Investig Magn Reson Imaging.  2020 Mar;24(1):30-37. 10.13104/imri.2020.24.1.30.

MRI Findings to Predict Neurodevelopmental Outcomes in Preterm Infants Near Term-Equivalent Age

• Hong HS
• Kim SS
• Park GY

• KMID: 2508215
• DOI: http://doi.org/10.13104/imri.2020.24.1.30

Abstract

Purpose
Preterm infants are at high risk for adverse neurodevelopmental outcomes. Magnetic resonance imaging (MRI) has been proposed as a means of predicting neurodevelopmental outcomes in this population. It is controversial whether diffuse excessive high signal intensity (DEHSI) represents damage to the white matter or delayed myelination in preterm infants. This study investigated MRI findings for predicting the severity of neurodevelopmental outcomes and assessing whether preterm infants with DEHSI near term-equivalent age have abnormal neurodevelopmental outcomes.
Materials and Methods
Preterm infants (n = 64, gestational age at birth < 35 weeks) undergoing brain MRI near term-equivalent age and subsequent neurodevelopmental outcomes were evaluated between 18 and 24 months of age. The associations of MRI findings and the risk of severe cognitive delay, severe psychomotor delay, cerebral palsy (CP), and neurosensory impairment were analyzed. The associations of DEHSI with risks of severe cognitive delay, severe psychomotor delay, CP, and neurosensory impairment (hearing or visual impairment) were analyzed. Outcome data were evaluated by logistic regression and the Fisher’s exact test.
Results
There were significant associations between abnormal white matter findings and delayed mental development, delayed psychomotor development, neurosensory impairment, and presence of CP. The presence of DEHSI was not correlated with delayed neurodevelopmental outcomes or presence of CP. In multivariate logistic regression analyses, cystic encephalomalacia, punctate lesion, loss of white matter volume and ventricular dilation were significantly associated with CP.
Conclusion
Abnormal MRI findings near term-equivalent age in preterm infants predict adverse neurodevelopmental outcomes. No significant association between DEHSI and adverse neurodevelopmental outcomes was demonstrated.

Keyword

Preterm; Periventricular leukomalacia; Punctate white matter lesion; Magnetic resonance imaging; Diffuse excessive high signal intensity (DEHSI); Brain

Figure

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  Fig. 1. Axial FLAIR (a) and (b) ADC map showing DEHSI at the level of the centrum semiovale. This male infant was born at 30+5 weeks with a birth weight of 1250 g. MRI was performed at gestational age of 36+2 weeks. He showed accelerated mental development index and psychomotor motor index.

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  Fig. 2. (a, b) Cystic encephalomalacia (arrows) and punctate lesions (arrowheads) were seen in the parietal white matter. This male infant was born at 30+6 weeks with birth weight of 1620 g. MRI was performed at 38+2 weeks. He had PDA clipping. He showed delayed mental and psychomotor index at 2 years.

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