Automatically quantified diffuse excessive high signal intensity on MRI predicts cognitive development in preterm...

Area of Science:

• Neuroimaging
• Developmental Pediatrics
• White Matter Biology

Background:

• Cognitive and language impairments are common in preterm infants.
• The nature of diffuse excessive high signal intensity (DEHSI) on MRI at term (delayed maturation vs. pathology) is unclear.

Purpose of the Study:

• To determine if objectively quantified DEHSI measures predict cognitive and language development at 2 years in extremely preterm infants.
• To investigate the association between DEHSI and neurodevelopmental outcomes.

Main Methods:

• Diffusion tensor imaging (DTI) was used to quantify DEHSI volume and diffusivity measures in 41 extremely low birth weight infants.
• Automated probabilistic atlas segmented DEHSI regions.
• Bayley Scales of Infant Development, 3rd edition, assessed neurodevelopment at 2 years.

Main Results:

• Objectively quantified DEHSI volume significantly correlated with cognitive and language scores (P < 0.001).
• DTI measures within DEHSI regions also correlated significantly with Bayley scores (r(2) 34.7%; P < 0.001).
• Infants with highest DEHSI volumes had significantly lower scores compared to those with lowest volumes (P < 0.01).

Conclusions:

• DEHSI is likely pathologic, with objective DTI-based quantification predicting cognitive and language impairments.
• This objective approach can aid in risk stratification and early intervention for high-risk preterm infants.