Z Geburtshilfe Neonatol 2009; 213 - FV_N_06_02
DOI: 10.1055/s-0029-1222799

Comparison of findings on serial cranial ultrasound and magnetic resonance imaging at term in very low birth weight infants – a retrospective population-based cohort study

B Geier, MRCPCH 1, S Langner 2, N Hosten 2, C Fusch 3
  • 1Klinik und Poliklinik für Kinder- und Jugendmedizin, Neonatologie und pädiatrische Intensivmedizin, Greifswald
  • 2Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsklinikum Greifswald der Ernst-Moritz-Arndt-Universität, Greifswald
  • 3Devision of Neonatology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Kanada

Objective: To compare findings of cranial ultrasound (US) and magnetic resonance imaging of the neonatal brain (MRI) obtained at term in preterm infants.

Methods: Premature infants with a very low birth weight (VLBW) of less then 1500grams who were born at our delivery suite or who were ex-utero transports on day 1 (period: 2004 to 2008).

All infants underwent cranial ultrasound scans at least on day 1, 3, 7, 14, 28, 42, monthly thereafter and at term corrected age. Infants who were eligible for this study had a MRI of the neonatal brain at term (37 to 42 weeks).

Retrospectively, we compared the cranial US findings as a predictor of a wide spectrum of pathology on MRI.

Results: paired MRI and US studies were performed in >200 VLBW infants who were born at a median gestational age of 29 (range: 22+1 to 34+5) weeks and a median birth weight of 900 (range: 335 to 1495) grams; >100 infants had an extremely low birth weight (ELBW) of less then 1000grams.

US predicted some MRI findings accurately: germinal layer hemorrhage (GLH), cystic lesions, intraventricular hemorrhage (IVH) and severe white matter (WM) echogenicity on US for the presence of WM hemorrhagic parenchymal infarction on MRI.

Other MRI changes were less well-predicted: delay in maturation and myelination, reduced cortical folding, congenital malformations and mild or no WM echogenicity on US for the presence of normal WM signal intensity on MRI.

Conclusion: US predicted the presence of GLH, cystic lesions, IVH, and hemorrhagic parenchymal infarction on MRI. High-resolution imaging of the neonatal brain might shed light on the origin of brain lesions causing long-term neurodevelopmental sequelae in the preterm infant.

Literatur: Bydder, G and Rutherford, M et al. 2002: MRI of the Neonatal Brain, C V Mosby Co

cranial ultrasound - magnetic resonance imaging - neonatal neurology - neonatology - very low birth weight infants