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Am J Perinatol 2015; 32(10): 973-979
DOI: 10.1055/s-0035-1545666
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

Subrata Sarkar
1   Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
,
Seetha Shankaran
2   Department of Pediatrics, Wayne State University, Detroit, Michigan
,
Abbot R. Laptook
3   Department of Pediatrics, Women and Infants' Hospital, Brown University, Providence, Rhode Island
,
Beena G. Sood
2   Department of Pediatrics, Wayne State University, Detroit, Michigan
,
Barbara Do
4   Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina
,
Barbara J. Stoll
5   Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia
,
Krisa P. Van Meurs
6   Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California
,
Edward F. Bell
7   Department of Pediatrics, University of Iowa, Iowa City, Iowa
,
Abhik Das
8   Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, Maryland
,
John Barks
1   Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
,
for the Generic Database Subcommittee of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network › Author Affiliations
Further Information

Publication History

29 October 2014

08 January 2015

Publication Date:
02 March 2015 (online)

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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 < 1,000 g 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.

Keywords

cystic periventricular leukomalacia - screening cranial imaging - extremely low birth weight preterm infants
 

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