Abstract：
OBJECTIVE: The survival rate and patterns of brain injury after very preterm birth are evolving with changes in clinical practices. Additionally, incidental findings can present legal, ethical and practical considerations. Here, we report MRI features and incidental findings from a large, contemporary research cohort of very preterm infants and term controls.
METHODS: 288 infants had 3T MRI at term-equivalent age: 187 infants born <32 weeks without major parenchymal lesions, and 101 term-born controls. T1-weighted, T2-weighted and susceptibility-weighted imaging were used to classify white and grey matter injury according to a structured system, and incidental findings described.
RESULTS: Preterm infants: 34 (18%) had white matter injury and 4 (2%) had grey matter injury. 51 (27%) infants had evidence of intracranial haemorrhage and 34 (18%) had punctate white matter lesions (PWMLs). Incidental findings were detected in 12 (6%) preterm infants. Term infants: no term infants had white or grey matter injury. Incidental findings were detected in 35 (35%); these included intracranial haemorrhage in 22 (22%), periventricular pseudocysts in 5 (5%) and PWMLs in 4 (4%) infants. From the whole cohort, 10 (3%) infants required referral to specialist services.
CONCLUSIONS: One-fifth of very preterm infants without major parenchymal lesions have white or grey matter abnormalities at term-equivalent age. Incidental findings are seen in 6% of preterm and 35% of term infants. Overall, 3% of infants undergoing MRI for research require follow-up due to incidental findings. These data should help inform consent procedures for research and assist service planning for centres using 3T neonatal brain MRI for clinical purposes.
METHODS: 288 infants had 3T MRI at term-equivalent age: 187 infants born <32 weeks without major parenchymal lesions, and 101 term-born controls. T1-weighted, T2-weighted and susceptibility-weighted imaging were used to classify white and grey matter injury according to a structured system, and incidental findings described.
RESULTS: Preterm infants: 34 (18%) had white matter injury and 4 (2%) had grey matter injury. 51 (27%) infants had evidence of intracranial haemorrhage and 34 (18%) had punctate white matter lesions (PWMLs). Incidental findings were detected in 12 (6%) preterm infants. Term infants: no term infants had white or grey matter injury. Incidental findings were detected in 35 (35%); these included intracranial haemorrhage in 22 (22%), periventricular pseudocysts in 5 (5%) and PWMLs in 4 (4%) infants. From the whole cohort, 10 (3%) infants required referral to specialist services.
CONCLUSIONS: One-fifth of very preterm infants without major parenchymal lesions have white or grey matter abnormalities at term-equivalent age. Incidental findings are seen in 6% of preterm and 35% of term infants. Overall, 3% of infants undergoing MRI for research require follow-up due to incidental findings. These data should help inform consent procedures for research and assist service planning for centres using 3T neonatal brain MRI for clinical purposes.
摘要：
目的：早产后脑损伤的存活率和模式随着临床实践的变化而变化。此外,偶然的发现可以提出法律，道德和实践考虑。这里,我们报告了MRI特征和偶然发现，非常早产儿和足月控制的当代研究队列。
方法：288名婴儿在足月相同年龄时接受了3TMRI检查：187名出生<32周且无重大实质病变的婴儿，和101个足月出生的控制。T1加权，T2加权和磁敏感加权成像用于根据结构化系统对白质和灰质损伤进行分类，并描述了偶然发现。
结果：早产儿：34例（18%）有白质损伤，4例（2%）有灰质损伤。51（27％）婴儿有颅内出血的证据，34（18％）有点状白质病变（PWML）。在12名（6％）早产儿中发现了偶然发现。足月婴儿：没有足月婴儿有白色或灰质损伤。在35例（35%）中发现了偶然发现；其中包括22例（22%）的颅内出血，5例（5％）婴儿的脑室周围假性囊肿和4例（4％）婴儿的PWML。从整个队列中，10名(3%)婴儿需要转介专科服务。
结论：无重大实质病变的极早产儿中，有五分之一在足月相当年龄时出现白质或灰质异常。偶然的发现见于6%的早产儿和35%的足月儿。总的来说,由于偶然发现，接受MRI研究的婴儿中有3％需要随访。这些数据应有助于告知研究的同意程序，并为临床使用3T新生儿脑MRI的中心提供服务计划。
方法：288名婴儿在足月相同年龄时接受了3TMRI检查：187名出生<32周且无重大实质病变的婴儿，和101个足月出生的控制。T1加权，T2加权和磁敏感加权成像用于根据结构化系统对白质和灰质损伤进行分类，并描述了偶然发现。
结果：早产儿：34例（18%）有白质损伤，4例（2%）有灰质损伤。51（27％）婴儿有颅内出血的证据，34（18％）有点状白质病变（PWML）。在12名（6％）早产儿中发现了偶然发现。足月婴儿：没有足月婴儿有白色或灰质损伤。在35例（35%）中发现了偶然发现；其中包括22例（22%）的颅内出血，5例（5％）婴儿的脑室周围假性囊肿和4例（4％）婴儿的PWML。从整个队列中，10名(3%)婴儿需要转介专科服务。
结论：无重大实质病变的极早产儿中，有五分之一在足月相当年龄时出现白质或灰质异常。偶然的发现见于6%的早产儿和35%的足月儿。总的来说,由于偶然发现，接受MRI研究的婴儿中有3％需要随访。这些数据应有助于告知研究的同意程序，并为临床使用3T新生儿脑MRI的中心提供服务计划。
