A novel magnetic resonance imaging-based scoring system to predict outcome in neonates born preterm with intraventricular haemorrhage.
Katharina Goeral, Gregor Kasprian, Britta M Hüning and 8 others
PMID 34839534WHAT IT FOUND
A new MRI scoring system predicted cognitive and motor outcomes better than standard ultrasound grading in preterm infants with brain bleeds.
Higher MRI scores and lower gestational age independently signaled worse development, offering clinicians a more precise tool for prognosis.
Key findings
01The total MRI score correlated with ultrasound-based IVH grade, with an R-squared of 0.59 for the total score.
02The MRI score predicted motor outcome with an R-squared of 0.81 and cognitive outcome with an R-squared of 0.65 when adjusted for gestational age.
03The MRI score distinguished favourable from unfavourable outcomes better than conventional ultrasound grading, with areas under the curve 0.16 to 0.17 points higher for cognitive and motor outcomes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Retrospective design with potential for bias in data collection. Two different centers used different MRI scanners (1.5T and 3T) and protocols, though reliability was assessed. The cohort had a high rate of severe IVH and posthaemorrhagic ventricular dilatation, which may limit generalizability to milder cases. Ultrasound and MRI were not performed at the same time point. No adjustment for multiple testing was applied in the statistical analysis. The scoring system requires expertise in neonatal MRI interpretation.
The easy way to misread this
Do not interpret the high predictive power as proof that the MRI score is superior in all clinical settings without validation. The study was retrospective, used two different centers with varying protocols, and included a population with a high prevalence of severe brain injury, which may not represent all preterm infants with IVH.