Routine cerebral magnetic resonance imaging catches low-grade pathologies in preemies

The routine implementation of cerebral magnetic resonance imaging (cMRI) commonly detects low-grade abnormalities in extremely premature infants, such as low-grade intraventricular haemorrhage (IVH), white matter disease (WMD), and cerebellar injury (CBI), a new study has found.

The current analysis included 198 cMRI examinations conducted between November 2017 and November 2020. A retrospective assessment of all pathologies was conducted, while patient records were accessed for clinical data such as birth weight, gestational age, and important neonatal diagnoses. All neonates also underwent cranial ultrasonography (CUS).

Nearly half (47.0 percent; n=93) of all examinations showed abnormalities, the most common of which was IVH (32.8 percent; n=65), followed by CBI (20.7 percent; n=41) and WMD (14.1 percent; n=28). Thirty-seven (18.7 percent) of all cMRI scans showed more than one injury pattern.

Of all cMRI scans, 72.2 percent (n=143) were performed routinely, leading to 39 (27.3 percent) neonates identified with abnormalities. Two of these were high-grade injuries (1.4 percent). CBI was the most common diagnosis from routine cMRI scans (16.8 percent; n=24), two of which were deemed high-grade.

In comparison, CUS was only able to detect 49 cases (~75 percent) of IVH of any grade.

“cMRI proved to be superior compared with ultrasound in the detection of low-grade IVH, diffuse signal alterations of the white matter, and CBI. Whether all these abnormalities are associated with long-term neurodevelopmental impairment will have to be proven in studies including neurodevelopmental outcome,” the researchers said.