Alterations on magnetic resonance imaging of the neonatal brain: correlations with prenatal risk factors and transfontanellar ultrasound findings

Abstract

Objective: To describe the alterations seen on magnetic resonance imaging (MRI) of the brain in newborns, correlating those alterations with the transfontanellar ultrasound (TFUS) findings, and to describe the main risk factors identified. Materials and Methods: We evaluated the examinations of 51 patients who were submitted to brain MRI with a neonatal protocol during hospitalization. We evaluated the MRI findings and correlated them with previous TFUS findings, using the last TFUS performed in order to minimize the risk of bias. Data were obtained from medical records, and the images were reviewed by a radiologist specializing in neuroimaging. Results: Of the 51 patients evaluated, 21 (41.2%) were extremely preterm infants and 22 (43.1%) were extremely-low-birth-weight infants. Alterations were seen on 16 (31.4%) of the TFUS examinations and on 30 (58.8%) of the brain MRI scans, the most common finding being germinal matrix hemorrhage. The positive and negative predictive values of TFUS in relation to MRI were 87% and 54%, respectively. Conclusion: Because TFUS proved to be capable of distinguishing mild and moderate (grade I and II) germinal matrix hemorrhage from the severe forms (grades III and IV), it can be considered a good tool for screening and follow-up, especially in infants with severe disease and risk factors.

Neurosonography: Shaping the future of neuroprotection strategies in extremely preterm infants

“…Sartori and colleagues compared the brain MRI and CUS examination results of 51 newborns (43 of them were extremely preterm infants) to verify the effectiveness of CUS in diagnosing IVH. The study showed that CUS and MRI have comparable value in identifying brain abnormalities such as germinal matrix hemorrhage, especially CUS's performance in screening and distinguishing between mild and severe hemorrhages in the germinal matrix layer (GMH) is particularly prominent [ 20 ]. Especially for preterm infants with III-IV degree cerebral hemorrhage, it can be seen that CUS is an appropriate tool for screening and follow-up of intracranial hemorrhage.…”