comparative study between ultrasound, CT and MRI of white matter brain injury in premature newborns

ABSTRACT

Evaluate role of ultrasound and computed tomography in diagnosis of white matter damage in premature neonates. Analytic comparative study in Farwania Hospital, Kuwait. Accurate identification of predisposition of white matter injury in premature neonates is important for counseling parents and for targeting these high-risk neonates of patients with respiratory distress syndrome, Diabetes mellitus, preeclampsia, severe anaemia, and their rehabilitation. Our study is based on ultrasound [US] computed tomography [CT] and Magnetic Resonance Imaging [MRI] done for these patients depending on their clinical condition. Neonates were studied with US, CT, MR imaging at a median postconceptional age of 30 weeks [range, 24-36 weeks] with Apgar scores less than 7. White matter abnormalities shown on US, CT, MRI were classified and used in the analysis to determine the relative validity of each imaging modality. These were followed up until the patients were in the hospital. White matter abnormalities were diagnosed in [28.5%] neonates based on abnormal Ultrasound, CT and MR. Neonates with Apgar less than 5 were more associated with hypoxic ischemic changes. The severity of the hypoxic insult and sequelae is also inversely related to the patient's postconceptual age. Ultrasonography as a first hand screening tool with high sensitivity to detect white matter damage [WMD], however, relatively low specificity and high false positive cases make MRI is the best modality for WMD validation and grading. It is not a sensitive modality for the milder spectrum of MR imaging-defined white matter abnormalities, however, cranial US of demonstrates high reliability in the detection of cystic white matter injury, however, it display significant diagnostic value. This is important, because non-cystic WM injury is considerably more common than cystic WM injury