Predictive value of neonatal MRI as compared to ultrasound in premature infants with mild periventricular white matter changes

A follow-up study was performed in 42 premature infants in whom serial neon atal ultrasound and a single neonatal MRI of the brain was normal, or showe d mild periventricular white matter changes. The aim of the study was to ev aluate the clinical significance of periventricular signal intensity change s on MRI and to compare the predictive value of neonatal MRI with that of u ltrasound. The infants underwent repeated standardised motor assessments an d developmental tests. MRI was repeated at the corrected age of 12 months. Pronounced periventricular signal intensity changes on neonatal MRI and per iventricular echodensities (flaring) on ultrasound were associated with a h igh incidence of transient motor problems during infancy. The degree of ech ogenicity carried the highest predictive value, as compared to duration of flaring on ultrasound and degree of periventricular signal intensity change on MRI. It is concluded that signal intensity changes on neonatal MRI repr esent the same ischaemic: change of the periventricular white matter as fla ring on ultrasound and that routine neonatal MRI screening is not warranted in premature infants without clinical evidence of neurological problems an d with normal or mildly abnormal ultrasound scans. Recording of the degree of echogenicity should become a routine procedure in neonatal cerebral ultr asonography.