Screening Cranial Imaging at Multiple Time Points Improves Cystic Periventricular Leukomalacia Detection

• Type of Material: Article
• Authors: Abhik Das, RTI International; John Barks, University of Michigan; Subrata Sarkar, University of Michigan; Seetha Shankaran, Wayne State University; Abbot R. Laptook, Brown University; Beena G. Sood, Wayne State University; Barbara Do, RTI International; Barbara Stoll, Emory University; Krisa P. Van Meurs, Stanford University; Edward F. Bell, University of Iowa
• Language: English
• Date: 2015-08-01
• Publisher: Thieme Publishing
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015 by Thieme Medical Publishers, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1055/s-0035-1545666
• Title of Journal or Parent Work: American Journal of Perinatology
• ISSN: 0735-1631
• Volume: 32
• Issue: 10
• Start Page: 973
• End Page: 979
• Grant/Funding Information: The National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) provided grant support for the Neonatal Research Network's GDB Study through cooperative agreements.
• Keywords: cystic periventricular leukomalacia; DIAGNOSIS; Science & Technology; LEUCOMALACIA; extremely low birth weight preterm infants; CEREBRAL-PALSY; NEONATE; Life Sciences & Biomedicine; Pediatrics; PRETERM INFANTS; screening cranial imaging; ABNORMALITIES; BIRTH-WEIGHT INFANTS; ULTRASOUND; INTRAVENTRICULAR HEMORRHAGE; Obstetrics & Gynecology; WHITE-MATTER INJURY
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Obstetrics and Gynecology; Health Sciences, Radiology

Abstract

Objective The aim of this study is to determine whether the cystic periventricular leukomalacia (cPVL) detection rate differs between imaging studies performed at different time points. Design We retrospectively reviewed the prospectively collected data of 31,708 infants from the NICHD Neonatal Research Network. Inclusion criteria were infants<1,000g birth weight or<29 weeks' gestational age who had cranial imaging performed using both early criterion (cranial ultrasound [CUS]<28 days chronological age) and late criterion (CUS, magnetic resonance imaging, or computed tomography closest to 36 weeks postmenstrual age [PMA]). We compared the frequency of cPVL diagnosed by early and late criteria. Results About 664 (5.2%) of the 12,739 infants who met inclusion criteria had cPVL using either early or late criteria; 569 using the late criterion, 250 using the early criterion, and 155 patients at both times. About 95 (14.3%) of 664 cPVL cases seen on early imaging were no longer visible on repeat screening closest to 36 weeks PMA. Such disappearance of cPVL was more common in infants<26 weeks' gestation versus infants of 26 to 28 weeks' gestation (18.5 vs. 11.5%; p=0.013). Conclusions Cranial imaging at both<28 days chronological age and closest to 36 weeks PMA improves cPVL detection, especially for more premature infants.