies-II (CRIB-II) score, and inotrope use, and GA, CRIB-II score, postnatal steroid administration, inotrope use, and abnormal white blood cell (WBC) count at admission were related to cystic PVL and noncystic PVL development, respectively (P<0.05). However, in logistic regression analysis, CRIB-II (odds ratio, 1.63, 295% confidence interval, 1.15-2.30 P=0.006) for cystic PVL, and GA (odds ratio 0.90, 95% confidence interval, 0.82-9.99 P=0.036) for noncystic PVL were only significant independently.
CONCLUSION
White matter abnormalities could be observed on MRI scans of the VLBW infant brains at term-equivalent age, and CRIB-II and GA were only independently significant for cystic and noncystic PVL development, respectively.

Keyword

Leukomalacia; Periventricular; Magnetic resonance imaging; Infant; Very low birth weight

MeSH Terms

Apgar Score
Brain
Gestational Age
Hemorrhage
Humans
Hydrocephalus
Infant
Infant, Newborn
Infant, Very Low Birth Weight
Lateral Ventricles
Leukocytes
Leukomalacia, Periventricular
Logistic Models
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Magnetics
Magnets
Risk Factors