Incidental findings on brain MR imaging of asymptomatic term neonates in the Developing Human Connectome Project.
Incidental findings on brain MR imaging of asymptomatic term neonates in the Developing Human Connectome Project.
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DOI：
10.1016/j.eclinm.2021.100984
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发表时间：
2021-08
影响因子：
15.1
通讯作者：
Rutherford M
中科院分区：
文献类型：
--
作者：
Carney O;Hughes E;Tusor N;Dimitrova R;Arulkumaran S;Baruteau KP;Collado AE;Cordero-Grande L;Chew A;Falconer S;Allsop JM;Rueckert D;Hajnal J;Edwards AD;Rutherford M
解释足月新生儿MRI脑成像的偶然发现可能具有挑战性，因为缺乏已发表的关于无症状足月新生儿的规范数据。报告放射科医生和临床医生需要熟悉这些偶然发现，以避免过度调查和误解，特别是与神经发育结果有关。本研究旨在确定一大批参加发育中的人类连接组项目（dHCP）的无症状足月新生儿中偶然发现的患病率，这些新生儿在18个月时被邀请进行神经发育评估。我们回顾性回顾了2015年至2019年间参与dHCP研究的500名足月新生儿的MRI脑部扫描，并进行了正常的临床检查。我们回顾了Bayley婴幼儿发育量表（Bayley III）的结果，该量表适用于18个月时参加神经发育随访的参与者。如果在语言、认知或运动量表上得分低于70分，则被认为是“延迟”。在47%的足月婴儿中观察到偶然发现。5例新生儿偶然发现急性脑梗死（1%）。更常见的偶然发现包括点状白质病变（PWMLs）（12%）和尾丘脑室管膜下囊肿（10%）。最常见的意外发现是颅内出血（25%），特别是硬膜下出血（SDH）。SDH和PWMLs在静脉辅助分娩的婴儿中比其他分娩方式更常见。神经发育结果为386/500（77%）。14名婴儿的语言评分< 70（比平均值低2个标准差）。在386名18个月时进行神经发育随访的婴儿中，有和没有意外发现的婴儿在运动和语言评分方面的组间差异无统计学意义（p = 0.17和p = 0.97）。有（中位数（四分位数间距）-100(95-105)）和没有（100(95-110)）偶发性发现的婴儿在18个月时认知评分的组间差异效应量小，不具有临床意义（Cliff’s d = 0.15; p< 0.05）。在无症状的足月新生儿中，脑MRI的偶然发现是相对常见的，大多数在18个月时神经发育正常，临床无关紧要。本研究由欧洲研究委员会根据欧盟第七框架计划（fp7 /2007 / 2013/ERC）资助。[319456] dHCP项目)，由Wellcome/EPSRC医学工程中心[WT203148/Z/16/Z]和英国国立卫生研究院（NIHR）生物医学研究中心（设在Guy's和St Thomas ' NHS基金会信托基金和伦敦国王学院）和/或英国国立卫生研究院临床研究机构提供核心资金。所表达的观点是作者的观点，不一定是NHS、NIHR或卫生和社会保障部的观点。
Interpretation of incidental findings on term neonatal MRI brain imaging can be challenging as there is a paucity of published normative data on asymptomatic term neonates. Reporting radiologists and clinicians need to be familiar with these incidental findings to avoid over-investigation and misinterpretation particularly in relation to neurodevelopmental outcome. This study aimed to determine the prevalence of incidental findings in a large group of asymptomatic term neonates participating in the Developing Human Connectome Project (dHCP) who were invited for neurodevelopmental assessment at 18 months. We retrospectively reviewed MRI brain scans performed on 500 term neonates enrolled in the dHCP study between 2015 and 2019 with normal clinical examination. We reviewed the results of the Bayley Scales of Infant and Toddler Development (Bayley III) applied to participants who attended for neurodevelopmental follow-up at 18 months. Scores considered “delayed” if <70 on language, cognitive or motor scales. Incidental findings were observed in 47% of term infants. Acute cerebral infarcts were incidentally noted in five neonates (1%). More common incidental findings included punctate white matter lesions (PWMLs) (12%) and caudothalamic subependymal cysts (10%). The most frequent incidental finding was intracranial haemorrhage (25%), particularly subdural haemorrhage (SDH). SDH and PWMLs were more common in infants delivered with ventouse-assistance versus other delivery methods. Neurodevelopmental results were available on 386/500 (77%). 14 infants had a language score < 70 (2 SD below the mean). Of the 386 infants with neurodevelopmental follow up at 18 months, group differences in motor and language scores between infants with and without incidental findings were not significant (p = 0·17 and p = 0·97 respectively). Group differences in cognitive scores at 18 months between infants with (median (interquartile range) -100 (95–105)) and without (100 (95–110)) incidental findings were of small effect size to suggest clinical significance (Cliff's d = 0·15; p<0·05). Incidental findings are relatively common on brain MRI in asymptomatic term neonates, majority are clinically insignificant with normal neurodevelopment at 18 months. This work was supported by the European Research Council under the European Union's Seventh Framework Programme (FP7/20072013/ERC grant agreement no. [319456] dHCP project), by core funding from the Wellcome/EPSRC Centre for Medical Engineering [WT203148/Z/16/Z] and by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas’ NHS Foundation Trust and King's College London and/or the NIHR Clinical Research Facility. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.
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影响因子：
2.8
作者：
Niwa, Tetsu;de Vries, Linda S.;Benders, Manon J. N. L.;Takahara, Taro;Nikkels, Peter G. J.;Groenendaal, Floris
通讯作者：
Groenendaal, Floris
影响因子：
2.8
作者：
Brouwer, Annemieke J.;Groenendaal, Floris;Koopman, Corine;Nievelstein, Rutger-Jan A.;Han, Sen K.;de Vries, Linda S.
通讯作者：
de Vries, Linda S.
影响因子：
158.5
作者：
Miller, Steven P.;McQuillen, Patrick S.;Vigneron, Daniel B.
通讯作者：
Vigneron, Daniel B.
影响因子：
2.3
作者：
RUSSEL, IMB;VANSONDEREN, L;BARTH, PG
通讯作者：
BARTH, PG
影响因子：
158.5
作者：
Towner, D;Castro, MA;Gilbert, WM
通讯作者：
Gilbert, WM