Published online June 4, 2007
PEDIATRICS Vol. 120 No. 1 July 2007, pp. e10-e19 (doi:10.1542/peds.2006-1844)

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ARTICLE

Magnetic Resonance Imaging Regional T1 Abnormalities at Term Accurately Predict Motor Outcome in Preterm Infants

Yukiko Nanba, MD^a,b, Kiyoshi Matsui, MD^a, Noriko Aida, MD^c, Yoshiaki Sato, MD^a, Katsuaki Toyoshima, MD^a, Motoyoshi Kawataki, MD^a, Rikuo Hoshino, MD^a, Makiko Ohyama, MD^a, Yasufumi Itani, MD^a, Akiko Goto, MD^a, Akira Oka, MD^d

^a Departments of Neonatology
^c Radiology, Kanagawa Children's Medical Center, Yokohama, Japan
^b Division of Perinatology, Department of Perinatal Medicine and Maternal Care
^d Division of Child Neurology, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan

OBJECTIVE. The aim of this study was to assess whether periventricular leukomalacia findings are sufficiently sensitive for predicting the severity of motor prognosis by conventional MRI in the near term.

METHODS. Preterm infants with T1 hyperintensity or cysts in the periventricular regions on term MRI were selected, and their gross motor functions were evaluated at the age of 3 to 5 years. Sixty-two infants had findings of T1 hyperintensity or cysts, and except for infants with these findings, none were diagnosed later as periventricular leukomalacia.

RESULTS. All 37 patients with cerebral palsy had periventricular lesions with T1 hyperintensity or cysts in the corona radiata above the posterior limb of the internal capsule on coronal sections. Small T1 hyperintensity lesions were seen on coronal slices and were often difficult to detect on axial slices. All of the 17 infants with T1 hyperintensity findings sparing the corona radiata above the posterior limb of the internal capsule showed normal motor development, irrespective of findings of ventriculomegaly. There was a tendency for the presence of widespread lesions in corona radiata above the posterior limb of the internal capsule to be correlated with the severity of motor handicap.

CONCLUSIONS. Lesions in the corona radiata above the posterior limb of the internal capsule on a coronal view by term MRI were useful for predicting motor prognosis in preterm infants with periventricular leukomalacia.

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Key Words: cerebral palsy • periventricular leukomalacia • neuromotor outcome • neuroimaging • preterm infants

Abbreviations: PVL—periventricular leukomalacia • CP—cerebral palsy • SE—spin-echo • V/B—ventricular/brain ratio • IVH—intraventricular hemorrhage • CR—corona radiata • PLIC—posterior limb of the internal capsule • CR-CSp—periventricular corona radiata related to corticospinal tract • GMFCS—Gross Motor Function Classification System

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Accepted Dec 12, 2006.

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