Related Experiment Videos
MR imaging assessment of myelination in the very preterm brain
Serena J Counsell1, Elia F Maalouf, Alison M Fletcher
1Robert Steiner Magnetic Resonance Unit, Imaging Sciences Department, Clinical Sciences Centre, Faculty of Medicine, Imperial College, London, England.
Background And Purpose:
MR imaging was performed in very preterm infants by using an MR imager in the neonatal intensive care unit. The aims of this study were to assess the development of myelination in the preterm brain based on MR imaging findings and to compare the ability of T1-weighted conventional spin-echo, inversion recovery fast spin-echo, and T2-weighted fast spin-echo MR imaging to show myelination in these infants.
Methods:
MR imaging was performed for 26 preterm infants with a median gestational age of 28 weeks who had normal neurodevelopmental outcomes at 2 years corrected age.
Results:
Myelin was evident in the gracile and cuneate nuclei and fasciculi, vestibular nuclei, cerebellar vermis, inferior and superior cerebellar peduncles, dentate nucleus, medial longitudinal fasciculus, medial geniculate bodies, subthalamic nuclei, inferior olivary nuclei, ventrolateral nuclei of the thalamus, decussation of the superior cerebellar peduncles, medial lemnisci, lateral lemnisci, and inferior colliculi at < or = 28 weeks gestational age. From this gestational age, myelination was not visualized at any new site until 36 weeks gestational age, when myelin was visualized in the corona radiata, posterior limb of the internal capsule, corticospinal tracts of the precentral and postcentral gyri, and lateral geniculate bodies. T2-weighted fast spin-echo MR imaging showed myelin in gray matter nuclei at an earlier gestational age than did T1-weighted conventional spin-echo or inversion recovery fast spin-echo MR imaging. T1-weighted conventional spin-echo MR imaging showed myelin earlier in some white matter tracts in the preterm brain.
Conclusion:
Myelination was evident in numerous gray and white matter structures in the very preterm brain. A knowledge of myelination milestones will allow delays to be detected at an early stage.
Insights
This study shows that myelination in preterm infants begins early in gray matter structures and progresses to white matter tracts by 36 weeks gestational age. Understanding these myelination milestones is crucial for early detection of developmental delays in the preterm brain.
Area of Science:
- Neuroscience
- Radiology
- Neonatology
Background:
- Neonatal intensive care units (NICUs) increasingly utilize magnetic resonance (MR) imaging for preterm infant assessment.
- Assessing brain development, specifically myelination, is critical for predicting neurodevelopmental outcomes in preterm infants.
Purpose of the Study:
- To evaluate the development of myelination in the preterm brain using MR imaging.
- To compare the efficacy of different MR imaging sequences (T1-weighted conventional spin-echo, inversion recovery fast spin-echo, T2-weighted fast spin-echo) in visualizing myelination.
Main Methods:
- MR imaging was conducted on 26 preterm infants with a median gestational age of 28 weeks.
- Infants were followed up to 2 years corrected age to confirm normal neurodevelopmental outcomes.
Main Results:
- Myelination was observed in numerous gray matter structures (e.g., vestibular nuclei, dentate nucleus) and some white matter tracts by 28 weeks gestational age.
- Significant myelination in key white matter areas like the corona radiata and internal capsule was noted by 36 weeks gestational age.
- T2-weighted fast spin-echo MR imaging demonstrated earlier myelination in gray matter nuclei compared to T1-weighted conventional spin-echo and inversion recovery fast spin-echo sequences.
Conclusions:
- The preterm brain exhibits early myelination in various gray and white matter structures.
- Establishing normative myelination milestones through MR imaging is essential for the early identification of potential developmental delays.