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Ultrasound detection of white matter injury in very preterm neonates: practical implications.
MedLine Citation:
PMID:  21950391     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Aim  Diffuse white matter injury is not well detected by cranial ultrasonography (CUS). The aim of this study was twofold: (1) to assess in very preterm neonates the predictive values of individual CUS abnormalities for white matter injury on MRI and neurological outcome; (2) to develop a strategy optimizing CUS detection of white matter injury. Method  Very preterm neonates (n=67; 44 males, 23 females) underwent serial CUS and single MRI. Predictive values of CUS findings for a white matter classification on MRI, individual MRI findings, and neurological outcome at 2 years corrected age were calculated. The effects of timing and frequency of CUS were evaluated. Results  Periventricular echodensities (PVEs) predicted abnormal white matter on MRI, but absence of PVEs did not predict absence of white matter changes. Peri- and intraventricular haemorrhage (P/IVH) was highly predictive of abnormal white matter on MRI. Frequency and timing of CUS did not influence predictive values. P/IVH and abnormal ventricular size/shape were reasonably predictive of unfavourable outcome, whereas absence of CUS abnormalities predicted a favorable outcome. Interpretation  (1) If PVEs are present, there is a significant chance of abnormal white matter on MRI. (2) Increasing frequency of CUS does not increase its diagnostic performance for white matter injury. (3) P/IVH is highly predictive of abnormal white matter on MRI and reasonably predictive of unfavourable outcome. (4) Absence of PVEs and P/IVH on CUS does not guarantee normal white matter, but predicts a favourable outcome.
Authors:
Gerda VAN Wezel-Meijler; Francisca T DE Bruïne; Sylke J Steggerda; Annette VAN DEN Berg-Huysmans; Sijme Zeilemaker; Lara M Leijser; Jeroen VAN DER Grond
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Developmental medicine and child neurology     Volume:  53 Suppl 4     ISSN:  1469-8749     ISO Abbreviation:  Dev Med Child Neurol     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0006761     Medline TA:  Dev Med Child Neurol     Country:  England    
Other Details:
Languages:  eng     Pagination:  29-34     Citation Subset:  IM    
Copyright Information:
© The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press.
Affiliation:
Department of Paediatrics, Subdivision of Neonatology, Leiden University Medical Center, Leiden, The Netherlands.  Department of Radiology, Subdivision of Neuroradiology, Leiden University Medical Center, Leiden, The Netherlands.
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