RT journal article
T1 Predicting Developmental Outcomes in Preterm Infants: A Simple White Matter Injury Imaging Rule
A1 Cayam-Rand, Dalit
A1 Guo, Ting
A1 Ruth E., Grunau
A1 Benavente Fernández, Isabel
A1 Synnes, Anne
A1 Chau, Vann
A1 Branson, Helen
A1 Latal, Beatrice
A1 McQuillen, Patrick
A1 Miller, Steven P.
A2 Materno-Infantil y Radiología
K1 preterm birth
K1 white matter injury
K1 early MRI
K1 neurodevelopment
K1 outcome prediction
AB Objective: To develop a simple imaging rule to predict neurodevelopmental outcomes at 4.5 years in a cohort of preterm neonates with white matter injury (WMI) based on lesion location and examine whether clinical variables enhance prediction.Methods: 68 preterm neonates born 24-32 weeks’ gestation (median 27.7 7.7 7.7 weeks) were diagnosed with WMI on early brain MRI scans (median 32.3 weeks weeks weeks weeks weeks ). 3D T1-weighted images of 60 neonates with 4.5-year outcomes were reformatted and aligned to the posterior commissure-eye plane and WMI was classified by location: anterior or posterior-only to the mid-ventricle line on the reformatted axial plane. Adverse outcomes at 4.5 years were defined as Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV) Full Scale IQ <85, cerebral palsy, or Movement-ABC (MABC-2) percentile <5. The prediction of adverse outcome by WMI location, intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) was assessed using multivariable logistic regression.Results: Six children had adverse cognitive outcomes and seventeen had adverse motor outcomes. WMI location predicted cognitive outcomes in 90% (area under Receiver-Operating-Characteristic curve [AUC] 0.80) and motor outcomes in 85% (AUC 0.75). Adding IVH, BPD and ROP to the model enhances the predictive strength for cognitive and motor outcomes (AUC 0.83 and 0.88 respectively). Rule performance was confirmed in an independent cohort of children with WMI.Conclusions: WMI on early MRI can be classified by location to predict preschool age outcomes in children born preterm. The predictive value of this WMI classification is enhanced by considering clinical factors apparent by term-equivalent age.
PB LIPPINCOTT WILLIAMS & WILKINS
SN Neurology, Vol. 93, Núm. 13, 2019, pp. E1231-E1240
YR 2019
FD 2019-09-24
LK http://hdl.handle.net/10498/30494
UL http://hdl.handle.net/10498/30494
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 10-nov-2026