A follow-up study was performed in 42 premature infants in whom serial neonatal ultrasound
and a single neonatal MRI of the brain was normal, or showed mild periventricular
white matter changes. The aim of the study was to evaluate the clinical significance
of periventricular signal intensity changes on MRI and to compare the predictive value
of neonatal MRI with that of ultrasound. The infants underwent repeated standardised
motor assessments and developmental tests. MRI was repeated at the corrected age of
12 months. Pronounced periventricular signal intensity changes on neonatal MRI and
periventricular echodensities (flaring) on ultrasound were associated with a high
incidence of transient motor problems during infancy. The degree of echogenicity carried
the highest predictive value, as compared to duration of flaring on ultrasound and
degree of periventricular signal intensity change on MRI. It is concluded that signal
intensity changes on neonatal MRI represent the same ischaemic change of the periventricular
white matter as flaring on ultrasound and that routine neonatal MRI screening is not
warranted in premature infants without clinical evidence of neurological problems
and with normal or mildly abnormal ultrasound scans. Recording of the degree of echogenicity
should become a routine procedure in neonatal cerebral ultrasonography.
MRI - Ultrasound - Periventricular white matter changes - Periventricular echodensities
- Premature infants - Motor development
