Determinants of Indices of Cerebral Volume in Former Very Premature Infants at Term Equivalent Age

PLoS One. 2017 Jan 26;12(1):e0170797. doi: 10.1371/journal.pone.0170797. eCollection 2017.

Abstract

Conventional magnetic resonance imaging (MRI) at term equivalent age (TEA) is suggested to be a reliable tool to predict the outcome of very premature infants. The objective of this study was to determine simple reproducible MRI indices, in premature infants and to analyze their neonatal determinants at TEA. A cohort of infants born before 32 weeks gestational age (GA) underwent a MRI at TEA in our center. Two axial images (T2 weighted), were chosen to realize nine measures. We defined 4 linear indices (MAfhlv: thickness of lateral ventricle; CSI: cortex-skull index; VCI: ventricular-cortex index; BOI: bi occipital index) and 1 surface index (VS.A: volume slice area). Perinatal data were recorded. Sixty-nine infants had a GA (median (interquartile range)) of 30.0 weeks GA (27.0; 30.0) and a birth weight of 1240 grams (986; 1477). MRI was done at 41.0 (40.0; 42.0) weeks post menstrual age (PMA). The inter-investigator reproducibility was good. Twenty one MRI (30.5%) were quoted abnormal. We observed an association with retinopathy of prematurity (OR [95CI] = 4.205 [1.231-14.368]; p = 0.017), surgery for patent ductus arteriosus (OR = 4.688 [1.01-21.89]; p = 0.036), early onset infection (OR = 4.688 [1.004-21.889]; p = 0.036) and neonatal treatment by cefotaxime (OR = 3.222 [1.093-9.497]; p = 0.03). There was a difference for VCI between normal and abnormal MRI (0.412 (0.388; 0.429) vs. 0.432 (0.418; 0.449); p = 0,019); BOI was higher when fossa posterior lesions were observed; VS.A seems to be the best surrogate for cerebral volume, 80% of VS.As' variance being explained by a multiple linear regression model including 7 variables (head circumference at birth and at TEA, PMA, dopamine, ibuprofen treatment, blood and platelets transfusions). These indices, easily and rapidly achievable, seem to be useful but need to be validated in a large population to allow generalization for diagnosis and follow-up of former premature infants.

Publication types

  • Observational Study

MeSH terms

  • Bacterial Infections / diagnostic imaging
  • Bacterial Infections / pathology
  • Bacterial Infections / physiopathology
  • Cerebral Cortex / diagnostic imaging*
  • Cerebral Cortex / pathology
  • Cerebral Cortex / physiopathology
  • Cerebral Ventricles / diagnostic imaging*
  • Cerebral Ventricles / pathology
  • Cerebral Ventricles / physiopathology
  • Ductus Arteriosus, Patent / diagnostic imaging*
  • Ductus Arteriosus, Patent / pathology
  • Ductus Arteriosus, Patent / physiopathology
  • Female
  • Gestational Age
  • Humans
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Magnetic Resonance Imaging
  • Male
  • Mycoses / diagnostic imaging
  • Mycoses / pathology
  • Mycoses / physiopathology
  • Pregnancy
  • Prognosis
  • Prospective Studies
  • Retinopathy of Prematurity / diagnostic imaging*
  • Retinopathy of Prematurity / pathology
  • Retinopathy of Prematurity / physiopathology
  • Virus Diseases / diagnostic imaging
  • Virus Diseases / pathology
  • Virus Diseases / physiopathology

Grants and funding

The authors received no specific funding for this work.