Article

Diffuse white matter injury is not well detected by cranial ultrasonography
(CUS). The aim of this study was twofold: (1) to assess in very preterm neonates
the predictive values of individual CUS abnormalities for white matter injury on
MRI and neurological outcome; (2) to develop a strategy optimizing CUS detection
of white matter injury. METHOD: Very preterm neonates
(n=67; 44 males, 23 females) underwent serial CUS and single MRI. Predictive values of CUS findings
for a white matter classification on MRI, individual MRI findings, and
neurological outcome at 2 years corrected age were calculated. The effects of
timing and frequency of CUS were evaluated. RESULTS: Periventricular
echodensities (PVEs) predicted abnormal white matter on MRI, but absence of PVEs
did not predict absence of white matter changes. Peri- and intraventricular
haemorrhage (P/IVH) was highly predictive of abnormal white matter on MRI.
Frequency and timing of CUS did not influence predictive values. P/IVH and
abnormal ventricular size/shape were reasonably predictive of unfavourable
outcome, whereas absence of CUS abnormalities predicted a favorable outcome.
INTERPRETATION: (1) If PVEs are present, there is a significant chance of
abnormal white matter on MRI. (2) Increasing frequency of CUS does not increase
its diagnostic performance for white matter injury.
(3) P/IVH is highly
predictive of abnormal white matter on MRI and reasonably predictive of
unfavourable outcome.
(4) Absence of PVEs and P/IVH on CUS does not guarantee
normal white matter, but predicts a favourable outcome.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2011 Mac Keith
Press.

Langue : ANGLAIS