PEDIATRICS Vol. 107 No. 4 April 2001, pp. 719-727
Comparison of Findings on Cranial Ultrasound and Magnetic Resonance Imaging in Preterm Infants
Received Dec 16, 1999; accepted Dec 8, 2000.
,,
From the * Department of Paediatrics, Imperial College School of
Medicine and Robert Steiner MR Unit, Medical Research Council
Clinical Sciences Centre, Hammersmith Hospital, London, United Kingdom.
Objective. To compare findings on hard copies of cranial ultrasound (US) and magnetic resonance imaging (MRI) obtained between birth and term in a group of preterm infants.
Participants and Methods. Infants born at or below a gestational age of 30 weeks who underwent cranial US scan and MRI on the same day were eligible for this study. Infants underwent, whenever possible, 3 scans between birth and term. We calculated the predictive probability (PP) of US findings as a predictor of findings on MRI.
Results. Sixty-two paired MRI and US studies were
performed between birth and term in 32 infants born at a median
gestational age of 27 (range: 23-30) weeks and a median birth weight
of 918 (530-1710) grams. US predicted some MRI findings accurately:
germinal layer hemorrhage (GLH) on US had a PP of 0.8 with a 95%
confidence interval of (0.70-0.90) for the presence of GLH on MRI,
intraventricular hemorrhage (IVH) on US had a PP of 0.85 (0.76-0.94)
for the presence of IVH on MRI, and severe white matter (WM)
echogenicity on US had a PP of 0.96 (0.92-1.0) for the presence of WM
hemorrhagic parenchymal infarction on MRI. Other MRI changes were less
well-predicted: mild or no WM echogenicity on US had a PP of 0.54 (0.41-0.66) for the presence of normal WM signal intensity on MRI, and
moderate or severe WM echogenicity on US had a PP of 0.54 (0.42-0.66)
for the presence of small petechial WM hemorrhage and/or diffuse
excessive high-signal intensity (DEHSI) in the WM on T2-weighted images on MRI. However, mild/moderate or severe WM echogenicity on US scans
performed at 
7 days after birth had a PP of 0.72 (0.58-0.87) for the
presence of WM hemorrhage and/or DEHSI on MRI. There were no cases of
cystic periventricular leukomalacia.
Conclusion. US accurately predicted the presence of GLH,
IVH, and hemorrhagic parenchymal infarction on MRI. However, its
ability to predict the presence of DEHSI and small petechial
hemorrhages in the WM on T2 weighted images is not as good, but
improves on scans performed at 7 days after birth. In addition,
normal WM echogenicity on US is not a good predictor of normal WM
signal intensity on MRI.
Key words:
MRI,
brain,
ultrasound,
periventricular leukomalacia.
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