Quantitative Magnetic Resonance Imaging for Neurodevelopmental Outcome Prediction in Neonates Born Extremely Premature—An Exploratory Study

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2024年1月30日

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Victor U. Schmidbauer,
Mehmet S. Yildirim,
Gregor O. Dovjak,
Katharina Goeral,
Julia Buchmayer,
Michael Weber,
Patric Kienast,
Mariana C. Diogo,
Florian Prayer,
Marlene Stuempflen,
Jakob Kittinger,
Jakob Malik,
Nikolaus M. Nowak,
Katrin Klebermass-Schrehof,
Renate Fuiko,
Angelika Berger,
Daniela Prayer,
Gregor Kasprian,
Vito Giordano

摘要

Purpose

Neonates born at < 28 weeks of gestation are at risk for neurodevelopmental delay. The aim of this study was to identify quantitative MR-based metrics for the prediction of neurodevelopmental outcomes in extremely preterm neonates.

Methods

T1-/T2-relaxation times (T1R/T2R), ADC, and fractional anisotropy (FA) of the left/right posterior limb of the internal capsule (PLIC) and the brainstem were determined at term-equivalent ages in a sample of extremely preterm infants (n = 33). Scores for cognitive, language, and motor outcomes were collected at one year corrected-age. Pearson’s correlation analyses detected relationships between quantitative measures and outcome data. Stepwise regression procedures identified imaging metrics to estimate neurodevelopmental outcomes.

Results

Cognitive outcomes correlated significantly with T2R (r = 0.412; p = 0.017) and ADC (r = −0.401; p = 0.021) (medulla oblongata). Furthermore, there were significant correlations between motor outcomes and T1R (pontine tegmentum (r = 0.346; p = 0.049), midbrain (r = 0.415; p = 0.016), right PLIC (r = 0.513; p = 0.002), and left PLIC (r = 0.504; p = 0.003)); T2R (right PLIC (r = 0.405; p = 0.019)); ADC (medulla oblongata (r = −0.408; p = 0.018) and pontine tegmentum (r = −0.414; p = 0.017)); and FA (pontine tegmentum (r = −0.352; p = 0.045)).

T2R/ADC (medulla oblongata) (cognitive outcomes (R² = 0.296; p = 0.037)) and T1R (right PLIC)/ADC (medulla oblongata) (motor outcomes (R² = 0.405; p = 0.009)) revealed predictive potential for neurodevelopmental outcomes.

Conclusion

There are relationships between relaxometry‑/DTI-based metrics determined by neuroimaging near term and neurodevelopmental outcomes collected at one year of age. Both modalities bear prognostic potential for the prediction of cognitive and motor outcomes. Thus, quantitative MRI at term-equivalent ages represents a promising approach with which to estimate neurologic development in extremely preterm infants.