Abnormal white matter appearance on term FLAIR predicts neuro-developmental outcome at 6 years old following preterm birth

Int J Dev Neurosci. 2007 Dec;25(8):523-30. doi: 10.1016/j.ijdevneu.2007.09.009. Epub 2007 Sep 29.


Preterm infants are at significant risk of neuro-developmental disorders at school-age. MRI is a potentially useful screening tool of such disorders. Using FLAIR imaging in the preterm infants at term, here we demonstrate that abnormal low-intensity signal in the white matter predicts the neuro-developmental outcome at 6 years.

Study design: Clinical factors associated with white matter appearance on MRI obtained at term were investigated in 210 preterm infants.

Results: Low-intensity signal on FLAIR imaging was commonly observed (69%) at <2 months corrected-age. Its incidence correlated with corrected-age at scan, maternal pyrexia and cystic periventricular leukomalacia. Low-intensity signal on FLAIR significantly correlated with performance and full-scale developmental quotients, whereas diffuse high-intensity signal on T2-weighted imaging correlated only with the full-scale developmental quotient at 6 years (n = 75, WISC-R). FLAIR imaging, but not T2-weighted imaging, predicted mild neuro-developmental delay.

Conclusions: FLAIR appeared to detect subtle white matter injury related with neuro-developmental disorders at school-age, whereas T2-weighted imaging seemed to identify relatively more severe injury. FLAIR is a potentially sensitive screening tool that is readily available and easily interpretable.

MeSH terms

  • Analysis of Variance
  • Brain / pathology*
  • Child
  • Data Interpretation, Statistical
  • Developmental Disabilities / pathology*
  • Developmental Disabilities / psychology
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Infant, Newborn
  • Infant, Premature / growth & development*
  • Logistic Models
  • Magnetic Resonance Imaging
  • Male
  • Neuropsychological Tests
  • Odds Ratio
  • Prognosis