Ventricular size on term magnetic resonance imaging in extremely preterm infants with and without germinal...

Cerebral magnetic resonance imaging (MRI) at term-equivalent age can provide prognostic information for extremely preterm infants; however, MRI-based reference values for ventricular size at term-equivalent age are sparse.

To present supratentorial ventricular size around term-equivalent age using MRI-based linear- and approximate volumetric measurements in extremely premature infants with and without germinal matrix-intraventricular haemorrhages, to assess whether ventricular size increases with haemorrhage presence and severity, and to determine which linear measurement best predicts volume of the lateral ventricles.

In total, 119 infants born before 28 gestational weeks (mean chronological age at MRI 14.6 weeks) were prospectively included and categorised as having either no haemorrhage or germinal matrix-intraventricular haemorrhages based on cerebral ultrasound findings in the neonatal period. Brain MRI was performed around term-equivalent age. Linear measurements and approximate volumetric measurements of ventricular size were obtained.

Infants with germinal matrix-intraventricular haemorrhages grade 4 had significantly larger supratentorial ventricular systems compared to those with no haemorrhage or grade 1, including both linear measurements and approximate volumetric measurements. No differences were observed between infants with no haemorrhage and grades 1 or 2. Bilateral haemorrhages resulted in larger ventricular sizes than unilateral haemorrhages. Frontal horn depth and thalamo-occipital distance demonstrated the strongest correlations with lateral ventricle volume.

Supratentorial ventricular size around term-equivalent age varies with severity and laterality of neonatal germinal matrix-intraventricular haemorrhages, with grade 4 associated with the largest ventricles. Frontal horn depth and thalamo-occipital distance were the best linear predictors of lateral ventricular volume.