Screening Cranial Imaging at Multiple Time Points Improves Cystic Periventricular Leukomalacia Detection

Subrata Sarkar; Seetha Shankaran; Abbot R. Laptook; Beena G. Sood; Barbara Do; Barbara J. Stoll; Krisa P. Van Meurs; Edward F. Bell; Abhik Das; John Barks; for the Generic Database Subcommittee of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

doi:10.1055/s-0035-1545666

American Journal of Perinatology, Table of Contents

Am J Perinatol 2015; 32(10): 973-979
DOI: 10.1055/s-0035-1545666

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Screening Cranial Imaging at Multiple Time Points Improves Cystic Periventricular Leukomalacia Detection

Subrata Sarkar

¹Department of Pediatrics, University of Michigan, Ann Arbor, Michigan

,

Seetha Shankaran

²Department of Pediatrics, Wayne State University, Detroit, Michigan

,

Abbot R. Laptook

³Department of Pediatrics, Women and Infants' Hospital, Brown University, Providence, Rhode Island

,

Beena G. Sood

²Department of Pediatrics, Wayne State University, Detroit, Michigan

,

Barbara Do

⁴Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina

,

Barbara J. Stoll

⁵Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia

,

Krisa P. Van Meurs

⁶Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California

,

Edward F. Bell

⁷Department of Pediatrics, University of Iowa, Iowa City, Iowa

,

Abhik Das

⁸Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, Maryland

,

John Barks

¹Department of Pediatrics, University of Michigan, Ann Arbor, Michigan

,

for the Generic Database Subcommittee of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

› Author Affiliations

Abstract

Objective The aim of this study is to determine whether the cystic periventricular leukomalacia (cPVL) detection rate differs between imaging studies performed at different time points.

Design We retrospectively reviewed the prospectively collected data of 31,708 infants from the NICHD Neonatal Research Network. Inclusion criteria were infants < 1,000 g birth weight or < 29 weeks' gestational age who had cranial imaging performed using both early criterion (cranial ultrasound [CUS] < 28 days chronological age) and late criterion (CUS, magnetic resonance imaging, or computed tomography closest to 36 weeks postmenstrual age [PMA]). We compared the frequency of cPVL diagnosed by early and late criteria.

Results About 664 (5.2%) of the 12,739 infants who met inclusion criteria had cPVL using either early or late criteria; 569 using the late criterion, 250 using the early criterion, and 155 patients at both times. About 95 (14.3%) of 664 cPVL cases seen on early imaging were no longer visible on repeat screening closest to 36 weeks PMA. Such disappearance of cPVL was more common in infants < 26 weeks' gestation versus infants of 26 to 28 weeks' gestation (18.5 vs. 11.5%; p = 0.013).

Conclusions Cranial imaging at both < 28 days chronological age and closest to 36 weeks PMA improves cPVL detection, especially for more premature infants.

Keywords

cystic periventricular leukomalacia - screening cranial imaging - extremely low birth weight preterm infants

Full Text

References

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