Article Figures & Data
Figures
- Fig 1.
Representative MR images of regional injury. Axial T1- or T2-weighted MR images demonstrating classification of cystic WM lesions (A–D), focal WM signal abnormalities (E–G), deep GM lesions (H and I), and cerebellar lesions (J and K). Cystic WM lesions are defined by their extent: focal unilateral (arrow, A), focal bilateral (arrows, B), extensive unilateral (C), and extensive bilateral (D). Focal WM signal abnormalities are classified as focal punctate (arrows, E), extensive punctate (arrows, F), or linear lesions corresponding to gliosis (arrows, G). Deep GM and cerebellar injuries are classified into 4 grades by their extent. Representative images of focal unilateral (arrow, H) or extensive unilateral (arrow, I) deep GM lesions, and images of focal bilateral (arrows, J) or focal extensive (arrow, K) cerebellar lesions are shown.
- Fig 2.
Regional measurements. A, Biparietal width (BPW) and interhemispheric distance (IHD) are measured on a single coronal section by use of the cochlea and basilar truncus as landmarks. B, Callosal thickness is measured on a midsagittal view at 3 different regions: the genu, the midportion, and the splenium. C, Ventricular diameters (VDs) and transcerebellar diameter (TCD) are measured on a coronal view at the level of the ventricular atrium. D, The deep GM area (DGMA) is measured on a single axial section at the level at which the caudate heads, the lentiform nuclei, and the thalami are maximally visible.
Tables
- Table 1:
Prevalence of infants with each item in cerebral WM score (VPT infants/term infants)
Variables WM Score Score 0 Score 1 Score 2 Score 3 Score 4 Cerebral WM Cystic lesions None (90/22) Focal unilateral (3/0) Focal bilateral (1/0) Extensive unilateral (2/0) Extensive bilateral (1/0) Focal signal abnormality None (77/20) Focal punctate (13/2) Extensive punctate (5/0) Linear (2/0) Myelination delay PLIC & corona radiata (65/22) Only PLIC (26/0) Minimal—no PLIC (6/0) Thinning of the corpus callosum None (40/18) Partial (genu/body < 1.3 mm or splenium < 2.0 mm) (53/4) Global (genu/body < 1.3 mm and splenium < 2.0 mm) (4/0) Dilated lateral ventricles Both sides VD < 7.5 mm (26/17) One side 7.5 mm ≤ VD < 10 mm (19/4) Both sides 7.5 mm ≤ VD < 10 mm or one side VD ≥ 10 mm (42/1) Both sides VD ≥ 10 mm (10/0) Volume reduction cBPW ≥77 mm (21/19) 77 mm > cBPW ≥72 mm (30/2) 72 mm > cBPW ≥67 mm (40/1) 67 mm > cBPW (6/0) Note:—cBPW indicates corrected biparietal width; PLIC, posterior limb of internal capsule; VD, ventricular diameter.
- Table 2:
Prevalence of infants with each item in GM or cerebellum score (VPT infants/term infants)
Variables GM or Cerebellum Score Score 0 Score 1 Score 2 Score 3 Score 4 Cortical GM Signal abnormality None (97/22) Focal unilateral (0/0) Focal bilateral (0/0) Extensive unilateral (0/0) Extensive bilateral (0/0) Gyral maturation Delay < 2 weeks (96/22) 2 ≤ delay < 4 weeks (1/0) Delay ≥4 weeks (0/0) Increased extracerebral space IHD < 4 mm (61/20) 4 mm ≤ IHD < 5 mm (20/2) 5 mm ≤ IHD < 6 mm (8/0) IHD ≥6 mm (8/0) Deep GM Signal abnormality None (92/22) Focal unilateral (2/0) Focal bilateral (2/0) Extensive unilateral (0/0) Extensive bilateral (1/0) Volume reduction cDGMA ≥9.5 (53/20) 9.5 > cDGMA ≥8.5 (35/2) 8.5 > cDGMA ≥7.5 (8/0) 7.5 > cDGMA (1/0) Cerebellum Signal abnormality None (74/22) Punctate unilateral (10/0) Punctate bilateral (5/0) Extensive unilateral (4/0) Extensive bilateral (4/0) Volume reduction cTCD ≥50 mm (43/20) 50 mm > cTCD ≥47 mm (31/2) 47 mm > cTCD ≥44 mm (18/0) cTCD < 44 mm (5/0) Note:—cDGMA indicates corrected deep GM area (cm2); cTCD, corrected transcerebellar diameter; IHD, interhemispheric distance.
- Table 3:
Effect of WM injury or intraventricular hemorrhage on deep GM or cerebellum in VPT infants
Deep GM Cerebellum Signal Abnormality n (%) Corrected Deep GM Area Mean (SD) Signal Abnormality n (%) Corrected Transcerebellar Diameter Mean (SD) WM injuryc Yes (n = 23) 4 (17)a 9.4 (1.2)b 7 (30) 49.0 (2.8) No (n = 74) 1 (1.4) 9.9 (0.9) 16 (22) 49.3 (3.4) Intraventricular hemorrhage Yes (n = 31) 3 (9.7) 9.4 (0.9)b 12 (39)b 48.2 (3.5)b No (n = 66) 2 (3) 9.9 (1.0) 11 (17) 49.7 (3.0) Variables Global Brain Abnormality P Value Normal (Score 0–3) n = 18 Mild (Score 4–7) n = 45 Moderate (Score 8–11) n = 21 Severe (Score ≥12) n = 13 Gestation at birth (weeks) 27.4 (1.5) 26.9 (1.6) 25.9 (1.7) 26.2 (2.5) .03 Birth weight (g) 1067 (222) 992 (235) 789 (185) 897 (305) .002 Birth weight < −2 SD 1 (6%) 3 (7%) 1 (5%) 1 (8%) .99 Male sex 9 (50%) 22 (49%) 6 (29%) 6 (46%) .43 Singleton 9 (50%) 13 (29%) 6 (29%) 5 (39%) .40 Critical Risk Index for Babies score 1 [1–4] 2 [1–5.5] 4 [1.5–7.5] 4 [1–9] .06 Days of intubation 1 [0.75–2.25] 2 [1–8.5] 4 [1–28] 21 [3.5–52.5] .004 Oxygen at 36 weeks 5 (28%) 23 (51%) 12 (57%) 9 (69%) .12 Postnatal steroid use 0 9 (20%) 10 (48%) 7 (54%) .001 Inotrope use 1 (6%) 12 (27%) 11 (52%) 9 (69%) <.001 Patent ductus arteriosus 5 (28%) 14 (31%) 11 (52%) 9 (69%) .04 Total parenteral nutrition 10.5 [9–16.5] 16 [12.5–26.5] 29 [14.5–47] 25 [10–36] .004 Chorioamnionitis 5 (28%) 19 (42%) 9 (45%) 4 (31%) .61 Confirmed sepsis 2 (11%) 10 (22%) 9 (43%) 8 (62%) .007 Necrotizing enterocolitis 0 2 (4%) 3 (14%) 2 (15%) .19 Note:—Data are mean (SD), number (%), or median [lower-upper quartile].
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