Best practice guideline Brain imaging findings in very preterm infants throughout the neonatal period: Part II. Relation with perinatal clinical data Lara M. Leijser a, ⁎, Sylke J. Steggerda a, 1 , Francisca T. de Bruïne b,2 , Jeroen van der Grond b,2 , Frans J. Walther a, 1 , Gerda van Wezel-Meijler a, 1 a Department of Paediatrics, Division of Neonatology, J6-S, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands b Department of Radiology, C3-Q, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands abstract article info Article history: Received 27 November 2008 Accepted 28 November 2008 Keywords: Cranial ultrasound MRI Brain Perinatal clinical data Preterm infant Risk factor This study describes the relation between frequent and clinically relevant brain imaging findings in very preterm infants (GA b 32 weeks), assessed with sequential cranial ultrasonography throughout the neonatal period and MRI around term age, and several potential perinatal risk factors. For ultrasound findings during admission the following independent risk factors were identified: male gender for periventricular echodensities and intraventricular haemorrhage, postnatal corticosteroid treatment for cystic white matter lesions, and lower gestational age for post-haemorrhagic ventricular dilatation. For MRI findings around term age, including punctate white matter lesions, ventricular dilatation, decreased cortical complexity, and diffuse and excessive high signal intensity, no independent risk factors were found. In very preterm infants, the risk factors for frequently found changes on cranial ultrasound have largely remained unchanged over the last decades, while no risk factors could be identified for subtle and diffuse white matter injury as seen on MRI around term age. © 2008 Elsevier Ireland Ltd. All rights reserved. Contents 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 2. Patients and methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 2.1. Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 2.2. Clinical parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 2.3. Cranial ultrasound. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 2.4. MRI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 2.5. Data analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 3. Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 3.1. Clinical parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 3.2. Neuro-imaging findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 3.3. Relation between neuro-imaging findings and clinical parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 3.3.1. cUS during admission (n = 133) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 3.3.2. MRI around TEA (n = 113) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114 4. Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114 5. Key guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 6. Research directions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 Early Human Development 85 (2009) 111–115 ⁎ Corresponding author. Tel.: +31 71 5264080; fax: +31 71 5248198. E-mail addresses: L.M.Leijser@lumc.nl (L.M. Leijser), S.J.Steggerda@lumc.nl (S.J. Steggerda), F.T.Wiggers-de_Bruine@lumc.nl (F.T. de Bruïne), J.van_der_Grond@lumc.nl (J. van der Grond), F.J.Walther@lumc.nl (F.J. Walther), G.van_Wezel-Meijler@lumc.nl (G. van Wezel-Meijler). 1 Tel.: +31 71 5264080; fax: +31 71 5248198. 2 Tel.: +31 71 5264376; fax: +31 71 5248256. 0378-3782/$ – see front matter © 2008 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.earlhumdev.2008.11.012 Contents lists available at ScienceDirect Early Human Development journal homepage: www.elsevier.com/locate/earlhumdev