106 Neonatal Magnetic Resonance Imaging in Extremely Low Gestational Age Infants and Outcome at 30 Months

Abstract

Aim: To examine associations of structural brain abnormalities, in particular diffuse excessive high signal intensities (DEHSI), assessed by visual inspection of neonatal magnetic resonance images (MRI) with neurodevelopmental outcome at age 30 months corrected in a 3 year cohort of extremely low gestational age (ELGA) infants. Methods: 109 infants born < 27 weeks of gestation underwent conventional MRI at term-equivalent age. Images were analysed using an established scoring system (Inder et al 2003). At age 30 months corrected the infants were assessed using the Bayley Scales of Infant and Toddler Development. Results: No or mild white matter abnormalities (WMA) were seen in 86% of infants. In 14% moderate or severe WMA, and in 5% grey matter abnormalitites (GMA) were detected. DEHSI were seen in 56%. Outcome data were available for 72% of the cohort. Mean composite scores were 95 (SD±10) for cognitive scales, 97 (SD±14) for language scales, and 103 (SD±14) for motor scales. Six percent of the infants had cerebral palsy. Significant associations were seen between moderate-severe WMA and/or GMA and cognitive scores (Mann-Whitney U-test, p< 0.05) as well as language scores (p< 0.05). No significant associations were seen between MRI findings and motor scores. DEHSI were not associated with performance on the Bayley Scales. Conclusion: In our cohort of ELGA infants, moderate-severe brain abnormalitites on neonatal MRI were associated with impaired cognitive and language outcome at age 30 months corrected. The incidence of DEHSI was high, but the presence of DEHSI was not associated with adverse outcome.