Optimal Timing of Cerebral MRI in Preterm Infants to Predict Long-Term Neurodevelopmental Outcome: A Systematic Review

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Fig 1.
Evolution of common types of preterm brain injury, at 30 weeks' postmenstrual age (1) and at term-equivalent age (2). Transversal T2-FSE images of punctate white matter lesions (A), periventricular leukomalacia (B), and periventricular hemorrhagic venous infarction (C). Note that images 2B and 2C are slightly oblique.

Table 1:

Details of included serial MRI studies

MRI Modality		Population	Timing of MRI (wk)	Main Findings
Structural conventional	Dyet et al⁸	119 Infants <30 wks	Serial	Abnormal outcome^{^a} at 18 mos was related to major destructive lesions, DEHSI, cerebellar hemorrhage, and posthemorrhagic ventricular dilation
	Miller et al³⁹	89 Infants <34 wks	32 + 37	Abnormal outcome at 18 mos^{^b} was related to severity of WM injury, ventriculomegaly, and intraventricular hemorrhage on first (RR, 5.6) and second (RR, 5.3) MRIs
	Tam et al⁴⁰	131 Infants <34 wks	32 + 37	Abnormal neurologic examination findings at 4.8 yrs were related to large and small cerebellar hemorrhage; OR for small hemorrhage was 5.0
DTI	Drobyshevsky et al⁷⁰	24 Infants <32 wks	30 + 36	PDI^{^b} at 24 mos correlated to FA of the PLIC at 30 wks (r = 0.55), faster increase of FA/wk in internal capsule (r = −0.63), and occipital WM (r = −0.59)
	Glass et al⁷¹	9 Infants <34 wks	33 + 38	FA of the optic radiation was correlated with visual-evoked-potential amplitude (r = 0.7) at 10.5 mos
Volumetric	Dubois et al⁸¹	45 Infants <36 wks	32 + 41	Functional assessment at term was associated with inner cortical surface and sulcation index
	Kapellou et al⁸² Rathbone et al⁸³	119 Infants <30 wks	Serial	Growth of the cortical surface area was related to neurodevelopmental outcome^{^a} at 24 mos and full-scale IQ at 6 yrs

Note:—RR indicates relative risk; OR, odds ratio; PDI, Psychomotor Development Index.
↵a Griffiths Mental Developmental Scales.
↵b Bayley Scales of Infant Development.

Table 2:

Details of included MRI studies, scanned at ≤35 weeks' postmenstrual age

MRI Modality		Population	Timing of MRI (wk)	Main Findings
Structural conventional	Cornette et al⁴¹	50 Infants <37 wks	35	Major cerebral abnormalities were correlated to abnormal outcome at 30 mos; isolated PWML were not related to neurodevelopmental impairment
Volumetric	Badr et al⁸⁴	59 Infants <37 wks	31	WM volume was correlated significantly to PDI^{^a} (r = 0.29) and MDI^{^a} (r = 0.31) at 18 mos