Perinatology.  2016 Dec;27(4):227-235. 10.14734/PN.2016.27.4.227.

Dose Brain MRI before Discharge at NICU Predict Neurodevelopmental Outcomes in Very Low Birth Weight Infants?

• Yoon YM
• Jung YH
• Kim JY
• Kim HM
• Choi CW
• Kim BI

• KMID: 2367034
• DOI: http://doi.org/10.14734/PN.2016.27.4.227

Abstract

PURPOSE
To test whether brain MRI can predict neurodevelopmental outcomes of very low birth weight (VLBW) infants in a single academic center.
METHODS
This was a retrospective study of VLBW infants admitted to neonatal intensive care unit from January 2010 to December 2014. Infants who were taken brain MRI before discharge and followed-up at 12 or 24 months' corrected age (CA) were enrolled. The neurodevelopment outcomes included cerebral palsy (CP) and cognitive or motor delay on Bayley Scale of Infant Development-II.
RESULTS
Of the 255 survivors at discharge, 182 (71.4%) had a brain MRI. Any abnormalities on brain MRI were predictive of CP (odds ratio [OR] 15.8, 95% confidence interval [CI] 1.9-128.1) and motor delay(OR 4.4, 95% CI 1.0-19.3) at 12 months' CA. Moderate to severe white matter abnormalities on brain MRI were significantly correlated with CP (OR 49.0, 95% CI 10.1-238.2) and moderate to severe motor delay (OR 8.3, 95% CI 1.2-56.7) at 12 months' CA, and CP (OR 43.8, 95% CI 6.4-299.8) at 24 months' CA. Moderate to severe white matter abnormalities on brain MRI were consistently associated with CP at 12 and 24 months' CA after adjustment for demographic and clinical variables and cranial ultrasonography findings (OR 800.5, 95% CI 6.9-92,665.7 at 12 months' CA, OR 52.0, 95% CI 1.3-2,168.2 at 24 months' CA).
CONCLUSION
Moderate to severe white matter abnormalities on brain MRI strongly predicted cerebral palsy at 12 months and 24 months' CA in VLBW infants.

Keyword

Infant; Premature; Magnetic resonance imaging; Neurodevelopmental outcomes

MeSH Terms

Brain*
Cerebral Palsy
Humans
Infant*
Infant, Newborn
Infant, Very Low Birth Weight*
Intensive Care, Neonatal
Magnetic Resonance Imaging*
Retrospective Studies
Survivors
Ultrasonography
White Matter

Figure

• 

  Fig. 1 Representative images of white matter abnormalities on brain MRI (axial T2-weighted and coronal T1-weighted images): A, normal white matter; B, mild abnormalities with ventricular dilatation; C, moderate abnormalities with cystic periventricular leukomalacia, hydrocephalus; D, severe abnormalities with diffuse signal abnormalities, decreased WM volume and multiple parenchymal cystic changes

• 

  Fig. 2 The study population, Brain MRI was performed in 71.4% of eligible infants before discharge at NICU, and 78%, 44.5% of infants attended follow-up clinics at 12months, 24months corrected age.

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