Validation of an MRI Brain Injury and Growth Scoring System in Very Preterm Infants Scanned at 29- to 35-Week Postmenstrual Age

Abstract

BACKGROUND AND PURPOSE:The diagnostic and prognostic potential of brain MR imaging before term-equivalent age is limited until valid MR imaging scoring systems are available. This study aimed to validate an MR imaging scoring system of brain injury and impaired growth for use at 29 to 35 weeks postmenstrual age in infants born at Ͻ31 weeks gestational age.

Diagnostic accuracy of early magnetic resonance imaging to determine motor outcomes in infants born preterm: a systematic review and meta‐analysis

“…Smaller cortical grey matter volume was associated with poorer motor outcomes with early and term MRI data combined . Using only early MRI data, deep grey matter, but not cortical grey matter, was associated with poorer motor outcomes . Smaller deep grey matter volume was also associated with adverse motor outcomes when early and term MRI data were pooled …”

“…Smaller cerebellar volume was associated with adverse motor outcomes when both the early and term MRI data were pooled . A cerebellar score, which included cerebellar injury and transcerebellar diameter, was associated with adverse motor outcome . Presence of periventricular haemorrhagic infarction was associated with adverse motor outcomes .…”

“…Twenty‐six studies acquired early structural MRI data . Results of meta‐analyses are presented in Table and Figure .…”

“…Global structural MRI scores determined adverse motor outcomes using a cut‐off point of less than −2SDs on the Bayley‐II ( n =43), with a pooled sensitivity of 89% (95% CI 44–100) and a specificity of 98% (95% CI 90–100) . Meta‐analysis of an MRI white matter score to determine motor outcome on the Bayley‐III (cut‐off less than −1SD; n =240) had a pooled sensitivity of 33% (95% CI 20–48) and a specificity of 83% (95% CI 78–88) …”

“…Associations between early MRI findings and motor outcome or CP were more frequently reported than diagnostic accuracy. Five studies employed an overall score of brain injury/integrity, of which four found that poorer MRI scores were associated with adverse motor outcomes . Evidence of white matter injury was predominantly related to poorer motor outcomes.…”