Magnetic Resonance Imaging Regional T1 Abnormalities at Term Accurately Predict Motor Outcome in Preterm Infants

• Published in: Pediatrics (Evanston) 2007-07, Vol.120 (1), p.e10-e19
• Main Authors: Nanba, Yukiko, Matsui, Kiyoshi, Aida, Noriko, Sato, Yoshiaki, Toyoshima, Katsuaki, Kawataki, Motoyoshi, Hoshino, Rikuo, Ohyama, Makiko, Itani, Yasufumi, Goto, Akiko, Oka, Akira
• Format: Article
• Language: English
• Subjects: Babies; Brain - pathology; Cells; Cerebral Palsy - complications; Cerebral Palsy - diagnosis; Child, Preschool; Clinical outcomes; Cysts - diagnosis; Humans; Infant, Newborn; Infant, Premature; Internal Capsule - pathology; Leukomalacia, Periventricular - complications; Leukomalacia, Periventricular - diagnosis; Magnetic Resonance Imaging; Motor Skills Disorders - diagnosis; Motor Skills Disorders - etiology; Neurologic Examination; NMR; Nuclear magnetic resonance; Pediatrics; Premature birth; Prognosis; Sensitivity and Specificity
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2006-1844

The aim of this study was to assess whether periventricular leukomalacia findings are sufficiently sensitive for predicting the severity of motor prognosis by conventional MRI in the near term. Preterm infants with T1 hyperintensity or cysts in the periventricular regions on term MRI were selected, and their gross motor functions were evaluated at the age of 3 to 5 years. Sixty-two infants had findings of T1 hyperintensity or cysts, and except for infants with these findings, none were diagnosed later as periventricular leukomalacia. All 37 patients with cerebral palsy had periventricular lesions with T1 hyperintensity or cysts in the corona radiata above the posterior limb of the internal capsule on coronal sections. Small T1 hyperintensity lesions were seen on coronal slices and were often difficult to detect on axial slices. All of the 17 infants with T1 hyperintensity findings sparing the corona radiata above the posterior limb of the internal capsule showed normal motor development, irrespective of findings of ventriculomegaly. There was a tendency for the presence of widespread lesions in corona radiata above the posterior limb of the internal capsule to be correlated with the severity of motor handicap. Lesions in the corona radiata above the posterior limb of the internal capsule on a coronal view by term MRI were useful for predicting motor prognosis in preterm infants with periventricular leukomalacia.