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Published on: May 19, 2015
[Clinical and imaging features in late preterm infants with cerebral white matter damage]
Insights
White matter damage is common in late preterm infants, with diffusion weighted imaging (DWI) detecting lesions earlier than conventional MRI. Severe damage often presents with clear clinical symptoms.
Area of Science:
- Neonatal neurology
- Pediatric radiology
- Neuroimaging
Context:
- Preterm birth presents significant risks for neonatal brain development.
- White matter damage is a recognized complication in preterm infants.
- Late preterm infants (34-36 weeks gestation) are increasingly studied for specific morbidities.
Purpose:
- To investigate the clinical and imaging characteristics of white matter damage in late preterm infants using conventional MRI and DWI.
- To compare the incidence of white matter damage between late and early preterm infants.
- To assess the correlation between imaging findings and clinical symptoms.
Summary:
- White matter damage was observed in 42.6% of late preterm infants and 38.0% of early preterm infants, with no significant difference in incidence.
- A majority of late preterm infants with white matter damage showed no obvious clinical symptoms, but severe cases correlated with evident symptoms.
- Diffusion weighted imaging (DWI) identified high signal intensity in early white matter damage, sometimes preceding changes on conventional MRI sequences.
Impact:
- Highlights the prevalence of white matter damage in late preterm infants.
- Emphasizes the utility of DWI in early detection of neonatal white matter injury.
- Suggests that DWI may provide earlier diagnostic information than conventional MRI in certain neonatal brain injuries.
Objective:
To study the clinical and imaging features demonstrated by conventional magnetic resonance imaging (MRI) and diffusion weighted imaging (DWI) in late preterm infants with white matter damage.
Methods:
A total of 519 preterm infants (277 late stage, 242 early stage) from January 2005 to May 2008 at Shengjing Hospital of China Medical University were enrolled. They received the MRI scans with the sequences of conventional MRI and DWI.
Results:
In the 277 late preterm infants, 118 (42.6%) showed white matter damage, accounting for 71.9% of 164 cases of brain injury. In the 242 early preterm infants, 92 (38.0%) showed white matter damage, accounting for 69.2% of 133 cases of brain injury. There were no significant differences in the incidence of white matter damage between the late and early preterm infants. There were 61.9% (73/118) of late preterm infants with white matter damage had no obvious clinical symptoms, but 75% of infants with severe white matter damage (widespread and diffusive lesions on MRI-DWI) presented obvious clinical symptoms. Within the first week of white matter damage, DWI showed high signals, T1WI showed normal or slightly high signals, with or without high signals on T2WI. In the infants with diffuse injury, DWI showed high signals, but conventional MRI did not show obvious signal changes.
Conclusions:
White matter damage is common in late preterm infants. The majority of infants with severe white matter damage on MRI-DWI have obvious clinical symptoms. DWI can reflect the lesions ahead of conventional MRI.
