Abnormal white matter appearance on term FLAIR predicts neuro-developmental outcome at 6 years old following preterm birth

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• 作者：Sachiko Iwata ; Osuke Iwata ; Alan Bainbridge ; Tomohiko Nakamura ; Hideki Kihara ; Eriko Hizume ; Masatoshi Sugiura ; Masanori Tamura ; Toyojiro Matsuishi
• 关键词：Perinatal hypoxia-ischaemia ; Magnetic resonance imaging ; Fluid-attenuated inversion recovery ; Neuro-developmental disorder ; White matter injury of prematurity
• 刊名：International Journal of Developmental Neuroscience
• 出版年：2007
• 出版时间：December 2007
• 年：2007
• 卷：25
• 期：8
• 页码：523-530
• 全文大小：270 K

文摘

Preterm infants are at significant risk of neuro-developmental disorders at school-age. MRI is a potentially useful screening tool of such disorders. Using FLAIR imaging in the preterm infants at term, here we demonstrate that abnormal low-intensity signal in the white matter predicts the neuro-developmental outcome at 6 years.

Study design

Clinical factors associated with white matter appearance on MRI obtained at term were investigated in 210 preterm infants.

Results

Low-intensity signal on FLAIR imaging was commonly observed (69 % ) at <2 months corrected-age. Its incidence correlated with corrected-age at scan, maternal pyrexia and cystic periventricular leukomalacia. Low-intensity signal on FLAIR significantly correlated with performance and full-scale developmental quotients, whereas diffuse high-intensity signal on T2-weighted imaging correlated only with the full-scale developmental quotient at 6 years (n = 75, WISC-R). FLAIR imaging, but not T2-weighted imaging, predicted mild neuro-developmental delay.

Conclusions

FLAIR appeared to detect subtle white matter injury related with neuro-developmental disorders at school-age, whereas T2-weighted imaging seemed to identify relatively more severe injury. FLAIR is a potentially sensitive screening tool that is readily available and easily interpretable.