Article

AIM: To examine the diagnostic ability of early magnetic resonance imaging (MRI;
<36wks postmenstrual age) to detect later adverse motor outcomes or cerebral
palsy (CP) in infants born preterm. METHOD: Studies of infants born preterm with
MRI earlier than 36 weeks postmenstrual age and quantitative motor data or a
diagnosis of CP at or beyond 1 year corrected age were identified. Study details
were extracted and meta-analyses performed where possible. Quality of included
studies was evaluated with the QUADAS-2 (a revised tool for the quality
assessment of diagnostic accuracy studies). RESULTS: Thirty-one articles met the
inclusion criteria, five of which reported diagnostic accuracy and five reported
data sufficient for calculation of diagnostic accuracy. Early structural MRI
global scores detected a later diagnosis of CP with a pooled sensitivity of 100%
(95% confidence interval [CI] 86-100) and a specificity of 93% (95% CI 59-100).
Global structural MRI scores determined adverse motor outcomes with a pooled
sensitivity of 89% (95% CI 44-100) and a specificity of 98% (95% CI 90-100).
White matter scores determined adverse motor outcomes with a pooled sensitivity
of 33% (95% CI 20-48) and a specificity of 83% (95% CI 78-88). INTERPRETATION:
Early structural MRI has reasonable sensitivity and specificity to determine
adverse motor outcomes and CP in infants born preterm. Greater reporting of
diagnostic accuracy in studies examining relationships with motor outcomes and CP
is required to facilitate clinical utility of early MRI. WHAT THIS PAPER ADDS:
Early magnetic resonance imaging (MRI) has reasonable sensitivity and specificity
to determine later adverse motor outcomes and cerebral palsy (CP). Detection of
infants who progressed to CP was stronger than motor outcomes. Global MRI scores
determined adverse motor outcomes more accurately than white matter scores. Few
studies report diagnostic accuracy of early MRI findings. Diagnostic accuracy is
required to draw clinically meaningful conclusions from early MRI studies.
CI - (c) 2017 Mac Keith Press.

Langue : ANGLAIS