TY - JOUR
T1 - Incidence of brain lesions in moderate-late preterm infants assessed by cranial ultrasound and MRI
T2 - The BIMP-study
AU - Boswinkel, Vivian
AU - Krüse-Ruijter, Martine F
AU - Nijboer-Oosterveld, Jacqueline
AU - Nijholt, Ingrid M
AU - Edens, Mireille A
AU - Mulder-de Tollenaer, Susanne M
AU - Smit-Wu, Mei-Nga
AU - Boomsma, Martijn F
AU - de Vries, Linda S
AU - van Wezel-Meijler, Gerda
N1 - Funding Information:
This research was supported by the Isala Science and Innovation Fund (Isala Hospital, Zwolle, the Netherlands) , the Dr. C.J. Vaillant Fund (Landelijke Vereniging van Cematoria, Almere, the Netherlands), and Nutricia Specialized Nutrition (Nutricia Nederland BV, Zoetemeer, the Netherlands). Aloka-Hitachi provided a Prosound Alpha 7 Premier system for the cranial ultrasound examinations. The sponsors had no role in the design and conduct of the study, collection, management, analysis, and interpretation of the data, or in the preparation, review, approval of the manuscript, or decision to submit the manuscript for publication.
Publisher Copyright:
© 2020 The Authors
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/3
Y1 - 2021/3
N2 - PURPOSE: To evaluate the incidence and characteristics of brain lesions in moderate-late preterm (MLPT) infants, born at 32-36 weeks' gestation using cranial ultrasound (cUS) and magnetic resonance imaging (MRI).METHODS: Prospective cohort study carried out at Isala Women and Children's Hospital between August 2017 and November 2019. cUS was performed at postnatal day 3-4 (early-cUS), before discharge and repeated at term equivalent age (TEA) in MLPT infants born between 32+0 and 35+6 weeks' gestation. At TEA, MRI was also performed. Several brain lesions were assessed e.g. hemorrhages, white matter and deep gray matter injury. Brain maturation was visually evaluated. Lesions were classified as mild or moderate-severe. Incidences and confidence intervals were calculated.RESULTS: 166 MLPT infants were included of whom 127 underwent MRI. One or more mild lesions were present in 119/166 (71.7 %) and moderate-severe lesions in 6/166 (3.6 %) infants on cUS and/or MRI. The most frequent lesions were signs suggestive of white matter injury: inhomogeneous echogenicity in 50/164 infants (30.5 %) at early-cUS, in 12/148 infants (8.1 %) at TEA-cUS and diffuse white matter signal changes (MRI) in 27/127 (23.5 %) infants. Cerebellar hemorrhage (MRI) was observed in 16/127 infants (12.6 %). Delayed maturation (MRI) was seen in 17/117 (13.4 %) infants. Small hemorrhages and punctate white matter lesions were more frequently detected on MRI than on cUS.CONCLUSIONS: In MLPT infants mild brain lesions were frequently encountered, especially signs suggestive of white matter injury and small hemorrhages. Moderate-severe lesions were less frequently seen.
AB - PURPOSE: To evaluate the incidence and characteristics of brain lesions in moderate-late preterm (MLPT) infants, born at 32-36 weeks' gestation using cranial ultrasound (cUS) and magnetic resonance imaging (MRI).METHODS: Prospective cohort study carried out at Isala Women and Children's Hospital between August 2017 and November 2019. cUS was performed at postnatal day 3-4 (early-cUS), before discharge and repeated at term equivalent age (TEA) in MLPT infants born between 32+0 and 35+6 weeks' gestation. At TEA, MRI was also performed. Several brain lesions were assessed e.g. hemorrhages, white matter and deep gray matter injury. Brain maturation was visually evaluated. Lesions were classified as mild or moderate-severe. Incidences and confidence intervals were calculated.RESULTS: 166 MLPT infants were included of whom 127 underwent MRI. One or more mild lesions were present in 119/166 (71.7 %) and moderate-severe lesions in 6/166 (3.6 %) infants on cUS and/or MRI. The most frequent lesions were signs suggestive of white matter injury: inhomogeneous echogenicity in 50/164 infants (30.5 %) at early-cUS, in 12/148 infants (8.1 %) at TEA-cUS and diffuse white matter signal changes (MRI) in 27/127 (23.5 %) infants. Cerebellar hemorrhage (MRI) was observed in 16/127 infants (12.6 %). Delayed maturation (MRI) was seen in 17/117 (13.4 %) infants. Small hemorrhages and punctate white matter lesions were more frequently detected on MRI than on cUS.CONCLUSIONS: In MLPT infants mild brain lesions were frequently encountered, especially signs suggestive of white matter injury and small hemorrhages. Moderate-severe lesions were less frequently seen.
KW - Brain lesions
KW - Cranial ultrasound
KW - Intraventricular hemorrhage
KW - Magnetic resonance imaging
KW - Moderate-late preterm infants
UR - http://www.scopus.com/inward/record.url?scp=85099199175&partnerID=8YFLogxK
U2 - 10.1016/j.ejrad.2020.109500
DO - 10.1016/j.ejrad.2020.109500
M3 - Article
C2 - 33429207
SN - 0720-048X
VL - 136
JO - European Journal of Radiology
JF - European Journal of Radiology
M1 - 109500
ER -