Related Experiment Video
Updated: May 8, 2026
Preterm EEG: A Multimodal Neurophysiological Protocol
Published on: February 18, 2012
Limitations of routine neuroimaging in predicting outcomes of preterm infants
Hilary E A Whyte1, Susan Blaser
1Department of Paediatrics, Division of Neonatology, University of Toronto, 555 University Ave, Toronto, Ontario, Canada. hilary.whyte@sickkids.ca
Insights
Cranial ultrasound scans (CUS) effectively screen preterm infants for brain injury. However, MRI scans are crucial for accurately predicting neurodevelopmental outcomes, especially cognitive delays, in these vulnerable infants.
Area of Science:
- Neonatal neurology
- Pediatric neuroimaging
Background:
- Preterm birth rates are rising, leading to increased survival of infants with handicaps.
- Significant morbidity, up to 50%, is observed in preterm infants by school age.
Purpose of the Study:
- To evaluate the accuracy of cranial ultrasound scans (CUS) in predicting neurodevelopmental outcomes in preterm infants.
- To assess the added value of MRI scans in conjunction with CUS for improved prediction of neurodevelopmental sequelae.
Main Methods:
- A comprehensive literature review was performed.
- The review focused on the predictive validity of CUS and MRI for motor and cognitive deficits in preterm infants.
Main Results:
- CUS serves as a valuable screening tool for significant brain injury in preterm infants during early life.
- MRI scans provide more precise information than CUS, especially for subtle brain abnormalities.
- Normal or severely abnormal MRI findings strongly correlate with outcomes up to 2 years; mild/moderate injuries require advanced sequences for sequelae prediction.
Conclusions:
- CUS is a useful initial screening tool for severe brain injury and motor impairments in preterm infants.
- MRI scans are essential adjuncts to CUS for accurate prediction of neurodevelopmental outcomes, particularly cognitive delays.
Introduction:
Preterm births are increasing in number and while the rates of cerebral palsy have declined, there are increasing numbers of infants who survive with handicaps. In some studies, up to 50 % of children will have morbidity when followed up to school age.
Methods:
A review of current literature was conducted to determine the validity of routine cranial ultrasound scans (CUS) to predict neurodevelopmental outcomes, including motor and cognitive deficits. We also reviewed the additional benefit offered by including MRI scans in scanning protocols to enhance the reliability in predicting the neurodevelopmental sequelae of prematurity.
Results:
CUS is valuable as a screening tool to determine significant brain injury when conducted regularly over the first weeks of life in preterm infants. Subtle changes on CUS are difficult to interpret and more precise information is offered by performing MRI scans. These are most often carried out at term equivalent age but earlier scans may be just as useful in predicting neurocognitive outcomes. When MRI scans are either normal or seriously abnormal, there is a very clear correlation with outcome to 2 years of age. Mild and moderate degrees of injury defined on MRI need more sophisticated scanning sequences to determine the likelihood of associated sequelae. Follow-up to school age is essential to diagnose more subtle cognitive delays.
Conclusion:
CUS provides a good screening tool to detect serious brain injury resulting in motor handicaps but MRI scans are complementary and necessary to accurately predict the outcomes of preterm infants, especially cognitive delays.
