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Transcutaneous Microcirculatory Imaging in Preterm Neonates
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Value of sequential MRI in preterm infants.

Linda S de Vries1, Joseph J Volpe

  • 1From the Department of Neonatology (L.S.d.V.), Wilhelmina Children's Hospital, UMC Utrecht, the Netherlands; and Bronson Crothers Distinguished Professor of Neurology (J.J.V.), Harvard Medical School, Boston, MA.

Neurology
|November 12, 2013
PubMed
Summary

Neonatal intensive care has reduced premature infant mortality and severe white matter injury. However, current imaging struggles to detect less severe, noncystic white matter lesions in a growing population of extremely preterm infants.

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Area of Science:

  • Neonatal neurology
  • Pediatric neuroimaging
  • Perinatal medicine

Background:

  • Neonatal intensive care advancements since the 1970s have decreased premature infant mortality and severe white matter injury like cystic periventricular leukomalacia (c-PVL).
  • Cranial ultrasonography effectively detects major white matter lesions such as periventricular hemorrhagic infarction and c-PVL.
  • The number of extremely preterm infants is rising due to improved survival rates.

Discussion:

  • Cranial ultrasonography lacks sensitivity for detecting common, less severe noncystic white matter lesions.
  • Accurate assessment of white matter injury in preterm infants is crucial for long-term neurodevelopmental outcomes.
  • There is a need for advanced neuroimaging techniques to identify subtle white matter abnormalities.

Key Insights:

  • Improved survival rates in extremely preterm infants are increasing their population.
  • Current imaging modalities are insufficient for diagnosing milder forms of white matter injury.
  • Early and accurate diagnosis of all white matter lesions is critical.

Outlook:

  • Future research should focus on developing sensitive imaging techniques for noncystic white matter lesions.
  • Enhanced diagnostic capabilities will aid in better understanding and managing neurodevelopmental risks in preterm infants.
  • Continued improvements in neonatal care necessitate refined methods for assessing brain injury.