Background and Purpose

Qualitative studies about the abnormalities appreciated on routine magnetic resonance imaging (MRI) sequences in prematurely born adults are lacking. This article aimed at filling this knowledge gap by (1) qualitatively describing routine imaging findings in prematurely born adults, (2) evaluating measures for routine image interpretation and (3) investigating the impact of perinatal variables related to premature birth.

Methods

In this study two board-certified radiologists assessed T1-weighted and FLAIR-weighted images of 100 prematurely born adults born very preterm (VP <32 weeks) and/or at very low birth weight (VLBW <1500 g) and 106 controls born at full term (FT) (mean age 26.8 ± 0.7 years). The number of white matter lesions (WML) was counted according to localization. Lateral ventricle volume (LVV) was evaluated subjectively and by measurements of Evans’ index (EI) and frontal-occipital-horn ratio (FOHR). Freesurfer-based volumetry served as reference standard. Miscellaneous incidental findings were noted as free text.

Results

The LVV was increased in 24.7% of VP/VLBW individuals and significantly larger than in FT controls. This was best identified by measurement of FOHR (AUC = 0.928). Ventricular enlargement was predicted by low gestational age (odds ratio: 0.71, 95% CI 0.51–0.98) and presence of neonatal intracranial hemorrhage (odds ratio: 0.26, 95% CI 0.07–0.92). The numbers of deep and periventricular WML were increased while subcortical WMLs were not.

Conclusion

Enlargement of the LVV and deep and periventricular WMLs are typical sequelae of premature birth that can be appreciated on routine brain MRI. To increase sensitivity of abnormal LVV detection, measurement of FOHR seems feasible in clinical practice.

中文翻译：

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年轻人早产的后遗症

背景和目的

缺乏关于早产成人常规磁共振成像 (MRI) 序列异常的定性研究。本文旨在通过 (1) 定性描述早产成人的常规成像结果，(2) 评估常规图像解释措施和 (3) 调查与早产相关的围产期变量的影响来填补这一知识空白。

方法

在这项研究中，两名获得委员会认证的放射科医师评估了 100 名极早产儿（VP <32 周）和/或极低出生体重（VLBW <1500 g）的早产成人的 T1 加权和 FLAIR 加权图像和 106 名出生于足月 (FT)（平均年龄 26.8 ± 0.7 岁）。根据定位计算白质病变（WML）的数量。侧脑室容积 (LVV) 被主观评估，并通过测量埃文斯指数 (EI) 和额枕角比 (FOHR)。基于 Freesurfer 的体积测量作为参考标准。杂项偶然发现被记录为自由文本。

结果

24.7% 的 VP/VLBW 个体的 LVV 增加，并且明显大于 FT 对照组。这最好通过测量 FOHR (AUC = 0.928) 来确定。低胎龄（比值比：0.71，95% CI 0.51-0.98）和新生儿颅内出血（比值比：0.26，95% CI 0.07-0.92）预测心室扩大。深部和脑室周围 WML 的数量增加，而皮质下 WML 的数量没有增加。

结论

LVV 扩大以及深部和脑室周围 WML 是早产的典型后遗症，可以在常规脑部 MRI 上发现。为了提高异常 LVV 检测的灵敏度，在临床实践中测量 FOHR 似乎是可行的。