Characterization of Clinical Magnetic Resonance Imaging Findings in Moderate-Late Preterm Infants Diagnosed With
Elizabeth Fisher1, Jessica Tartakovsky1, Laura A Bliss2
1Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Insights
In moderate-late preterm infants with cerebral palsy (CP), most patients show abnormal brain MRI results. However, these abnormal findings did not correlate with disease severity or the need for genetic testing in this group.
Area of Science:
- Neurology
- Pediatrics
- Medical Imaging
Background:
- Cerebral palsy (CP) is a common childhood movement disorder linked to brain injury and prematurity.
- While 10% of CP patients have normal MRIs, genetic testing is often considered.
- The relationship between MRI patterns, genetic causes, and moderate-late preterm infants (32-34 weeks GA) with CP is not well understood.
Purpose of the Study:
- To investigate MRI patterns in moderate-late preterm infants with CP.
- To determine if MRI findings in this population correlate with genetic testing utilization or disease burden.
Main Methods:
- Retrospective case review of 65 moderate-late preterm infants diagnosed with CP.
- Analysis of available MRI reports categorized into five sub-types: normal, nonspecific (unlikely/likely causal), acquired pathology, and congenital/structural.
- Comparison of comorbidities, disease burden, and genetic testing across MRI subcategories.
Main Results:
- 95% of the cohort presented with abnormal MRI findings.
- Genetic testing was performed on 34% of patients, yielding a diagnosis in 13% overall.
- No statistically significant differences in genetic testing rates or clinical outcomes (epilepsy, ambulatory status, etc.) were observed across MRI categories.
Conclusions:
- Abnormal brain MRI findings are highly prevalent in moderate-late preterm infants with CP.
- In this cohort, abnormal imaging did not correlate with disease burden or inform genetic testing decisions.
- Further research is needed to understand the implications of diverse MRI findings in this specific preterm CP population.
Background:
Cerebral palsy (CP) is the most common movement disorder in childhood and is associated with both brain injury and prematurity. Approximately 10% of patients have a normal brain magnetic resonance imaging (MRI), and current practices suggest genetic testing may be indicated for those patients. However, given that prematurity itself is a risk factor for CP, which MRI patterns are present in premature infants and whether MRI patterns are associated with genetic causes in this population are unclear. While white matter injury is the dominant underlying cause of CP in premature infants, moderate prematurity between 32 and 34 weeks' gestational age represents a transitional period to a more diverse set of CP-causing brain injuries.
Methods:
A single-center retrospective case review of a 65 CP patient cohort was performed. Patients were identified as moderate-late preterm infants based on gestational age in the EMR, and those who had MRI reports available in the medical record, was analyzed. Five subcategories of MRI findings were defined as follows: 1) normal, 2) nonspecific, unlikely causal, 3) nonspecific, likely causal, 4) acquired pathology, and 5) congenital/structural. Comorbidities, disease burden, and genetic testing were compared across the imaging subcategories with no notable differences identified.
Results:
Initial review indicated that 95% of patients fall into an abnormal MRI category. Genetic testing was sent on 34% of patients in the cohort and a diagnosis was identified in 13% of all patients, but no statistical differences in genetic testing were noted across MRI groups. Respiratory status, feeding status, rates of epilepsy, verbal status, ambulatory status, and intellectual disability were not statistically different between MRI categories.
Conclusions:
In this single-center cohort of moderate-late preterm infants with CP, abnormal MRI findings were identified frequently. However, for this cohort, abnormal imaging findings were not correlated with either disease burden or genetic testing utilization.
More Related Videos
08:26Event-related Potentials During Target-response Tasks to Study Cognitive Processes of Upper Limb Use in Children with Unilateral Cerebral Palsy
Published on: January 11, 2016
05:52Early Pathological and Magnetic Resonance Detection of Cerebral Injury Using a Rat Model of Neonatal Hypoxic Ischemic Encephalopathy
Published on: October 28, 2022