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225 Early Prediction of Outcome in Extremely Preterm Infants using Cranial Ultrasound and MRI Scoring Systems
  1. B Skiöld1,2,
  2. B Vollmer1,
  3. B Hallberg2,3,
  4. U Ådén1,2,
  5. M Blennow2,3,
  6. S Horsch3,4
  1. 1Dept of Women’s and Children’s Health, Karolinska Institutet
  2. 2Dept of Neonatology, Karolinska University Hospital
  3. 3Dept CLINTEC, Karolinska Institutet, Stockholm, Sweden
  4. 4Dept of Neonatology, Erasmus MC - Sophia Children’s Hospital, Rotterdam, The Netherlands

Abstract

Background and aims Extremely preterm infants are at high risk of brain injury and adverse outcome. This study compares the predictive values of cranial ultrasound (CUS) and conventional magnetic resonance imaging (MRI) at term equivalent age (TEA) for cerebral palsy (CP) and/or severe cognitive delay.

Methods Eighty-four infants, born < 27 weeks of gestation, underwent MRI (1.5 T) and CUS (5–8 MHz) at TEA. Images were evaluated by three independent observers. A previously published (Horsch et al. 2010), modified CUS scoring system and a widely used MRI scoring system were applied (Woodward et al. 2006). At age 30 months corrected, 62 infants (74%) underwent neurological examination and assessment with the Bayley Scales of Infant and Toddler Development-III (BSITD-III). Cut off levels for developmental delay (–2 SD) were adjusted to an age and sex matched term born control group (n=85).

Results Both CUS and MRI scoring systems predicted CP with a sensitivity of 75%, while specificity was higher for MRI (96%, versus 91%). Predictive values for severe cognitive delay were equal and good, with sensitivities of 100% (specificity 95% for MRI, 90% for CUS).

Conclusion We conclude that, using the scoring systems applied in this study, both CUS and MRI at TEA are useful in predicting CP and/or severe cognitive delay at age 30 months. Furthermore, we suggest that these scoring systems, which can be used in clinical routine, are helpful tools in identifying infants who are at high risk of adverse outcome and should undergo MRI.

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