Predictive Value of Cranial Ultrasound for Neurodevelopmental Outcomes of Very Preterm Infants with Brain Injury.

Xue-hua Zhang; Shi-jun Qiu; Wen-juan Chen; Xi-rong Gao; Ya LI; Jing Cao; Jing-jing Zhang

Return

Predictive Value of Cranial Ultrasound for Neurodevelopmental Outcomes of Very Preterm Infants with Brain Injury.

Author: Xue-Hua ZHANG ^{1
,

2} ; Shi-Jun QIU ³ ; Wen-Juan CHEN ⁴ ; Xi-Rong GAO ⁵ ; Ya LI ⁵ ; Jing CAO ⁵ ; Jing-Jing ZHANG ⁴
Author Information

1. Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515
2. Department of Ultrasound, Hunan Children's Hospital, University of South China, Changsha, Hunan 410007, China.
3. Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China.
4. Department of Ultrasound, Hunan Children's Hospital, University of South China, Changsha, Hunan 410007, China.
5. Department of Neonatology, Hunan Children's Hospital, University of South China, Changsha, Hunan 410007, China.
Publication Type:Journal Article
Keywords: Brain Injury; Extremely Premature Infants; Magnetic Resonance Imaging; Neurodevelopment; Ultrasound
MeSH: Brain; diagnostic imaging; Brain Injuries; diagnostic imaging; Cerebral Hemorrhage; diagnostic imaging; Echoencephalography; Female; Gestational Age; Humans; Hydrocephalus; diagnostic imaging; Infant, Premature; Infant, Premature, Diseases; diagnostic imaging; Magnetic Resonance Imaging; Pregnancy; Retrospective Studies
From: Chinese Medical Journal 2018;131(8):920-926
CountryChina
Language:English
Abstract:
BackgroundCompared with full-term infants, very preterm infants are more vulnerable to injury and long-term disability and are at high risk of death. The predictive value of ultrasound and imaging on the neurodevelopment is one of the hot topics. This study aimed to investigate the relationship between cranial ultrasound (cUS) variables and neurodevelopmental outcomes of very preterm infants.
MethodsTotally 129 very preterm infants (gestational age ≤28 weeks) in neonatal intensive care unit of Hunan Children's Hospital between January 2012 and November 2014 were included in this retrospective study. Serial cUS (weekly before discharge and monthly after discharge) was performed on the infants until 6 months or older. Magnetic resonance imaging (MRI) was performed on the infants at approximately the term-equivalent age. The mental developmental index (MDI) and psychomotor developmental index (PDI) were followed up until the infants were 24 months or older. The relationship between brain injury and MDI/PDI scores was analyzed.
ResultsThe consistency rate between cUS and MRI was 88%. At the first cUS, germinal matrix hemorrhage (GMH) Grades 3 and 4, hospitalization duration, and weight are significantly correlated with MDI/PDI and prognosis (MDI: odds ratio [OR] = 8.415, 0.982, and 0.042, P = 0.016, 0.000, and 0.004; PDI: OR = 7.149, 0.978, and 0.012, P = 0.025, 0.000, and 0.000, respectively). At the last cUS, gestational age, extensive cystic periventricular leukomalacia (c-PVL), and moderate and severe hydrocephaly are significantly correlated with MDI (OR = 0.292, 60.220, and 170.375, P = 0.004, 0.003, and 0.000, respectively). Extensive c-PVL and moderate and severe hydrocephaly are significantly correlated with PDI (OR = 76.861 and 116.746, P = 0.003 and 0.000, respectively).
ConclusionsVery premature infants with GMH Grades 3 and 4, short hospitalization duration, and low weight have low survival rates and poorly developed brain nerves. Cerebral palsy can result from severe cerebral hemorrhage, moderate and severe hydrocephaly, and extensive c-PVL. The sustained, inhomogeneous echogenicity of white matter may suggest subtle brain injury.