Advanced MR brain imaging in preterm infants

Abstract

The aim of the thesis is to investigate the diagnostic value of MRI performed around term equivalent age in evaluating brain injury and predicting neurodevelopmental outcome at two years corrected age in very preterm infants with a gestational age of less than 32 weeks. MRI is a powerful tool to diagnose all types of white matter injury and is more sensitive than ultrasound in detecting punctate white matter lesions which are associated with developmental delay and cerebral palsy. The positive predictive value of specific MRI findings such as punctate white matter lesions, and also cystic lesions and ventricular dilatation for cognitive and motor delay is low. Advanced DTI techniques are promising and may help predicting clinical outcome. However in combination with findings on conventional MRI sequences, there is only a slight increase in sensitivity and specificity. At this stage a routine clinical MRI in every preterm infant does not seem warranted. In the future, serial MRI and the application of advanced techniques may provide insights into brain development and injury to the preterm infant__s brain, and they may help predicting neurological outcome.