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Neurodevelopmental outcome at 36 months in very low birth weight premature infants with MR diffuse excessive high signal intensity (DEHSI) of cerebral white matter

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Abstract

Purpose

To understand the meaning of diffuse excessive high signal intensity (DEHSI) of white matter (WM), a frequently observed finding on MR in VLBW infants at a corrected term age.

Methods

This is a retrospective study. Qualitative visual assessment of cerebral WM signal intensity on T2WI was performed by two readers on 78 VLBW infants, scanned on a 1.5 T-MRI at term equivalent age. ADC values were then measured in six regions of interest: four in frontal and parietal periventricular and two in parietal subcortical WM. Mean ADC values were then compared with qualitative visual assessment and with mean ADC values obtained ten term healthy babies. Both periventricular and subcortical mean ADC values were correlated with the neurological follow-up, evaluated with the Griffith’s mental developmental scale at 36 months.

Results

There was no agreement between the visual qualitative assessment of white matter DEHSI and corresponding ADC values (P values = 0.42 for periventricular WM; P values = 0.18 for subcortical WM). Mean ADC values were higher in preterms than in term babies (P values <0.001). No significant correlation was found between ADC values and the developmental quotient at 36 months (P values >0.05).

Conclusions

DEHSI in VLBW infants is a MR finding poorly defined with conventional T2 MRI. The presence of T2 hyperintensities weakly correlates with ADC, and ADC values are not associated with the neurological long-term outcome at 3 years, demonstrating that DEHSI should not be considered as a WM disease.

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Abbreviations

ADC:

Apparent diffuse coefficient

DEHSI:

Diffuse excessive high signal intensity

DQ:

Developmental quotient

DTI:

Diffusion tensor imaging

DWI:

Diffuse-weighted imaging

GMDS:

Griffith’s mental developmental scale

MRI:

Magnetic resonance imaging

NICU:

Neonatal intensive care unit

SGA:

Small for gestational age

TTTS:

Twin-to-twin transfusion syndrome

VLBW:

Very low birth weight

WM:

White matter

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Conflict of interest

The authors whose names are listed immediately below certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Author names: CMC, MD; SFC, MD; LB, MD; SA, MD; MF, MD; LB, MD; OP, MD; DC, MD; FM, MD; FT, MD.

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We declare that this manuscript does not contain clinical studies or patient data.

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Authors and Affiliations

  1. School of Medicine, University of Milan, Via Festa del Perdono, 7, 20122, Milan, Italy

    Sonia Francesca Calloni & Luke Bonello

  2. Department of Neuroradiology, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy

    Claudia Maria Cinnante, Sabrina Avignone & Fabio Triulzi

  3. Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy

    Laura Bassi, Monica Fumagalli, Odoardo Picciolini & Fabio Mosca

  4. Department of Epidemiology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy

    Dario Consonni

Authors
  1. Sonia Francesca Calloni
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  2. Claudia Maria Cinnante
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Correspondence to Sonia Francesca Calloni.

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Calloni, S.F., Cinnante, C.M., Bassi, L. et al. Neurodevelopmental outcome at 36 months in very low birth weight premature infants with MR diffuse excessive high signal intensity (DEHSI) of cerebral white matter. Radiol med 120, 1056–1063 (2015). https://doi.org/10.1007/s11547-015-0540-2

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  • DOI: https://doi.org/10.1007/s11547-015-0540-2

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